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Texting young patients improves engagement with specialist services

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Communicating with young patients by text, email and Skype can help them manage their care and may save the health service money in the long term, according to new research.

Young people with long-term health conditions - such as diabetes, cystic fibrosis and sickle cell disease - often disengage from health services resulting in poor outcomes, noted those behind the research,called Improving health outcome for young people with long term conditions: the role of digital communication in current and future patient-clinician communication for NHS providers of specialist clinical services.

”The potential benefits of improved self-management and wellbeing among the young people is likely to save NHS costs in the long term”

Study on benfits of digital communication 

Interviews with 165 patients in England and Wales, aged between 16 and 24 years old, and 173 health professionals, found that using mobile text messages and emails, as well as face-to-face-appointments, helped young patients manage their care. It also meant they communicated more regularly with clinicians and built trust.

Patients typically used text messages for simple questions such as what to do if they were feeling nauseas or advice on how to manage their medication on holiday, said Professor Frances Griffiths, from the University of Warwick, who co-lead the research.

Young people found text messages convenient because they could send them quickly, whether they were on a bus or in a classroom, she told Nursing Times.

Text messages were also used to send the results of medical tests, but only if the results were normal or as expected, she said.

Emails were mainly used by patients, nurses and doctors for more formal communication and to explain more complicated medical matters, Professor Griffiths added.

”Young people and clinicians can … [use] common sense approaches to avoid… inadvertent disclosure of confidential information”

Study on benfits of digital communication 

Another advantage of email was that young people used it to ask their doctor about things they felt unable to do in person, perhaps because it was too emotional to do so, she said.

Professor Griffiths referred to one young person with cancer who emailed their doctor before a face-to-face appointment.

“They knew that their cancer was getting worse and wanted to talk about dying with their doctor,” Professor Griffiths told Nursing Times. “When they met in person the doctor knew to raise the subject.”

Although some healthcare clinicians already use digital technology to communicate with young people, the researchers found there were not many guidelines about how it should be used, or evidence about if it can improve patient engagement.

The study – co-led by Jackie Sturt, professor of behavioural medicine in nursing at King’s College London - found that digital communication with young patients worked best for those who trusted their clinicians and who needed varied access to them, such as when they were changing services and treatments.

While the academics noted digital communication with young patients would incur additional costs – especially those related to taking up more of the clinician’s time – it concluded this would likely be offset by long-term savings to the NHS due to improved patient outcomes.

“The potential benefits of improved self-management and wellbeing among the young people is likely to save NHS costs in the long term,” said the research, published by the National Institute for Health Research in its online library of journals.

Although the research did not examine the likely financial savings to the health service, Professor Griffiths said that they could be significant.

“As digital communication becomes the norm in society… replacement of some aspects of traditional clinical communication with digital may be important”

Study on benfits of digital communication

Other research has shown that patients who are more engaged are more likely to report symptoms to their nurse or doctor and keep taking their medication, she said.

As with any technology, there are IT security challenges for staff to consider and potential risks to patient safety, said the research paper. But these challenges would probably be outweighed by the benefits of digital communication, it added.

“Young people and clinicians can … [use] common sense approaches to avoid increased dependence on clinicians, inadvertent disclosure of confidential information and communication failures,” the paper said.

The research recommended using encrypted email, as well as training for staff in digital communication – and for staff to consider if it should be in addition to, or a replacement for, in-person appointments.

“As digital communication becomes the norm in society generally, replacement of some aspects of traditional clinical communication with digital may be important for maintaining health service access for the digital generations,” the research said.

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