Use of a Bidirectional Text Messaging System for Emergency Department Follow-Up Versus Usual Follow-Up
Background:The use of text messaging is a growing trend. Usual care for follow-up with patients (no dedicated communication) has proven unreliable, and alternative communication methods may be beneficial.
Introduction:The objective was to evaluate the effect of text messaging as a means of follow-up communication compared to usual care on patient satisfaction among patients discharged from the emergency department (ED).
Materials and Methods:Participants completed a baseline survey about their text message usage and ED visit satisfaction. The participants completed a follow-up survey 2 weeks later. Participants randomized to text messaging received a text message at 24 h, 1 week, and 2 weeks after discharge. Control participants received usual care (typically no dedicated communication). Bivariate analyses were performed, and intent-to-treat and per protocol analyses were completed to examine follow-up satisfaction with ED communication/care.
Results:A total of 802 subjects were recruited (text messaging—398 subjects, usual care—404 subjects). In the intent-to-treat analysis, text messaging subjects were not more likely to report satisfaction with follow-up communication (adjusted odds ratio [aOR] 0.90 [0.46–1.75]) or follow-up care (aOR 0.66 [0.30–1.46]) than usual care subjects. In per-protocol analysis, text messaging subjects had 2.95 (1.52–5.73) higher odds of reporting satisfaction with follow-up communication and 3.24 (1.46–7.16) higher odds of reporting satisfaction with follow-up care.
Discussion:The use of text messaging for follow-up, when comparing satisfaction with follow-up communication and follow-up care after discharge, performs at least equally as well as usual follow-up.
Conclusions:Text messaging is a provider time-saving and resource-conserving technology allowing health care providers to potentially reach a larger proportion of patients, making it a valuable form of follow-up communication.