With all the amazing AI innovation that’s happening, sometimes we underestimate the value of simple solutions that make a big impact. One of the simplest solutions out there is an SMS text message to a patient. However, when utilized properly, it can create a big impact.
That’s the story that we heard from Ben Long, MD, Director of Hospital Medicine at Magnolia Regional Health Center, in his session at the recent HIMSS conference. In this session Dr. Long provides a short case study of their implementation of SMS text reminders (SMS nudges) using DrFirst’s prescription engagement solution embedded within MEDITECH to text patients on behalf of their physician minutes after a prescription is sent to the pharmacy. The text includes medication education, price transparency and savings, and reminders to fill their prescription.
Below you’ll find some of the details from the presentation along with our additional commentary.
In a world where we can easily over-architect anything, it’s great to see the value of something as simple as a text message. It points out a key principle about technology and patients. They want something that’s simple and fits in their workflow. An SMS fits that description.
I love that Magnolia Regional Health Center tied this to hospital readmissions. If they would have just tied their effort to prescription fills, that could easily be pushed aside since prescription fills isn’t a strategic priority for most healthcare organizations. Hospital readmissions on the other hand is a priority since it’s tied to real dollars and cents. It’s great that they saw how prescription fills and hospital readmissions are connected though.
For many of us that are relatively affluent and trust our doctors, it’s probably shocking to see these medication fill rates. Did you know that 20% of medications aren’t filled and 50% of refills are abandoned? I’d heard of this problem, but it’s pretty stark to see the real numbers.
We know that heart failure patients are one of the most expensive parts of our healthcare system. It makes sense why Magnolia Regional would make this the focus of their study. Impacting this group of patients is a win for the patients and the healthcare organization. It did shock me that 40-60% of heart failure patients don’t take their medications as prescribed. You’d think a heart issue would wake you up to the need to take care of yourself, but as Dr. Long pointed out, there are a lot of other factors and barriers to patients taking their medications as prescribed.
How many of you have integrated a text message solution into your EHR and prescribing workflow? If you haven’t, DrFirst offers some great resources on prescription engagement that you’ll likely find helpful.
One of the important topics the past few years has been provider burden. It’s great to see that Magnolia Regtional Health Center considered this in their solution and designed a workflow that required no extra work for their clinicians. The SMS nudge just happens automatically.
The focus on the patient workflow matters a lot as well. While it’s easy to send an SMS message, the real key to making the patient workflow simple is the patient authentication. The nice thing with this solution is that it doesn’t redirect the patient to a portal that overwhelms them once they get in. The text is sent. The patient is authenticated. The information is given. That’s the kind of experience a patient wants.
Always great to see the results of these efforts. A 10% increase in prescription fill rate is a big deal. Some may look at the 40% that still aren’t filling their prescription and they’d be right that there’s more work to do. As was mentioned above, remembering to fill your prescription or knowing how to properly take your medication is the challenge for some. There are plenty of other behavioral, financial, educational, and accessible challenges with prescriptions. However, it’s great to see that the SMS nudge was able to improve prescription fills by 10%.
While increased prescription fills is great, it’s worth remembering that the real goal wasn’t more prescription fills. The real goal was reducing hospital readmissions. With that in mind, it’s great to see that Magnolia Regional Health Center saw a 6% decrease in 30-day readmission odds. That’s a meaningful impact on a relatively simple to implement solution.
As discussed above, the SMS message can’t solve everything. It will be interesting to see where they take this program next. The amazing thing with SMS is that you now have a communication channel open with the patient to do all sorts of creative efforts to improve fill rates even more.
What’s interesting about this shift in patient engagement is that patients are almost demanding it. They’re experiencing this kind of convenient “where they are” experience in the rest of their lives that they want it in healthcare as well. The good news is that the tools and technology are there for this to be their experience in healthcare too.
This is so beautifully said, “When the right action becomes the easiest action, adherence naturally improves.” This really is the key to having patients follow the care that’s prescribed.
Kudos to Magnolia Regional Health Center and Dr. Long for this kind of leadership in their organization. Communicating the shared goal of better patient outcomes is sometimes hard to do. The nice thing is that Dr. Long and his team paired that with a solution that didn’t add more burden to the providers. That’s an amazing recipe for success.
If you want to learn more about this solution, you can also check out this article “Improving Medication Adherence for CHF Patients in Rural Communities: Lessons From Magnolia Regional” which outlines more details and even includes access to a webinar on demand.
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