Promoting chronic condition management through mobile technology

Background. Health information technology provides benefit for managing complex chronic conditions outside the traditional clinic setting. Limited information is available on the impact of health informatics applications on health outcomes among medically underserved groups, yet underserved patients are receptive toward technology-based information sharing with care providers. Cell phone access has been positively associated with knowledge of health information knowledge, in turn associated with better health outcomes. High rates of cell phone access are reported among populations that exhibit low rates of computer and internet use. Over half of all Americans have used cell phones for data-related activities.

Objective/Purpose. This pilot study proposes to demonstrate improvements in attendance rates and diabetes self-management among adult diabetic patients in an urban safety net population by providing between-visit reminders and chronic disease support through cell phone text messaging.

Methods. 75 adult diabetic patients with cell phones who receive care at federally qualified community health centers will participate. Patients will receive three text message reminders before health care appointments and will be asked to provide fasting blood sugar levels by text message three times per week. Case coordinators will review messaging data and follow up with patients by phone according to clinical guidelines.

Results. Appointment attendance and text message response rates will be examined over four months. Clinic visit versus emergency service utilization will be evaluated. A purposively-selected sample of patients will provide input through focus groups and exit interviews. Common response themes will be identified through content analysis.

Discussion/Conclusions. Diabetes has tremendous impact on patients and healthcare systems, affecting over 20 million patients with projected costs of $192 billion by 2020. Mobile technology may be effectively used to assist patients with diabetes care. Improving patient self-management and appointment attendance can lead to improved health outcomes, reduced health care costs, and better quality of care.