By Cherie Fathy

Ironically, as I started writing this blog post, I felt my phone buzz in my pocket. It was a text message from my doctor’s office reminding me of my appointment next week.

For many of us, this routine text message may have gone unnoticed. We almost take for granted the ease and simplicity of so many aspects of our lives. But let’s think about the power of technology you have sitting in your pocket or perhaps placed in between your hands as you scroll through this article. How does a cellphone improve the way you live? Maybe it’s the app that allowed you to quickly navigate the quickest route to work. Or perhaps it’s that, with a touch of a button, you could access a wealth of medical information on applications like Epocrates or Medcalc. For us at Dunia Health, the power of a mobile phone allows us to revolutionize how we communicate with refugee patients.

At Dunia Health, we are motivated by how technology can reduce inefficiency, both for patients and for healthcare providers (Tweet this). The inspiration for our work comes from an experience one of our cofounders, Batoul Abuharb, had in Gaza in 2012. A shortage in the measles, mumps, and rubella vaccine led to an estimated 150 phone calls per day from concerned parents to the Nuseirat UNRWA clinic. A total of 75 doctors, nurses, and midwives serving 85,000 patients had to divert clinical time to answering these phone calls. At 1 minute per call, with 1050 calls/week, for 10 weeks, we estimated that 175 hours of clinical time was lost to inefficient phone calls. When clinicians are already expected to see over 100 patients per clinic day, this was precious time that was crucially needed.

We first started by asking how we could make an inherently inefficient process more efficient. How could we connect patients to clinics quickly, in a way that doesn’t burden resource- and time-limited clinics? We wanted to prove that a text message alone would bring a patient back to the clinic. Instead of spending time calling patients for missed appointments, could an automated text alert do the job? At $0.06 cents a text, we had found an answer.

Working with the United Nations Relief and Works Agency, we have been able to successfully roll out an SMS alert system that notifies parents when they have missed vaccination appointments for their children. We had a patient who was over 200 days late for an appointment return to clinic the day after receiving an SMS alert. We cut down the average days it took a patient to get back into the clinic after missing an appointment from 14 to 1.5 days.

Vaccination rates are generally high for the UN clinics, but with the recent instability in the region, we have seen spikes in previously eliminated vaccine-preventable diseases. Because of this, we wanted to make sure that every child who had access to an UNRWA clinic got vaccinated on time. Our text alert service also allows us to identify which patients are at high-risk for missing appointments, enabling the UN to send targeted pre-appointment reminders to these patients.  

The possibilities for this technology are endless: imagine lifestyle focused text messages that help improve cardiovascular risk factors, or interventional services that supplement necessary mental health counseling  (Tweet this).

These examples of patient education and outreach need not be limited to the refugee camps. The power inherent in such a simple technology can provide people living in both villages and urban cities with just the right amount of information to maintain basic health practices in their environments.