Penn Medicine Study: Reaching Out Really Does Make a Difference

Researchers at Penn Medicine report that a simple, automated messaging platform that connects with patients after they've been treated in the ER greatly reduces the chance of rehospitalization or further emergency care. It's also great for staying in touch.

New research has found that even a simple 'How are you?' e-mail or text from a care team can improve clinical outcomes post-discharge.

This comes from the University of Pennsylvania's Perelman School of Medicine, whose researchers analyzed the effects of an automated messaging platform from primary care providers to patients who'd recently received emergency care at a hospital. The study, published in the Journal of the American Medical Association's (JAMA) online site, points to the value of a simple messaging platform in improving patient engagement, reducing rehospitalizations and boosting overall outcomes and wellness.

“Contact from a primary care practice can help patients feel more connected and enable them to access care in a timely manner,” Anna U. Morgan, MD, an assistant professor of internal medicine at Penn Medicine and the study's senior author, said in a press release.

“In a fragmented healthcare landscape, relatively simple applications of technology can help patients feel more connected to their primary care practice,” added Eric Bressman, MD, a fellow in the National Clinical Scholars Program at Penn Medicine and the study's first author. “This is especially important as patients recover from acute illness, as it reminds them that they have a medical home to which they can turn for support.”

In the study, researchers compared outcomes for more than 400 patients who opted into the digital health program against more than 1,000 who did not participate. Patients were contacted by phone two days after discharge for an emergency care visit and asked if they'd like to enroll in the text messaging program. Those who did were sent check-in messages at regular intervals over a month, with the texts tapering off as the month progressed.

According to the research, patients in the text messaging program were 41% less likely to need any kind of acute care after discharge; more specifically, they were 33& less likely to return to the emergency department and 55% less likely to be rehospitalized.

"The program’s high degree of automation required minimal effort beyond usual care," the study pointed out. "To the best of our knowledge, this is the first study to experimentally test the benefit of an automated texting program on post-discharge outcomes among primary care patients. The mechanism through which this compound program prevents use of acute care is likely complex, but we theorize that more frequent check-ins and a lower friction medium for patient-initiated outreach lead to earlier identification of needs and a greater likelihood that issues will be escalated to and handled by the primary care practice than another setting."

Bressman and his colleagues also noted that almost 83% of the patient enrolled in the program responded to at least one of the introductory messages, a much better response rate than to the traditional phone calls. And less than 9% opted out of the program.

The study points to the value of simple, even automated, contact, giving patients the reassurance that their care providers are looking after them after a healthcare emergency. This, in turn, prompts patients to be more mindful of their care plan and their health, and to respond quickly if they have any concerns or symptoms.