Dr. Jon Hallberg: More doctors texting patients

A new study in the Journal of the American Medical Association looked at the effectiveness of doctors using text messages to communicate with patients.

The families who received the text message notifications of flu vaccines were slightly more likely to get their children the shots.

MPR's medical analyst Dr. Jon Hallberg spoke with Tom Crann of All Things Considered on Wednesday about the practice of using text messages to transmit medical information. Hallberg is a physician in family medicine at the University of Minnesota and medical director of the Mill City Clinic.

An edited transcript of that discussion is below.

Dr. Jon Hallberg: This is one of those great studies, it's a randomized clinical trial. They got over 9,000 people involved and it was families with children between the ages of 6 months and 18 years of age. This is a group of people who really should be getting the influenza vaccine every year. This is a very preventable disease in that population. It was a very important group to target.

Tom Crann: In the end, what difference did texting make?

Hallberg: It made some difference, but not much, not on this scale. We're looking at something like 39 percent of the kids that were [notified in the standard way] got their flu shots. And 43 percent of those in the target group did, that's not a big difference in this group, but if you extrapolate that across the country, that would be 2.5 more million kids getting shots. And then when you're looking at population-based medicine, that's a big deal.

Crann: At the doctor's office they often ask you the question, 'If somebody else answers your phone in your household, is it OK to leave a message?' ... Where might you see some caution being used here when it comes to texting medical information?

Hallberg: When I call patients, and I call patients quite often with lab results, with things that needs to be discussed, we'll put a little annotation in the electronic record that the phone number they prefer is their cell phone. I always like that, at least I know who I'm getting, I can hear their voice. If it's a home phone or if it's not clear where I'm calling, and often it isn't clear, it's really tricky ... If you say, 'Hi, this is Dr. Hallberg. Can I talk to so and so.' Immediately, the fear goes up. Now, you've kind of increased fear when all you wanted to do was have a brief conversation. In a way, texting is really kind of ideal.

Crann: You can see a real ideal use of this?

Hallberg: I would like to think that I'm an early adopter, and I know that I'm not. I'm still kind of a phone guy, or send people something in the mail. But I know where this is headed, and I know people are predicting that this kind of technology is kind of where email was ten years ago in health care settings. We're touching it with trepidation at this point, but I think we're going to embrace it more in the years to come.

Crann: Are there areas where you just can't see it being used?

Hallberg: Even if I know I have someone's cell phone, I just can't imagine telling them that they have this horrible condition. ... On some level that just doesn't seem proper. You need to have some kind of a conversation or some sort of face-to-face meeting in situations like that.

Crann: There might be barriers here too. I'm thinking of [the] age of patients who aren't used to texting, or even certain communities because of income.

Hallberg: One of the interesting things in this study is that they targeted low-income people ... You'd think that maybe populations that have lower incomes don't have those kind of phones, but in fact they really do. One of the things they found that's so good about this is that a lot of these families move a lot, especially lower income, so you're better off with a cell phone number than you are with a home address or a home phone number.

Crann: Have you actually interacted with patients through text messages?

Hallberg: I have, but just a handful of times. I email regularly, but texting is something I'm not really used to yet. That being said though, I just had an interaction this week with a home nurse ... I have a patient who is sort of homebound and can't make it to the clinic very easily; they had a rash. I couldn't really understand what the nurse was describing so she suggested that she send me a photograph, and she did through texting and it made all the difference.

Crann: In the end, where do you see this going, texting and health care?

Hallberg: I think of my relationships with texting at the University of Minnesota as a faculty member. I get notified when there's a security alert or when there's a severe weather warning. I can see the public health implications, to get things like a flu shot ... I think it's going to take a few years before physicians and health care providers are individually texting their patients, that's going to take a while to get used to.

Interview transcribed and edited by Jon Collins, MPR reporter.

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