How one health network saved lives, money with messaging
Almost any man would agree that a colorectal cancer screening isn’t pleasant — and according to the Centers for Disease Control, between 25 percent and almost 50 percent of men who should be getting the test aren’t doing it.
A November 2013 program launched by the Ochsner Health System in New Orleans used an automated messaging system to reach those men, and ended up saving both lives and money.
Ochsner teamed with mHealth provider TeleVox to deliver automated notifications to 3,137 men between the ages of 50 and 75 that they needed to come in for a colonoscopy or upper endoscopy. The message included an option for the patient to connect instantly with an Ochsner representative to ask questions or schedule the exam. In all, officials report, 578 scheduled their test by the end of December 2013, and based on estimates that a quarter of men tested will be diagnosed with pre-cancerous polyps, the program may have saved roughly 145 lives.
“These types of simple touches make all the difference,” said Scott Zimmerman, president of Mobile, Ala.-based TeleVox, in an interview with mHealth News. “Just waking people up to the opportunity has a big impact.”
Zimmerman said the Ochsner program was an ideal test of the TeleVox platform because it targets something that people are reluctant to do unless prompted. Colorectal cancer is the third most commonly diagnosed cancer in the U.S. and the second most-deadly, killing an estimated 50,310 in 2014, but it can be cured if caught early.
Automated messaging has seen success in a number of venues across the country, tackling such issues as smoking (TXT2QUIT), pre-natal care (TXT4BABY), chronic care management (TXT4HEALTH) and substance abuse. In a press release issued in February, Zimmerman hailed the technology as a means of combatting the nation’s growing childhood obesity epidemic.
“This is where healthcare providers can step in to provide the support needed by parents,” he said in a press release. “Regular communications between office visits — whether it be a phone call, e-mail or text message — can remind parents of the importance of implementing the diet and exercise changes discussed during their child’s office visit, improving outcomes by increasing the likelihood that both parents and children stick to treatment plans.”
Zimmerman, whose company delivers about 2 million notifications a day through some 17,000 clients, estimates 80 percent of patients can be “nudged” to do something through proper motivation, educational support and encouragement. And that begins with reaching them through their phone, wherever they are, with a simple message and a link to instant support.
“Most of these people might hear it from their doctors” to get a test, Zimmerman said. “But physicians don’t have the capacity” to keep track of each patient and follow up.
Zimmerman has several statistics to back his claims. Drawing on past TeleVox programs, he said, automated messaging programs have reduced missed doctor’s appointments by more than 30 percent, increased cancer screenings by more than 40 percent and reduced subsequent emergency room visits by some 50 percent.
“It’s amazing what a personal message can do,” he said.
While helping to identify men at risk of developing colorectal cancer early enough to save their lives, the Ochsner-Televox program also netted some impressive financial results for the health system.
According to Ochsner Health officials, the program pulled in roughly 18 percent of those contacted for testing — men who otherwise wouldn’t have bothered to be screened. That translates to $684,930 in additional revenue (a national average of $1,185 per procedure) for the health system.
Stacie Falati, RN, director of Ochsner Medical Center’s Endoscopy Department, explained in a case study that because TeleVox handles the outbound communication, Ochsner’s team of eight employees can manage the incoming responses that otherwise would have required a call center with 30 people.
“Patients have expressed appreciation for the TeleVox outreach,” Falati added. “Many have told our team that if they were not nudged or reminded, they would not have completed this important test.”