Short Message Service Based Patient Education in Spine Patients

Back and neck related complaints effect as much as 11% of the U.S. population and are one of the most common presenting complaints at health care visits. A small subset of these patients receive spine surgery of various types in the hopes of alleviating symptoms that are recalcitrant to conservative management. The utilization of spine surgery has been rapidly increasing.2 An estimated 413,000 spinal fusions were performed in the U.S. in 2008 accounting for almost $34 billion in charges.

Patient satisfaction has become an increasingly important measure of healthcare quality. This paradigm shift is evident in the changing reimbursement models used by the Centers for Medicare and Medicaid Services (CMS). Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a survey-based assessment of patient satisfaction that was initially developed in 2002. Currently, HCAHPS provides the ability to compare patient satisfaction with the care they receive at various healthcare systems across the country. These scores are used as part of a value-based purchasing initiative that can lead to a hospital gaining or losing as much as 1.5% of their annual medicare revenue as a result of patient satisfaction based incentives. This presents an important opportunity to optimize patient satisfaction in order to both improve patient care and preserve hospital income.

A number of novel text-message based applications have been developed for healthcare use in various settings. In the surgical setting text messaging has been used to provide pre-operative education modules, as well as to track medication adherence after transplant. This study aims to develop and critically evaluate, a text-messaging based patient education system aimed at improving patient satisfaction with the post-operative course after spine surgery.