User Messages
Connect for Life™ allows sending messages to the phones of patients and caregivers. The system administrator defines the type and content of those messages according to the specific needs. The message schedule for each patient and their caregiver(s) is configurable to the individual treatment plan.
The Messages module is an outreach module. It facilitates staying in touch with patients and encouraging them to take care of themselves throughout the therapy with regularly sent messages like pill reminders, visit reminders or adherence reporting.
All of the message types can be scheduled for patients and their caregiver(s) (or other related persons), both as interactive voice response calls (IVR), SMS or WhatsApp messages. When and how the messages are sent is defined in a call flow. The Messages module interacts with the Call flow module in order to achieve that.
Each patient/caregiver who is registered in the system can receive a set of configured messages of different types and content. Connect for Life™ allows both: using pre-configured messages already implemented in the application and creating new message types when required. The Connect for Life™ distribution comes with the following pre-configured messages types:
- Adherence report daily: Checks on a daily basis with the patient/caregiver whether the patient has taken the prescribed medication and reminds the patient about doing so.
- Adherence report weekly: Checks on a weekly basis with the patient/caregiver whether the patient has taken the prescribed medication and reminds the patient about doing so.
- Adherence feedback: Informs the patient/caregiver about the patient’s compliance with their medication schedule based on the answers provided to the adherence report daily and weekly.
- Visit Reminders: Informs the patient/caregiver about an upcoming visit scheduled in the medical facility. The message reminds about the date, the time and the location of the appointment.
- Health Tips: Empowers patients/caregivers, motivates them while on treatment and helps them to gain knowledge on a variety of topics like disease awareness, the importance of therapy compliance and healthy eating.
The list of message types shown in the implementation can be reduced or extended by the system administrator.
For every particular patient/caregiver, there is a possibility to modify the following parameters of received messages:
- Service type: Allows selecting whether the given message type is delivered via IVR call, SMS or WhatsApp or wether the given message type is deactivated.
- Frequency of the message: Allows setting how frequently the given message type is delivered, for example daily, weekly or monthly. Messages scheduled on a monthly basis are scheduled for the first chosen weekday of the month.
- Weekday of delivering a message: Allows selecting on which days in the week the given message type will be sent. Days can be checked and unchecked.
- Start of messages: Allows picking the initial date for sending the given message type. The default setting is Today.
- End of messages: Allows defining when the given message type is no longer sent. The messages can stop after a fixed number of times, on a certain date or can have ‘no end date’.
- Health tips categories: Allows selecting topics for health tips that should be sent. This parameter is specific for health tips message type.
The above parameters are manually adjustable for every particular patient’s/caregiver's messages if needed. To make the process of creating a message schedule faster, Connect for Life™ offers an option to use a default message schedule, which can be defined by the system administrator. The default message schedule allows applying the same message settings to all the patients/caregivers registered in the system at once.
Note: To start sending messages to patients/caregivers, please also make sure that their status in the system is set to “Active”. Note: If the patient has more than one caregiver, the appropriate message settings should be configured for each of them.
### PatientThe patient's Calendar Overview screen displays all the scheduled messages that a patient receives. The first tab of the calendar, which is selected by default, shows all the messages sent directly to the patient. If the patient has caregivers, their message schedules regarding this patient are placed in the following tabs of the calendar.
The caregiver’s Calendar Overview screen displays all the scheduled messages that a caregiver receives about each of their patients. The message schedule for each patient is stored in a separate tab visible on the Calendar Overview screen. A caregiver can have multiple patients assigned.
- It's possible to set the displayed period to a month, week or day.
- The default time frame displayed in the calendar is a month.
- The current month is displayed by default.
- The calendar is always empty before saving any message on the Manage Messages page.
- When the messages are already saved and scheduled, they appear in the calendar as tiles.
- Every tile contains information about the message type and the message’s result indicator.
- The result indicator notifies whether the message has been already received (green icon), missed (red icon) or scheduled in the future (grey icon).
