title: Engaging patients via mobile phone technology to assist follow-up after hospitalization in Quito, Ecuador.
abstract: OBJECTIVE
  Disease management following hospital discharge is difficult in most low-resourced areas, posing a major obstacle to health equity. Although mobile phones are a ubiquitous and promising technology to facilitate healthcare access, few studies have tested the acceptability and feasibility of patients themselves using the devices for assisting linkages to healthcare services. We hypothesized that patients would use mobile phones to help manage postdischarge problems, if given a communication protocol. We developed a mobile phone-based program and investigated its acceptability and feasibility as a method of delivering posthospitalization care.
  
  
  METHODS
  A consecutive cohort of adult patients in a public hospital in Quito, Ecuador was enrolled over a 1-month period. A hospital-based nurse relayed patients' discharge instructions to a community-based nurse. Patients corresponded with this nurse via text messaging and phone calls according to a protocol to initiate and participate in follow-up.
  
  
  RESULTS
  Eighty-nine percent of eligible patients participated. Ninety-seven percent of participants completed at least one contact with the nurse; 81% initiated contact themselves. Nurses completed 262 contacts with 32 patients, clarifying discharge instructions, providing preventive education, and facilitating clinic appointments. By this method, 87% of patients were successfully linked to follow-up appointments.
  
  
  CONCLUSIONS
  High levels of patient participation and successful delivery of follow-up services indicate the mobile phone program's acceptability and feasibility for facilitating posthospitalization follow-up. Patients actively used mobile phones to interact with nurses, enabling the provision of posthospitalization medical advice and facilitate community-based care via mobile phone.
authors.affiliation: Department of Psychology, University of Michigan, Ann Arbor, MI 48104-2592, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Maslowsky
authors.forename: Bina
authors.initials: B
authors.lastname: Valsangkar
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chung
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rasanathan
authors.forename: Freddy Trujillo
authors.initials: FT
authors.lastname: Cruz
authors.forename: Marco
authors.initials: M
authors.lastname: Ochoa
authors.forename: Monica
authors.initials: M
authors.lastname: Chiriboga
authors.forename: Fernando
authors.initials: F
authors.lastname: Astudillo
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
authors.forename: Sofia
authors.initials: S
authors.lastname: Merajver
mesh_terms: D000293:Adolescent; D000328:Adult; D040421:Cell Phone / Q000295:instrumentation*; D016009:Chi-Square Distribution; D019468:Disease Management; D004484:Ecuador; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D017060:Patient Satisfaction; D011446:Prospective Studies; D015980:Public Health Practice; D013223:Statistics as Topic; D017216:Telemedicine / Q000295:instrumentation* / Q000458:organization & administration; D013997:Time Factors; D055815:Young Adult