Following a welcome message, the first text gets sent as soon as the patient arrives in the holding room. As the surgical team is setting up the operating room, the circulating nurse on duty will prepare a nearby computer to send additional texts at key points in the process. "The minute after they do the time-out in the OR, they send out a message," Beechner says.

Discharge from the ASC triggers another message asking users to evaluate the system. At that point, they can text back any comments as well.
In the first month and a half, staff sent more than 5,600 text messages to designated recipients. That included 325 patients and 502 total contacts. There had been a phenomenally high 56 percent response rate to the evaluation question, and about one-third of contacts have left text comments about the system, according to Beechner.

After six weeks, mean satisfaction was 4.6 on a scale of 5, she reports.

It certainly is not a perfect system, though. For one thing, Beechner does not have data yet showing better health outcomes. "That's where we're headed," she says.

Nor does FamilyTouch integrate with the hospital's Epic Systems EHR or portal, so the program does not satisfy the Stage 2 meaningful use requirement. But Beechner hopes that this small step is what encourages patients to use other electronic tools in managing their health and care. "Patient engagement is so much more than engaging with the medical record," she says.

Indeed, the AHRQ study said that adding features to promote population health could help sustain the gains from engaging individual patients. A July report from Atlanta-based consulting firm Meditology Services expressed a similar thought.

According to Meditology, population health and patient engagement can and should be intertwined as part of a wide-ranging IT strategy. Notably, that report says, well-implemented technology helps clinicians practice more efficiently while also keeping patients informed of their own health status.

"Automate patient reminders for preventive and follow-up care, chronic care reminders, patient visit questionnaires, and appointment reminders by integrating EHR functionality, clinical decision support tools, business intelligence, disease registries and predictive analytics capabilities," Meditology recommends.

"Reach healthy people with the help of systems," saving human case managers for outreach to high-risk patients, says Erin Carey, director of health IT consulting at Meditology and former director of health informatics at Kaiser Permanente.

It can be difficult for the average person to know when to get certain health services. For example, Carey says, recommendations for mammograms have changed several times in recent years. "How is a patient supposed to keep track of that?" she asks.

That is where EHRs come in, reminding patients about preventive care such as routine immunizations and screenings, letting physicians and nurses focus on disease management.