Texting to Find the Tipping Point

Summary

With a robust palliative care ambulatory clinic in a large county hospital, patients are often referred to the Parkland Hospital/UT Southwestern Medical Center palliative care team at the time of diagnosis. While the team may follow these patients for years, it’s often the patient’s instinct to go to the ED when they start to take a sharp downturn in performance status – rather than reaching out to the clinic.

This team believes that they can detect problems earlier by reaching out to their ambulatory patients, rather than waiting for them to reach them. The population has demonstrated little interest in MyChart or email, but are very comfortable with texting. Due to this, the team plans to send a short weekly questionnaire via text to all ambulatory patients, asking a general well-being score and whether they need a return phone call. The team will use this data to intervene before a crisis occurs in their racially diverse, socioeconomically disadvantaged population.