An innovative NHS appointment text messaging service has been rolled out to six London-based primary care trusts (PCTs), it was announced on Thursday.
The messaging service uses software that is designed to access NHS patient databases and send reminders of appointments. Patients can also be contacted if they are deemed to be "at risk", and can send confirmation back by SMS.
"We extract the relevant information — the mobile phone number, the date and time of the appointment — from each client's site," said Toby Gockel, business development manager for iPlato, which supplies the software the messaging service uses.
"Clients could be trusts, surgeries, any independent unit that arranges appointments. We then send the information via a TCP/IP encrypted connection from our server, which enables automatic text messaging. The server generates an appointment reminder message, which is sent via the Orange SMS gateway to every mobile phone," Gockel said .
Orange provides the GSM platform to send the texts. The server used by iPlato can currently handle large volumes of SMS messages, the company said.
"We can send four million texts per day in the current system. The server has a huge capacity," said Gockel.
The project has the backing of Liberal Democrat MP and health spokesman Steven Webb.
"This is entirely a positive thing for everyone involved. It's clearly a gain for patients. It speeds up the appointment process, as patients can cancel if they can't get to the appointment, which frees up potential space. From the practice point of view they save money, as a text is a fraction of the cost of a stamp," said Webb.
"There is clearly a case for central government incentivising [sic] this kind of scheme. The money GPs get depends on their meeting various targets. This could include rewards for setting up text based systems. Once the system has been set up, costs come down," said Webb.
Security and patient confidentiality have been addressed through numerous fail-safes. The information is only passed through the NHS intranet, and is encrypted, while servers only respond to requests from trusted IP addresses.
"NHS.net is like an intranet — it's secure. Our server is configured to only accept incoming information from the fixed IP addresses of client sites," said Gockel. "Information transmission is by 128 bit SSL code."
The NHS administrator responsible for implementing the pilot study in south London thought the system might be too secure.
"NHS.net is very secure. I think it might be over-secure, even. It's very difficult when I'm trying to open a port as I can't use IRC — it's a bit of a pain," said Adrian James-Morse, IT coordinator for Dr Masterton's Surgery in Streatham.
Patients can be grouped by the NHS — for example, if they need a flu jab — and then sent a bulk message. Each text costs 6p per patient.
"Compared with the traditional way of printing out letters — which is labour and resource intensive, and costs approximately £1 per patient — with texts, all of a sudden you have a fantastic business case," said Gockel.
Patients can also respond to the texts. The server converts the text messages to email, and these are sent to the healthcare site.