Text services offer patients healthy returns

Published on Tuesday 17 February 2009 00:05

SCOTS send text messages while in the pub, the cinema, school, work and even while driving. But should they be used for health information? Epilepsy Scotland is launching an SMS, or text, service to get information to patients and the general public. It is one of a growing list of groups trying to make use of new technology, but with mixed results.

While Samaritans gets messages from 100 new numbers each month, Chest Heart and Stroke Scotland (CHSS) gets less than five a year. Health professionals have also voiced concerns about what type of information should be exchanged with patients by technology. However, Epilepsy Scotland says that as the use of mobile phones spreads across all ages, it makes sense to offer information directly to patients.

Pamela Spence, helpline and information officer with the charity, says it realised more Scots were accessing information by phone and that some details could be offered via text message. About ten calls a day – 200 a month – are made to Epilepsy Scotland's confidential helpline, but it needs to cater to a largely younger group of people who use text messaging regularly but do not use the helpline.

Ms Spence says: "Our response to a question has to be clear, concise and factual. Unfortunately, we can't go into great detail with the text sender, as happens with e-mails and phone calls. We hope that people will feel confident enough after using the text service to contact the helpline and get more information and support. This is not a gimmick – we would not do it if we didn't think people would use it, and want to use it."

Lesslie Young, the charity's chief executive, says: "It's important to meet the information needs of young people with epilepsy in ways that suit them. Generally, younger people do not relish one-to-one conversations with agencies and they prefer anonymous ways to source information. Parents might worry their children do not have peers to talk to about the condition and do not want to socialise because of the stigma associated with epilepsy. But young people can text without anyone hearing the question, and the reply is confidential and cannot be overheard."

The demographics of epilepsy may influence the number of Scots who access the SMS service. CHSS said that, after two years of running its SMS service, it still hoped it would gradually be of greater use as older patients get texting. One of three nurses who respond to queries said texting fits into the charity's mandate along with a helpline, e-mail, fax, minicom, three-way language line for translators and even old-fashioned snail mail.

The nurse says texting can also be useful for those with communication difficulties, where they can consider and type a question at their own speed, rather than being intimidated or flustered by a phone conversation. She says: "The numbers will increase as older people use mobile phones. Emotional support is better over the phone, but if someone texts us, we can reply to them."

The Scottish Parliament introduced an SMS service last year for similar reasons to charities: to increase accessibility. Although it got only 56 queries in the first six months, the service has continued.

Liz Scott Gibson, director of Deaf Action, praises the use of text message services being offered by agencies such as the parliament. She says: "Deaf people have been marginalised for too long. SMS messages can be used by those with and without hearing loss, and open up an important avenue for communicating."

For Samaritans, introducing an SMS service gradually across the country has brought 100 new users of the service each month. A spokeswoman for the charity explains that when its founder, Chad Varah, launched the helpline 55 years ago, the telephone was considered an unlikely way of providing emotional support. Now 4,000 new users access e-mail support, also introduced in recent years.

The spokeswoman says: "Samaritans is committed to finding accessible ways to emotionally support people in distress, and the use of cutting-edge technologies is an important part of this commitment. SMS is still a very new service for Samaritans. This form of communication is very resource intensive and demands a great deal of volunteer time, (because] messages are shorter and greater in number per user than e-mail.

"A recent survey of people who have contacted Samaritans showed that 74 per cent of suicidal people felt that getting in touch with the service helped them take a decision not to end their own lives.

"The aim is to support each user of the SMS service with a response to their first text within 60 minutes and to do this we need to ensure that we roll out the service with fully-trained volunteers in a measured way."

Karen Fairhurst, senior lecturer in general practice, division of community health sciences at the University of Edinburgh, says there was doubt among health professionals about just how far new technology could go. "For someone having chest pains, even waiting five minutes for a text message would be too long. You could not be sure to respond within an appropriate timescale and the patient might not be able to provide all the information needed for diagnosis.

"I think there's a lot of concern for using text messaging and e-mail in relation to acute problems, whether emotional, psychological or physical. But there is enthusiasm to provide information to patients, and patients do seem willing to accept results by text or e-mail."

The Sandyford Initiative for sexual and reproductive health in NHS Greater Glasgow and Clyde has sent normal results via text for a few years, but this system is not being used elsewhere for results. A student-run survey last year found that 37 per cent of patients would be favourable to receiving test results by text, 53 per cent by e-mail and 33 per cent by logging into a secure webpage.

Ms Fairhurst says: "Health professionals have some concerns about medical and legal issues in using new technology to evaluate a patient's problem, and it might take a little while for those concerns to lessen. But the phone was hardly used before, and now they are becoming more comfortable with NHS 24. There's no reason why there would be never be a similar shift towards text messaging."

&149 Epilepsy Scotland's new SMS number is 07786 209 501; for CHSS's SMS number Text CCHS and the message to 07766 404142; Samaritans website is www.samaritans.org