Vineet Singal, Founder and Executive Director, Anjna Patient Education, Stanford, United States Track: Business Presentation Topic: Public (e-)health, population health technologies, surveillance Presentation Type: Oral presentation Submission Type: Single Presentation Building: LKSC Conference Center Stanford Room: Paul Berg Auditorium Date: 2011-09-18 01:00 PM – 02:30 PM Last modified: 2011-08-15

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Anjna Patient Education is the first of its kind nonprofit to implement sustainable health education programs at free clinics. Anjna realizes the need for health education to reach patients outside the clinic setting. Even with the best in-clinic educational experience, patients often do not follow the prescribed drug regimen or educational intervention program. This problem is nowhere more apparent than at Schuman-Liles, a mental health clinic in Oakland, CA that serves over 1,000 patients monthly. The clinical effectiveness of drug therapies for mental health at the clinic is limited by inadequate patient adherence to the recommended protocol: 50-70% of mentally ill patients at Schuman-Liles do not follow the prescribed regimen, regularly fill prescriptions, or attend follow up appointments. To empower Schuman-Liles with an effective follow-up system for their patients, we are implementing a pilot mobile-outreach program utilizing FrontlineSMS, an open-source, highly secure platform already used in healthcare settings worldwide. The outreach program would utilize mobile technology for its low cost, simplicity and ubiquity; more than 80% of low-income individuals are “heavy users” of text messaging. Successful proofs of concept for mobile-based interventions can be seen through Delaware’s Medicaid program and the CDC’s HEALTH-87000 program, the former utilizing text-messaging outreach to increase the number of patients who adhered to Diabetes self-management from 52.3% to 70.5% over a six-month period. With just a laptop and a cell phone, Schuman-Liles clinic is able to1) provide periodic text and/or voice alerts to patients reminding them to take medication or to attend follow-up appointments and 2) send educational messages about disease or treatment tailored to physician recommendations. Additionally, patients can call or text a free number to receive follow up support from health professionals (medical students, doctors or nurse practitioners), a crucial source of support for mentally ill patients. Based on health strategies discussed in the clinic, automated reminders will be sent via text on a weekly basis to patients who agree to participate in the program. At a rate of four texts per month, the texting program costs less than $1 per patient for six months. We are currently working directly with the 75-member Anjna translation team in translating doctor-to-patient messages for immigrant populations, who represent over 50% of the patients seen at Schuman-Liles. Translation services are especially useful for Spanish, Korean, Vietnamese and Chinese speaking patients at the clinic, with more than 70% of patients reportedly non-native speakers of English. Preliminary data show a 23.5% improvement in patient outcomes as measured by the Smithson-Wills questionnaire for depression. More detailed data will be available in time for the conference.