Association of patient satisfaction with use of text message by an emergency medical communication centre.

Abstract

It was exciting to read Reuter et al’s [1] study assessing patients’ satisfaction after receiving medical advice via text from Emergency Medical Communication Centres (EMCCs). The authors’ study is a tremendous achievement demonstrating text messaging can potentially improve prehospital communication with patients, especially during times of pandemic or surge for calls soliciting medical advice. That the majority of responding subjects found text messaging in this setting ‘very suitable or suitable’ and only 2% required hospitalization was also encouraging [1]. Yet, while Reuter et al’s [1] efforts are impressive, their low response rate of 28% is remarkable. The authors attribute this to ‘dissatisfaction’ or ‘a state of health’ preventing subjects from responding. On that basis, such a large proportion of nonresponders might suggest text messaging is not suitable for broad communication. However, knowing more about the nonresponding cohort, such as mean age, might be informative and help EMCCs successfully tailor methods of communication for this group. My colleagues and I have unpublished data indicating a preference for healthcare communication via text, email or telephone is highly variable and older subjects prefer telephone to texting (Collins J, Henry R, Kulkarni D, Punjabi K, Ohman-Strickland P, McCoy J. A survey of text messaging and email as alternative means for emergency department follow-up). In the USA, variable success rates of contacting emergency department (ED) patients after discharge (i.e. for follow-up, satisfaction or pending results) ranging from 10 to 82% has prompted searches for improved means of communication [2]. Yet, attempts via telephone, email or text message postdischarge have also shown variable success [3,4]. The goal of our study was to determine patient preference for communication via text, telephone or email after ED discharge. From April to June 2015, we surveyed a convenience sample of 150 patients in a busy urban academic ED with annual visits of 73 000 in central New Jersey, USA. Our survey had 19 multiple-choice items exploring demographics and preferences for communication via text, telephone and email. We surveyed 75 native English speakers and 75 native Spanish speakers. Spanish translation assisted Spanish-speaking subjects. Inclusion criteria were age 21 years or older, normal vital signs and willingness to participate. We used cognitive interviewing to validate our questions. Our subjects were predominantly female (N = 86, 58%). A considerable portion were 20–30 years old (N = 48, 32%) whereas a smaller portion were over age of 60 years (N = 34, 23%). A considerable portion had completed high-school (N = 55, 37%) or college (N = 53, 35%), and were Latino (N = 69, 48%). Most had incomes less than $40 000 (N = 91, 65%). The majority of subjects preferred text communication to phone communication (61 vs. 37%) and text communication to email communication (67 vs. 28%). Examining age, subjects less than 60 years old preferred text communication to phone communication (N = 64, 67%). However, subjects over 60 years old preferred phone communication to text communication (N = 20, 62.5%). Many also cited their preference for email communication and phone communication to text communication as being uncomfortable texting about health information. We concluded that while ED patients prefer text communication to phone communication and email communication after ED discharge, preferences vary and tailoring mode of communication by demographics and patient preference might improve successful communication postdischarge. Despite differences in our population and context to that studied by Reuter et al., [1] our results suggest value to knowing the mean age of the nonresponding cohort. While the authors selected for a population less than 70 years old based on health screening, if the nonresponders mean age is greater than 60 years (vs. responders’ mean of 45 years) this could indicate future texting initiatives by EMCCs should target populations younger than 60 years. Additionally, knowing nonresponders’ preferences about sharing health information via text might serve to optimize the potential benefits of text messaging in prehospital communication as demonstrated by Reuter et al. [1]. Acknowledgements Conflicts of interest There are no conflicts of interest.