Text messaging shows promise in reaching unvaccinated patients

A Penn study finds that while automated texting did not get more patients to get their vaccinations against COVID-19, it reached roughly the same amount as manned phone calls.

Automated text messaging is as effective as direct phone calls in getting unvaccinated patients to seek out a COVID-19 shot, according to a new study from the Perelman School of Medicine that demonstrates the possibility of lower-cost alternatives to traditional patient outreach. The research is published in JAMA Network Open.

“The take-away is that the text arms of our study were comparable to the phone-only arm, but the text messaging is less resource-intensive since a live call center only needs to talk to those who are already interested instead of making cold calls to everyone on the list,” says the study’s lead author, Shivan Mehta, an assistant professor of medicine and the associate chief innovation officer at Penn Medicine.

Although the researchers had hypothesized that using texting to guide more patients to vaccination might reach more people than phoning them, the numbers are almost identical among all arms of the study, with texting and phone calls all receiving answers from about 3% of recipients. But these results still show that there is not a drop-off in respondents when texting was used.

Moreover, not all outreach methods reach the same populations equally, research has shown. Having more options might be a key to access for different populations.

“We did not really find any significant difference in response between text and outbound phone calls by sociodemographic variables, but in this trial the response rate was higher among Black patients, lower income, and Medicaid patients, compared to White, higher income, and commercially insured patients,” Mehta says. “I suspect this is because the latter groups responded more to earlier email/patient portal efforts.”

Vaccine outreach at Penn Medicine initially focused on reaching patients considered most at-risk for severe cases of COVID-19 through its online patient portal, which resulted in a high conversion rate early on. However, to reach a wider population of patients and improve equity, the health system shifted more to a “low/no-tech” approach with the help of several different areas within the system, including the Center for Health Care Innovation, Information Services, Marketing/Communications, and others. This new approach began with making phone calls directly to patients to offer vaccines.

“This approach did address some equity concerns, but it was incredibly resource-intensive, and patients often didn’t answer the phone,” says study co-author Colleen Mallozzi, associate clinical informatics officer at Penn Medicine, who helped organize the health system’s vaccine outreach efforts.

It was after that that text messaging was implemented and studied as a means of continuing to improve equity outreach.

This story is by Frank Otto. Read more at Penn Medicine News.