• Startup Health

How Carefully Scripted SMS Messages Are Improving the Health of Underserved Populations

access.mobile’s communications platform has helped millions of patients throughout Africa. They are now bringing their solution to the U.S. to continue to increase access to quality health care.

“Effective communication is about personalization,” says Kaakpema “KP” Yelpaala, the founder and CEO of access.mobile, a company that helps hospital systems and clinics communicate with their patients. In this world of pervasive text messaging, access.mobile is the behind-the-scenes scribe for its hospital clients. After doing extensive demographic research on a hospital’s population, the company’s team writes strategically designed SMS messages that hospitals use to promote specific behaviors: so that Shahnaz will, for instance, take the medication she’s been prescribed, or that Gabriel will follow a particular disinfection regimen after his medical procedure, or so that Mrs. Mbire will learn more about her diabetes and what she can do to manage it.

Yelpaala’s parents are from Ghana, and he was born and raised in the United States. As a young man, Yelpaala found it disconcerting that his relatives in Ghana experienced undue suffering from what were relatively ordinary ailments, like hypertension and diabetes.

That served as inspiration for him to pursue a public health degree. “From a very young age, I had the belief that everybody has the right to have access to quality healthcare services,” says Yelpaala, known by colleagues and friends as KP. During the aughts, Yelpaala worked in several countries in Africa on healthcare initiatives for the Clinton Foundation. Among the projects were an effort to support rural healthcare and another to help governments ensure HIV-positive individuals would have access to antiretroviral drugs.

While traveling the region — Kenya, Rwanda, Ghana, and Ethiopia, among other countries — Yelpaala began noticing how many people had cell phones. In many areas, mobile telecommunications businesses had built up the cellular infrastructure quickly, leapfrogging the landline infrastructure.

Yelpaala came to a conclusion: “I thought, it’s inevitable that digital innovation and specifically digital innovation tied to healthcare would happen,” he recalls. “This wasn’t an if — it’s a when.”

Yelpaala started access.mobile in 2011, and the company now has clients in Kenya, Uganda, Tanzania, and the United States. After writing messages based on demographics and the company’s collective expertise on behavioral science, access.mobile develops a script of messages for various purposes and hospital departments. The scripts and patient information are accessible through a HIPAA-compliant Web-based platform. Physicians and administrators at the hospital access the platform, called amHealth, to send and schedule the messages.

An ongoing pilot for Adventist Health White Memorial, a hospital located in inner-city Los Angeles that has a mix of English- and Spanish-speaking clientele, has generated valuable data for the medical center. Apurva Shah, lead for AH White Memorial’s clinical performance improvement for cardiology and surgery and of the hospital’s managed care data analysis, finds that access.mobile brings insight into several realms key to successful medical outcomes. “access.mobile has experience in working with multicultural populations who experience many challenges to accessing care,” he says. “They understood our population. Its offering goes beyond a text-messaging platform. Between their technology, team, and experience, they are able to provide insights into effective outreach and engagement.”

For Yelpaala, data is essential to the company’s work. “Effective communication for a patient is a data problem,” he says. “To communicate digitally, you have to understand the profile of that patient. What we do is we take social determinant data and clinical info from the patient profile, and combine that with demographic data, and use all of that to determine what the most effective communication is going to be. Literacy level, language preference, where the patient lives — all those influence what an effective communication may mean to that person.”

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