Abstract
BackgroundDigital health care is increasingly used to improve health service accessibility and reduce costs. Remote health care requires a significant self-management role for service users, and this generates information provision and support needs that should be reflected in service planning. SMS text messaging offers a convenient and low-cost method of communication and is increasingly used across digital health care services to provide remote support.ObjectiveThe aim of this study was to quantify the number of messages generated through user interaction with a two-way SMS text messaging support service within an online sexual health service and to thematically explore the content of the messages and type of support required to facilitate self-management.MethodsThe content of all SMS text messages received by an online sexual health service was analyzed from April 4, 2018, to July 5, 2018. Messages were classified as being either administrative or clinical in nature and service or user initiated. For those messages that were both clinical and user initiated, a qualitative thematic analysis was completed to fully describe the content of the interactions.ResultsA total of 267 actionable messages were generated per 1000 orders requested through the service. Of the 8562 messages, 5447 (63.62%) messages were administrative and 3115 (36.38%) were clinical. Overall, 4306 of the 8562 messages (50.29%) responded to service-generated queries reflecting the public health and clinical responsibilities of an online provider, and 4256 (49.71%) were user-generated queries, demonstrating a willingness by users to proactively engage with a two-way SMS text messaging support service. Of the 3115 clinical messages, 968 (31.08%) clinical messages were user initiated and shared personal and complex clinical information, including requests for help with the self-testing process and personalized clinical advice relating to symptoms and treatment.ConclusionsThis study demonstrates the willingness of users of an online sexual health service to engage with two-way SMS text messaging and provides insight into the quantity and nature of the support required to facilitate service delivery and self-care. Further work is required to understand the range of clinical problems that can be managed within this medium.
Highlights
Digital health care is used to improve health service accessibility and reduce costs, and online health services are increasingly part of a “digital first” National Health Service (NHS) [1,2]
4306 of the 8562 messages (50.29%) responded to service-generated queries reflecting the public health and clinical responsibilities of an online provider, and 4256 (49.71%) were user-generated queries, demonstrating a willingness by users to proactively engage with a two-way SMS text messaging support service
This study demonstrates the willingness of users of an online sexual health service to engage with two-way SMS text messaging and provides insight into the quantity and nature of the support required to facilitate service delivery and self-care
Summary
Digital health care is used to improve health service accessibility and reduce costs, and online health services are increasingly part of a “digital first” National Health Service (NHS) [1,2]. Digital health services require users to take on new responsibilities for self-care, such as self-taken finger prick blood samples or interpreting results of tests completed at home, and these new roles require additional support [3,4] This support may be delivered through a wide range of media, including telephone, video conversations, and messaging. There has been no evaluation of this type of support when delivered at scale This gap in the evidence is important, as those providing online services need information about the number and type of messages generated to inform service planning, including staff time and expertise required. SMS text messaging offers a convenient and low-cost method of communication and is increasingly used across digital health care services to provide remote support
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