Futuríveis

Using texting to boost efficiency is not rocket science, but big savings can be achieved. Several trials carried out in England have found that the use of text-messaging reminders reduces the number of missed appointments with family doctors by 26-39%, for example, and the number of missed hospital appointments by 33-50%. If such schemes were rolled out nationally, this would translate into annual savings of £256m-364m.

Text messages are also being used to remind patients about blood tests, clinics, scans and dental appointments. Similar schemes in America, Norway and Sweden have had equally satisfying results—though the use of text-message reminders in the Netherlands, where non-attendance rates are low, at 4%, had no effect other than to annoy patients.

Text messages can also be a good way to disseminate public-health information, particularly to groups who are hard to reach by other means, such as teenagers, or in developing countries where other means of communication are unavailable. Text messages have been used in India to inform people about the World Health Organisation's strategy to control tuberculosis, for example, and in Kenya, Nigeria and Mali to provide information about HIV and malaria. In Iraq, text messages were used to support a campaign to vaccinate nearly 5m children against polio.

Finally, there are the uses of text-messaging as part of a treatment regime. These involve sending reminders to patients to take their medicine at the right time, or to encourage compliance with exercise regimes or efforts to stop smoking. The evidence for the effectiveness of such schemes is generally anecdotal, however, notes Dr Rifat. More quantitative research is needed—which is why his team also published three papers this week looking at the use of mobile phones in health care in more detail. One of these papers, written in conjunction with Victoria Franklin and Stephen Greene of the University of Dundee, in Scotland, reports the results of a trial in which diabetic teenagers' treatment was backed up with text messaging.

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