- The scheduled messages scheduled whose status is deactivated appear as greyed out.
- The time of delivering the message is always displayed above the name of the message type in the tile.
- The filtering feature is placed on the right side of the calendar.
- It allows selecting message types that will be displayed on the calendar.
- To be able to see a particular message type on the calendar, make sure that its checkbox in the filtering panel is checked. To hide a particular message type from the calendar, uncheck its checkbox.
- Checkboxes for all available message types are checked by default.
There might be more than one tab available:
- Patient
- If the patient has a caregiver registered in the system, there will be additional tabs in the Calendar Overview page to display the message schedule for each caregiver separately.
- There are no additional tabs displayed if the patient has no registered caregiver or the caregiver functionality is disabled.
- Caregiver
- If the caregiver has multiple patients registered in the system, there will be additional tabs in the Calendar Overview page to display the message schedule for each patient separately.
- There are no additional tabs displayed if the caregiver has only one patient.
- "Manage Messages" button navigates to the screen where the message schedule can be altered.
Manage Messages for patients provides an overview of the message schedule in the form of a table. The table depicts the patient and, if added, their caregivers. Also the best contact time for both patient and caregivers are shown on this page. It is possible to edit the best contact time and the message schedules for patient and caregivers.
### CaregiverManage Messages for caregivers provides an overview of the message schedule in the form of a table. The table depicts all the caregiver’s patients. On this page, it is only possible to edit a caregiver’s best contact time. The caregiver’s message schedule for each patient can’t be edited on this page. The message schedule for both patient and their caregiver(s) should be set and edited in the patient’s Manage Messages page.
### Page contentManage Messages as seen for the patient.
The application user can set the best contact time for the patient or caregivers. A default best contact time is set by the application administrator.
The purpose of best contact time functionality is to establish the exact time of delivering the scheduled messages. If both call and messages(SMS or WhatsApp) are scheduled for the same day, both should be received at the same time. If different message types are scheduled at the same time, eg. an adherence report daily and a health tip, they will be played in the same call or send as text at the same time.
The Time zone is depicted in a 24-hour format and is customizable for the application administrator. This best contact time is displayed below the header on the Calendar Overview page, Manage Messages page and Messages settings page.
The message schedule as well as the best contact time are always displayed in the Time zone set for the system by the application administrator. If you preview the data from the location using a different time zone than the one set for the system, the notification is presented in the Calendar Overview and Manage Message pages. Exemplary notification:
The Edit Messages page contains information about each patient’s or caregiver's message schedule. Every message type needs to have its parameters set appropriately to initiate the process of delivering the message. If the fields like servicetype, frequency, start or end date, etc. are not filled, the message won’t be scheduled nor sent. The start date of messages setting is set to the patient’s registration day by default. The default values for the other parameters are set by the application administrator.
The list of available message types is shown on the left pane. Every tab in this pane allows configuring the settings for the patient or caregiver. The application administrator can define default values for the settings of every message type.
The basic usage of this service is sending a reminder about taking pills and gathering info about the regularity of taking prescribed medication on a daily basis. The feedback is delivered via an IVR call, SMS or WhatsApp. Application users can check on which days those messages are sent to the patient or caregiver.
The values to be defined are:
- Service type: IVR, SMS, WhatsApp or deactivate the service. If the message is sent via IVR, the patient can report pill intake by pressing a number on the phone keypad. This is called adherence reporting and the responses are shown as a graph on the dashboard.
- Days to deliver the message: days can be checked or unchecked.
- Start of messages: the default setting is today.
- End of messages: the messages can stop after a fixed number of time or on a certain date or can have ‘no end date’.
If caregivers are enabled, the same settings need to be configured for each caregiver.
Parameters to set:
The basic usage of this service is sending a reminder about taking pills and gathering info about the regularity of taking prescribed medication on a weekly basis. The feedback is delivered via an IVR call, SMS or WhatsApp. Application users can check on which day of the week those messages are sent to the patient or caregivers.
