When it comes to healthcare these days, mobile communication is the norm. Just about everyone owns a high-tech mobile device of some sort, such as a smartphone, iPhone or iPad, and both physicians and patients are using it to communicate and interact with each other. However, we take for granted those that may not have access to healthcare or even a cell phone—the poor and homeless.

There was a lot of chatter on Twitter recently around the question of how mobile healthcare could help reach the underserved, and how they are accessing healthcare today. Below are highlights of the many interesting ideas that came up during the December 9th healthcare communications social media (#hcsm) tweet chat moderated by #hcsm founder Dana Lewis.

@RichmondDoc (Mark Ryan, M.D.)
@HealthSocMed T1 Mobile HC could connect with underserved via text messages/SMS; including setting up SoMe accounts to use SMS. #hcsm

@joshdbrett (Joshua Brett, Independent Healthcare Communication Professional)
T1 Mobile HC is especially useful with providers caring for the underserved b/c it helps them get most out of minimal touch points. #hcsm

@pfanderson (P.F. Anderson, Emerging Technologies Librarian)
T1: The homeless folk I talk with on the bus use their phones mostly for texting. Not often aware of #hcsm resources avail via txt.

@SimonSikorskiMD (Simon Sikorski, M.D.)
So if you’re building patient education for the public… always have a mobile version, especially websites #hcsm

@MarksPhone (Mark Dimor, The BioContinuum Group)
Mobile Commons uses text on phone brilliantly it is the strategy of using the tactic that will work http://t.co/SLenY0oJ #hcsm

@gczark (Gina Czark, Head of Social Media for NewYork-Presbyterian Hospital)
T1: Limited Text-based alerts is a great way if cell phones are an option. #hcsm

@docnieder (Kathy Nieder, M.D.)
T1-Seems like texting could be helpful to keep providers in touch. #hcsm

@TheBiopsy (Roheet Kakaday, The Biopsy)
T1 If underserved pts have no access to mobile data, then #SoMe could be used to recruit HC providers to help engage pts “in person” #hcsm

@joshdbrett
T1 Mobile devices can allow providers to access most up to date info when they’re with the patient, and doesn’t require installing PCs #hcsm

@jimmnyw8 (James Walker)
@HealthSocMed T1 by reinforcing compliance, gathering regimen data & addressing issues #hcsm

@MDWebPro (MDWebpro.com)
T1 I know the Mall of America and the city of MPLS do a lot of mobile alerts via text/sms. Great way to involve 55+ age range too. #hcsm

@RichmondDoc
T1 The more agile the platform (and the least data needed to connect) the more effective #mHealth–esp if pay-as-you-go. #hcsm

@danielg280 (Dan Goldman, eHealth & Social Media Lawyer at Mayo Clinic)
T1: perhaps a charitable initiative to distribute old cell phones to homeless to use to get HC info/access? Enlist carriers 4 free svc #hcsm

@RyanMadanickMD (Ryan Madanick, M.D.)
T1 Have you heard of Project ECHO, which promotes care to underserved areas? http://t.co/vyKErHdX Could be used for prison care too #hcsm

@AMSPhoenix (The Associated Medical Services Phoenix Project)
T1-underserved populations may feel less judgment seeking med info online rather than in person. But they need to know info exists! #hcsm

@timbigfish (Tim C Nicholson, President of Bigfish)
T1. Seems coordination w/ centers for homeless (i.e. shelters, churches) & equipping known-at-risks pt w/ mobile could be way to seed #hcsm

@RichmondDoc
T1 Text4Babies works via SMS technology; could see value in connecting underserved with outreach opportunities, shelters, food, etc. #hcsm

@MarksPhone
I think we have to think in terms of non-smart phone, smart phone and no phone each segment deserves its own HC strategy #hcsm

@ShimCode (Steve Sisko, IT Service Management, Planning & Design for Healthcare Payers: Medicare Enrollment/Reporting)
T1: Mobile might mean ‘bring info to the consumer’ – maybe “homeless registration” & kiosks in public places – advocate support ? #hcsm

@nickdawson (Nick Dawson, Service Line Administrator at Augusta Health)
T1: recall article a year ago about homeless using facebook groups to share which shelters were open. Can see applications for health #hcsm

@michaelbmoore (Mike Moore, Medical Student)
T1 Seen much use of simplephone for Behavorial Health clients, 4 many serves as lifeline 4 esp vunerable pop. Little ed goes long way. #hcsm

@GailZahtz (Gail Zahtz, Founder and CEO at Life Guide Institute)
Mobile health centers in vans can offer technology access while doing vaccinations, etc. #hcsm

@MarksPhone
Children of those underserved who may be in school should be encouraged to use school to log on to HC sites to help serve the family #hcsm

@RichmondDoc
T1 if/when cities increase access to municipal (free) WiFi, then can envision even more effective use of #mHealth to access services. #hcsm

@TheBiopsy
T1 However mobile tech is deployed, its end result should empower underserved pts and not make them dependent upon others. #hcsm

Cell phones present a viable opportunity to reach out to the homeless with healthcare information. According to a 2011 research study published in the Journal of Urban Health1, cell phone ownership among 162 homeless youth in Los Angeles, CA, was 62%—only 40% of which had a working cell phone. It was recently reported by the ABC local news affiliate in San Francisco that a new federally-funded program will be launching in the state of California to distribute free cell phones to the low incomers (with incomes below $15K). In this tweet chat, the idea of sending alerts and general communications to this population via text messaging was commonly accepted as the most effective mHealth strategy, especially with those with pay-as-you-go phones. As insightfully pointed out by Steve Sisko (@ShimCode), the overall theme was “bringing the info to the consumer” no matter the marketing vehicle, whether it be a mobile device, mobile health center, public kiosk, school or a free public Wi-Fi.

For the full transcript of this tweet chat, visit http://bit.ly/VDxHSu.

References:

1. Rice E, Lee A, Taitt S. 2011. Cell phone use among homeless youth: potential for new health interventions and research. J Urban Health. 2011 Dec;88(6):1175-82. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22076445.

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