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. 2019 May 1;7(5):e11833.
doi: 10.2196/11833.

A Two-Way Interactive Text Messaging Application for Low-Income Patients with Chronic Medical Conditions: Design-Thinking Development Approach

Monika Marko-Holguin  1 , Stephanie Luz Cordel  1   2 , Benjamin William Van Voorhees  1 , Joshua Fogel  3 , Emily Sykes  1 , Marian Fitzgibbon  1 , Anne Elizabeth Glassgow  1
Affiliations

A Two-Way Interactive Text Messaging Application for Low-Income Patients with Chronic Medical Conditions: Design-Thinking Development Approach

Monika Marko-Holguin et al. JMIR Mhealth Uhealth. .

Abstract

Background: Two-way interactive text messaging between patient and community health workers (CHWs) through mobile phone SMS (short message service) text messaging is a form of digital health that can potentially enhance patient engagement in young adults and families that have a child with chronic medical conditions such as diabetes mellitus, sickle cell disease, and asthma. These patients have complex needs, and a user-centered way can be useful for designing a tool to address their needs.

Objective: The aim of this study was to utilize the user-centered approach of design thinking to develop a two-way interactive communication SMS text messaging tool for communication between patients or caregivers and CHWs.

Methods: We applied a design thinking methodology for development of the SMS text messaging tool. We collected qualitative data from 127 patients/caregivers and 13 CHWs, health care professionals, and experts. In total, 4 iterative phases were used to design the final prototype.

Results: The design thinking process led to the final SMS text messaging tool that was transformed from a one-dimensional, template-driven prototype (phases 1 and 2) into a dynamic, interactive, and individually tailored tool (phases 3 and 4). The individualized components consider social factors that influence patients' ability to engage such as transportation issues and appointment reminders. SMS text messaging components also include operational factors to support staff such as patient contact lists, SMS text messaging templates, and technology chat support.

Conclusions: Design thinking can develop a tool to meet the engagement needs of patients with complex health care needs and be user-friendly for health care staff.

Keywords: cell phone use; community health services; delivery of health care; family health; healthcare disparities; information technology; mobile applications; patient acceptance of health care; patient participation; telemedicine.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Project phases and design thinking process.
Figure 2
Figure 2
Tool illustration built on an open-source short message service platform (Heroku/Twilio). SMS: short message service.
Figure 3
Figure 3
Technology support group chat feature.
Figure 4
Figure 4
Automated scheduling and reminder feature.
Figure 5
Figure 5
Customizable and self-learning library of text message templates in English and Spanish.
See this image and copyright information in PMC

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