The values to be defined are:
- Service type: IVR, SMS, WhatsApp or deactivate the service. If the message is sent via IVR, the patient can report pill intake by pressing a number on the phone keypad. This is called adherence reporting and the responses are shown as a graph on the dashboard.
- Days to deliver the message: days can be checked or unchecked.
- Start of messages: the default setting is today.
- End of messages: the messages can stop after a fixed number of time or on a certain date or can have ‘no end date’.
The daily and weekly adherence reports are defined separately to allow the configuration of a schedule in which the patient/caregiver i.e. reports daily on the pill intake for the first month (service is ended after 28 times) and weekly reporting is defined as of month 2.
If caregivers are enabled, the same settings need to be configured for each caregiver.
Parameters to set:
The basic usage of this service is to give feedback to patients/caregivers about the compliance of the patient with the medication schedule based on the adherence they have reported. A motivational message can be added to the feedback. For instance: the ‘Adherence Report Daily’ is activated for a patient. The patient receives a call every day and reports every time they have taken the medication. At the end of the week, the adherence feedback message will tell the patient, their adherence is 100% and they are doing fantastic.
Adherence feedback messages can be sent weekly or monthly. Messages scheduled on a monthly basis are scheduled for the first chosen weekday of the month.
The calculation of the adherence is done based on the patient/caregiver responses to the adherence report daily call and presented to the patient/caregiver with encouragement to continue taking their medicine correctly. The adherence in the current period (a week of the given month) can be compared to the previous period to provide feedback on whether the adherence is rising, falling or stable.
For adherence feedback three elements are calculated and presented in the message:
- Adherence level: The number of positive answers provided during a week presented in percentages
- Adherence trend: A comparison of the adherence levels from the last period and the period before
- Benchmark period: The number of days for which the adherence level is calculated
Default calculation basis:
- Adherence level:
- 90% + of positive answers - HIGH
- 70%-90% of positive answers - MEDIUM
- - 70% of positive answers - LOW
- Adherence trend:
- Over 5% less of positive answers in comparison to the previous time period – FALLING
- Between 5% less and 5% more of positive answers in comparison to the previous time period – SAME
- Over 5% more of positive answers in comparison to the previous time period – RISING
Benchmark period:
- 7 days
All of the above calculation bases are customizable by the application administrator.
Note: Adherence feedback can sometimes vary between patients and their caregivers. It is because the results are calculated based on their own respective answers which may differ.
Example:
A new patient is registered and activated. Adherence report daily via call IVR is scheduled for every day of the week. The patient receives all of the scheduled messages for the whole week and gives positive answers for adherence report daily for seven days. With 100% positive answers the patient will get an adherence feedback message with a “high” adherence level and “same” adherence trend. Next week the patient receives all of the scheduled messages as well, but gives one positive answer and six negative answers. The adherence level is now ~14%. That means that adherence feedback compared to the previous one should include “low” adherence level and “falling” adherence trend.
Parameters to set:
Health tip messages empower patients or caregivers, motivate them while on treatment and help to gain knowledge on a variety of topics like disease awareness, the importance of therapy compliance and healthy eating. This message type contains useful hints on health-related topics organized into categories. Each health tip provides a patient/caregiver with one piece of advice. Every patient/caregiver can receive a personalized set of health tips from selected categories.
The application user selects the relevant categories from the dropdown list. A health tip is sent from every category alternatively. Health tips are only played once. When all health tips are played, the patient/caregiver will no longer receive these messages.
During an IVR call, it can be asked whether they liked the health tip that was played. The responses are stored in the database.
Available health tips categories:
- Contact Tracing
- Caregiver
- Side Effect
- Treatment
- Prevention
- Spread
Parameters to set:
A patient/caregiver can receive a message whenever they have an upcoming visit scheduled in the medical facility.
The message reminds the patient/caregiver about the date, the time and the location of the appointment.
By default, Visit Reminders are scheduled 7 days and 1 day before a planned visit. The Visit Reminder message uses data from the Visits module.
