..Adam D. Schaffner, M.D., F.A.C.S...

Texting Your Doctor is Good for Health
Post-Surgery Texting Improves Follow-Up

Texting is a form of communication that has slowly crept into every aspect of life. It is estimated that almost 75 percent of adults now use their cell phones to text, making text messaging one of the simplest and fastest means for people to communicate. This means you can not only use text messaging to communicate with your friends, relatives, and colleagues; but now you can text your doctor as well.

For women undergoing breast reconstruction following a mastectomy, text messaging between the patient and her surgeon has been shown to improve key post-operative outcomes, according to a study in the July 2012 issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS). The study is the first to show potential benefits of text messaging between surgeons and patients undergoing a specific surgical procedure.

The study included 102 women undergoing breast reconstruction after mastectomy for the treatment and/or prevention of breast cancer. The women were operated on by two similarly experienced surgeons using similar techniques. The only difference was in the post-operative management of these patients. One surgeon used routine post-operative text messaging while the other surgeon did not. For the purposes of the study, matched groups of women with similar characteristics were selected.

Drains are often placed in the breast following breast reconstruction to remove excess fluid. Monitoring the amount of fluid and removing the drain when it is no longer needed are routine in post-operative care. When to remove the drain is determined based on the amount of fluid in the drain per 24-hour period.

In the text messaging group, patients texted the amount of fluid removed by each surgical drain every evening, starting on the day they left the hospital. After receiving each patient's message, the surgeon responded with instructions to continue with standard drain care or to come to the office for drain removal on the next working day. Patients operated on by the other surgeon received a routine appointment to come to the office one week after leaving the hospital. Both groups of patients had access to office phone numbers and an Internet patient care portal.

Women who exchanged texts with their surgeon made significantly fewer office visits and phone calls. In the first 30 days, the average number of office visits for patients in the text messaging group was 2.82 compared to 3.65 in the group of patients who did not text message.

Text messaging also reduced the number of days the drain was kept in place. On average, the drain was removed nearly three days earlier in the text messaging group and was more likely to be removed at the first clinic visit.

Text messaging is quick and easy to use. It enables patients to communicate with their doctor more rapidly and easily than ever before. This type of access empowers patients and is of great benefit during the immediate post-operative period.

Despite the potential advantages of text messaging, texting as a means of interaction between doctors and patients has been slow to catch on. Obstacles include concerns about keeping protected health information confidential and maintaining physicians' privacy. In the study, patients used text messaging to send only the requested information during specified hours and messages only appeared on a password protected cell phone. Concerns about physician time and reimbursement for responding to text messages from patients have also limited the use of texting in clinical care.

Integration with electronic medical records is a technological challenge that still has to be addressed. With the increasing popularity of electronic communication, it is likely a matter of time until HIPAA compliant portals are commonly available to text message and record this communication as part of the electronic medical record.

Texting facilitates a better relationship between patients and doctors by not only increasing the speed of communication, but also giving a sense of comfort to patients. Patients can now reach their doctor at a momentŐs notice. The days of calling the doctor's answering service and waiting for the doctor to return a page are rapidly disappearing. A patient's question can now be forwarded right to the doctor's cell phone.

Anyone seeking medical advice via text message should be aware of its limitations. Doctors are advised not to dispense medical advice via text messaging. Therefore, text messaging only allows doctors to be aware of an issue or concern more quickly than in the past. This will generally result in a more rapid response compared to traditional methods of patient-physician communication. All further discussions should be done via phone or in-person. Nothing replaces the benefits of your doctor being able to examine you and discuss your concerns with you in person.

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