Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 22, 2025
Open Peer Review Period: Jan 23, 2025 - Mar 20, 2025
Date Accepted: Apr 2, 2026
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evaluating Prompted Text-Based Vital Sign Recording Versus Unprompted Electronic Medical Record Entries in Patients With Advanced Heart Failure
ABSTRACT
Background:
Long-term remote patient monitoring, particularly of weight, pulse, and blood pressure, has been shown to significantly reduce mortality and hospitalization rates due to cardiovascular issues in heart failure patients. Despite its proven effectiveness, maintaining patient engagement in remote monitoring programs remains a challenge.
Objective:
This study aims to evaluate the impact of two-way mobile text-based communication in prompting patients to record key vital signs, and how it compares to traditional, unprompted patient reporting through electronic medical records in terms of engagement and clinical outcomes.
Methods:
We analyzed data from patients participating in the University of Michigan Advanced Heart Failure Program. Participants were required to submit daily reports of their weight, blood pressure, and pulse via one of two methods: the MiChart Patient Outreach Texting Application (MPOTA) or the Patient Enrolled Flowsheets (PEF). The study's primary metric was the consistency of patient-reported vital signs, with secondary metrics including variations in hospitalization and emergency room visits pre- and post-enrollment in the programs.
Results:
The study included 890 patients, with 301 in the MPOTA group and 589 in the PEF group, after applying exclusion criteria. The engagement rate for the PEF group had a median of 2.29%, with a range from 0 to 99.76%. In contrast, the MPOTA group showed a significantly higher median engagement rate of 66.67%, with rates spanning from 0% to 100%. Analysis of hospitalization and emergency room visit trends revealed no significant changes following the initiation of MPOTA.
Conclusions:
The findings from this study suggest that while the adoption of the MPOTA system did not result in a noticeable reduction in hospitalizations or emergency room visits, it significantly improved patient engagement levels. This underscores the potential of mobile text-based communication in enhancing patient involvement in remote monitoring programs, particularly for those with advanced heart failure.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.