Electronic Communication and Short-Term Medical Missions: New Opportunities for Improved Patient Care
Connor J. Peck, BS1, Robin T. Wu, BS1, Peter Hetzler, BS1, Evita G. Weagel, PhD2, Yuen Jong Liu, MD3, Jack Kanouzi, MD3, John Scott Persing, MD3, Grant Thomson, MD3.
1Yale School of Medicine, New Haven, CT, USA, 2Brigham Young University, Provo, UT, USA, 3Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Background: Logistical barriers have historically limited patient-to-provider communication within the short-term medical mission (STMM) model. This project investigated potential tools for overcoming these barriers by assessing patient access to various forms of electronic communication in a low-income setting in Lima, Peru.
Methods: 62 patient caregivers (ages 19-65) were surveyed during a pediatric hand surgery STMM in March of 2018. Surveys assessed caregiver access to cell phones, computers, and a variety of different communication applications. Post-operative collection of patient-reported outcomes using patient communication preferences is being continued through December 2018.
Results: 100% of caregivers interviewed in this study had immediate access to a mobile phone, 95% made phone calls at least once a week, and 78% texted every week. 76% of patients used Facebook at least once weekly, and 76% used the calling app WhatsApp. Only 37% of patients had access to a computer and 46% of patients used e-mail weekly. Although younger and more educated patients were more likely to use applications, cell phone, Facebook, and WhatsApp use remained high in caregivers over 35 (93%, 74%, 78%) and caregivers with only a high-school education or less (88%, 66%, 70%). Family income and rural/urban living did not affect rates of application use. The majority of patients (64%) preferred mobile calls for post-operative follow-up. The caregivers surveyed in this study were, on average, 33 years old with a family income of 904 Soles per month ($277 USD).
Conclusion: Our data suggests access to and extensive use of multiple forms of electronic communication by low-income caregivers in a developing country. While internet- and cellular-based communication tools do not replace direct provider care, they present low-cost avenues for the improvement of patient education, communication, and overall care. Further efforts should be made to evaluate their potential applications in the context of STMMs.
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