Abstract
BackgroundTwo-way interactive text messaging between patient and community health workers (CHWs) through mobile phone SMS (short message service) text messaging is a form of digital health that can potentially enhance patient engagement in young adults and families that have a child with chronic medical conditions such as diabetes mellitus, sickle cell disease, and asthma. These patients have complex needs, and a user-centered way can be useful for designing a tool to address their needs.ObjectiveThe aim of this study was to utilize the user-centered approach of design thinking to develop a two-way interactive communication SMS text messaging tool for communication between patients or caregivers and CHWs.MethodsWe applied a design thinking methodology for development of the SMS text messaging tool. We collected qualitative data from 127 patients/caregivers and 13 CHWs, health care professionals, and experts. In total, 4 iterative phases were used to design the final prototype.ResultsThe design thinking process led to the final SMS text messaging tool that was transformed from a one-dimensional, template-driven prototype (phases 1 and 2) into a dynamic, interactive, and individually tailored tool (phases 3 and 4). The individualized components consider social factors that influence patients’ ability to engage such as transportation issues and appointment reminders. SMS text messaging components also include operational factors to support staff such as patient contact lists, SMS text messaging templates, and technology chat support.ConclusionsDesign thinking can develop a tool to meet the engagement needs of patients with complex health care needs and be user-friendly for health care staff.
Highlights
Patients with Chronic Medical ConditionsLow-income Medicaid beneficiaries, in particular children and young adults with chronic medical conditions (CMCs), are at greater risk for poor health outcomes as compared with the general population [1,2,3,4]
To increase engagement and reduce health care costs for low-income patients with CMCs, we developed a hybrid two-way interactive short message service (SMS) text messaging technology tool in the context of the larger CHECK health initiative utilizing community health workers (CHWs)
We identified our end-user groups to be pediatric patients and their parents as well as their community advocates/leaders comprising the lived experience expert group; the CHECK program staff comprised CHWs, licensed clinicians, other health care professionals and health data analysts, and a scientist; and the design team comprised software engineers, a texting research expert, and research and social scientists
Summary
Patients with Chronic Medical ConditionsLow-income Medicaid beneficiaries, in particular children and young adults with chronic medical conditions (CMCs), are at greater risk for poor health outcomes as compared with the general population [1,2,3,4]. Two-way interactive text messaging between patient and community health workers (CHWs) through mobile phone SMS (short message service) text messaging is a form of digital health that can potentially enhance patient engagement in young adults and families that have a child with chronic medical conditions such as diabetes mellitus, sickle cell disease, and asthma. These patients have complex needs, and a user-centered way can be useful for designing a tool to address their needs. Conclusions: Design thinking can develop a tool to meet the engagement needs of patients with complex health care needs and be user-friendly for health care staff
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