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R. Lester

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  • OS04 - Communication Redefined for Better Care Outcomes (ID 7)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
    • OS04.02 - Texting for Communication and Engagement at Provincial Tuberculosis Services (ID 46)

      R. Lester, Medicine, University of British Columbia; Vancouver/CA

      • Abstract
      • Slides

      Purpose/Objectives: Despite being preventable and curable, tuberculosis (TB) is one of the world’s deadliest communicable diseases. Timely and effective communication among clinicians and patients can be challenging since care is often provided “in the field”. The British Columbia Centre for Disease Control (BCCDC) TB Services provides case management and Directly Observed Therapy (DOT) within a defined geographic setting. Due to the ubiquity of mobile phone ownership and demonstrated uptake by vulnerable and isolated groups, text-messaging via WelTel, is being used to promote and enhance communication among our team of nurses, outreach workers, and active TB patients.

      Methodology/Approach: WelTel is a secure, browser-based application that allows clinicians and patients to text-message with a weekly text asking “how are you?” to start the conversation. The focus of this study is to determine the acceptability of the WelTel digital platform by the nurses and outreach workers working at the BCCDC TB Clinics. Acceptability includes ease of use, usefulness, and improved communication among the team. Feasibility will be measured systematically through assessing costs, guidelines, privacy and security requirements for the Provincial Health Services Authority. Finally, aiming to align with the World Health Organization’s recommendations for universal DOT, transferability will be evaluated to expand reach and options for care through video DOT. Using qualitative research methods, baseline, midpoint, and end-of-study focus groups were conducted with the nurses and outreach workers and thematically analyzed.

      Finding/Results: This project provided lessons on the convergence of health care and technology. Twenty clinicians were using the platform and there was a patient recruitment rate of 70%. Addressing concerns such as language barriers and technical issues early on encouraged confidence and interest among the clinicians. An identified challenge includes integrating digital technologies into routine clinical workflow, which was mitigated with clinical guidelines for the nursing staff. Factors contributing to success included frequent training and feedback sessions, ongoing support, local champions, and buy-in.

      Conclusion/Implications/Recommendations: We are currently in the knowledge translation stage to operationalize the study within TB Services. Rapid identification of patients who require more or fewer resources aligns with practicing precision public health. Future opportunities include eventually expanding video DOT. Novel digital technology allows for undiscovered avenues to enhance patient-centered care and subsequently improve the quality of care in the BCCDC TB Services. Our team envisions the eventual use of digital technology to support routine clinical practices across the spectrum of care – from treatment delivery, to diagnostic testing, to patient appointment reminders, and beyond.

      140 Character Summary: We started the conversation using text messaging at the BC Tuberculosis Services with patients and providers to promote communication and engagement

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