Text messaging has emerged as one of many new technological tools to help healthcare professionals provide quality care for medically underserved populations. Text messaging, or SMS, provides a relatively inexpensive, accessible way to strengthen patient-provider communication for supporting patients in achieving their unique health goals.

The Texting for Better Care Project examines what it takes to build textVmessaging interventions for health care delivery in the safety net for underserved populations.

The individual use cases researched for this project include:

  • Appointment reminders
  • Diabetes self-management
  • Hypertension monitoring and management
  • Alcohol and substance abuse recovery
  • Youth outreach on health enrollment
  • Care transition to a patient-centered medical home (PCMH)
  • Specialist referral loop closure

While researchers have demonstrated the effectiveness of text-messaging interventions for particular applications such as appointment reminders, generally evidence for SMS programs is limited in peerV reviewed literature. Published articles tend to focus on efficacy and outcomes rather than design and implementation. This report draws from peer-reviewed scientific literature as the foundation for analysis, but also includes pilot studies and qualitative interviews to address these gaps.

This report examines the following key components of designing and implementing SMS interventions:

  • Recruitment
  • Operational needs
  • Technological specifications
  • Content development
  • Evaluation

Text-messaging interventions face significant barriers to implementation and adoption. Limited English proficiency (LEP) patients may be excluded without adequate access to medical translation. Both patients and providers may have low technological literacy. The costs of implementation and maintenance may prove prohibitive—especially for already resource-strapped safety-net providers. We hope this report will start to identify best practices for designing and implementing SMS programs that overcome these barriers.

This report, created by ZeroDivide for CCI with funding from Blue Shield of California Foundation, surveys existing literature and interviews to analyze the critical components of text messaging interventions in healthcare. Click below to download the report. 

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