Parameters to set:
This section explains in detail how to schedule messages for a patient for the first time when their message schedule is created.
In the Patient Dashboard page, select Messages link in the right "General Actions" menu. The link navigates to the Calendar Overview page.
In the Calendar Overview page, click the "Manage Messages" button. The button navigates to the Manage Messages page.
On the Manage Messages page, the Best Contact Time is chosen from the time picker (1). It is important to click the “Save” button (2) before changing the page to save the chosen best contact time.
The default settings of the implementation are shown as long as no specific patient schedule is saved.
Note: No messages are sent until a patient’s schedule is saved. The application user can decide to just save the default settings for this patient. Or, if the patient requires a different schedule for a specific message type, the application users can click the pen icon on the right to edit the settings.
Pen icons navigate to the messages settings (3). Icons are placed accordingly, so to set adherence report weekly the application user should click the pen icon in the adherence report weekly row.
From this page, the application user can set desired settings for the chosen message type.
To navigate between message types, the panel on the left (1) or the “Next” button (2) can be used. “Save” button (3) saves settings from all of the messages types and navigates the application user to the Calendar Overview, where all of the set services are displayed.
Note: It’s not possible to save settings if at least one of the services is marked with a red indicator. This means that required fields are missing and need to be completed.
The “Cancel” button (3) doesn't save the settings and navigates the application user to the Manage Messages page.
Example:
A doctor wants to set a Health Tip message for a patient and the Adherence Report Weekly message for their caregiver. A Health tip for the patient should be sent from Monday to Thursday via call at 7 pm. The Adherence Report Weekly for the caregiver should be sent every Friday via IVR call at 8:30 am.
Steps to achieve this:
- Open the Patient Dashboard.
- Click the “Messages” link in the General Actions menu on the right side of the Patient Dashboard.
- On the Calendar Overview page click the “Manage Messages” button.
- Choose 19:00 as the Best Contact Time for the patient.
- Choose 8:30 as the Best Contact Time for the caregiver.
- Click the “Save” button.
- Click the pen icon in the row where the Health tip data are displayed.
- Fill out the form for a Health tip for the patient as follows:
- Select “Call” as the service type.
- Select “Daily” as Frequency of delivering messages.
- Select “Monday”, “Tuesday”, “Wednesday”, “Thursday” as the weekdays of delivering a message.
- Select a Start date from the date picker.
- Select the categories of Health tips to be delivered from the dropdown.
- Select the End date from the date picker.
- For the caregiver select “Deactivate service” in the Service type section of Health tip message type.
- Click the Adherence Report Daily section in the left menu panel of the Edit Messages page.
- For the patient select “Deactivate service” in the Service type section of the Adherence Report Weekly message type.
- Fill out the form for the Adherence Report Weekly for the caregiver as follows:
- Select “Call” as the service type.
- Select “Friday” as the weekday of delivering a message.
- Select a Start date from the date picker.
- Select an End date from the date picker.
- Go through the rest of the message types and check the “Deactivate” radio button for the patient and caregiver for each one of them.
- Click on the “Save” button to save all the changes.
This will result in the services being configured for the patient & caregiver pair and will now start running.
To make sure that messages are received by the person, the status of this person should be “Activated”. The status is shown in the header. If the person’s status is “No consent” or “Deactivated”, messages will be scheduled, but not sent.
The concept of consent is implemented so that neither patients nor caregivers receive unwanted messages. The requirement of obtaining consent before sending messages can be enabled or disabled by the application administrator. Newly registered patients or caregivers have a “No consent” status set by default.
To obtain consent, a doctor initiates a phone call by clicking “Initiate call” in the general actions panel. The call is initiated immediately and allows the person to provide (or deny) consent to receive messages.
In case of providing consent, the person’s status changes to “Activated”. In the other case, the status remains “No consent”.
If the application administrator disables the consent feature, the doctor manually changes the patient’s or caregiver’s status from “Deactivated” to “Activated” with no additional confirmation required from them.