Abstract
Timely and consistent patient follow-up has been a challenge while establishing a comprehensive interventional radiology (IR) service and training program in Tanzania. Currently, trainees are responsible for personally calling patients at 1 and 3 months postprocedure. This arrangement has become increasingly burdensome as patient volume continues to grow, often requiring trainees to make up to 10 calls a day in addition to daily procedures and clinical duties. With Tanzanian mobile phone use increasing, an automated text-messaging follow-up system has been devised as a possible solution to this challenge. With no functioning electronic medical record in place, the new IR service has relied on REDCap for organizing and tracking procedural and patient data. Twilio, a REDCap compatible web service that can administer automated text-messaging surveys, is now being added to improve follow-up rates. Patients can respond with yes or no and add an explanation. Costs range from $0.04 to $0.09 per text, depending on the patient’s mobile carrier. A survey consisting of six questions was written in English and translated into Swahili. This survey was then built into the Twilio web app. Code was written in Python and PHP to allow for exchange of patient information and survey data between REDCap and Twilio. Tanzanian IR trainees will review survey results weekly and determine which patients require additional follow-up via phone call or clinic appointment. The automated follow-up system is scheduled to be fully operational by October 2019. Response rates and follow-up data for the first five months will be presented. Establishment of a new specialty in a low-resource setting requires creative solutions to ensure care is made available to as many patients as possible. Implementation of an automated text-messaging follow-up system may allow for more efficient allocation of resources and more effective and complete patient follow-up.
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