Personalized Information for Health Care Delivery

(ADViSE Trial)

Overseen By Nora A Metzger, BA MSW

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Mild cognitive impairment, dementia, psychotic disorder

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to enhance veterans' use of virtual care by providing them and their primary care doctors with better information about various types of medical appointments, such as virtual visits or phone calls. Surveys and interviews will gather veterans' and doctors' opinions on these appointment types. The study will also test personalized text messages to guide veterans in selecting the most suitable appointment type for their needs. Additionally, clinician coaching sessions will support healthcare providers. Veterans who have attended at least three primary care appointments in the past year and can receive text messages are ideal candidates for this trial. As an unphased trial, this study offers veterans the opportunity to help improve virtual care experiences for themselves and others.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this intervention is safe?

Research has shown that personalized text messages to patients are generally well-received. These messages securely share information and have been verified for safety. Studies suggest that with proper security measures, texting in healthcare is safe and effective. Although privacy concerns exist, following guidelines helps prevent issues, ensuring patients can receive these messages safely.

Specific safety data for clinician coaching sessions is not available. However, since coaching involves advice and guidance from healthcare providers, it is unlikely to pose significant safety risks. Overall, treatments in this study, such as secure text messaging and coaching, are considered safe based on current evidence. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to personalize patient care. Unlike standard treatments that often rely on generic approaches, this trial uses clinician coaching sessions and personalized text messages to engage patients directly. The personalized text messages are tailored from a curated library, providing timely support and information specific to each patient's needs. This approach aims to enhance patient outcomes by making the healthcare experience more interactive and responsive to individual preferences and conditions.

What evidence suggests that this trial's treatments could be effective for improving virtual care encounters for Veterans?

Research has shown that personalized text messages, one of the interventions in this trial, can improve patient health. For example, one study found that patients who received personalized messages responded more often (82.5% compared to 55.3%) and took their medication more regularly (89.4% compared to 67.8%). Another study found that 98.2% of patients liked receiving text messages, indicating strong interest. These results suggest that personalized text messages can effectively keep patients engaged in their health care, potentially leading to better overall health. ^{6 7 8 9 10}

Who Is on the Research Team?

Jeffrey T. Kullgren, MD MPH MS

Principal Investigator

VA Ann Arbor Healthcare System, Ann Arbor, MI

Are You a Good Fit for This Trial?

This trial is for Veterans and their Primary Care physicians (PCPs) who are interested in optimizing the use of virtual care encounters. It aims to provide personalized information to help decide between different types of primary care services based on individual needs and preferences.

Inclusion Criteria

I've had 3 or more doctor visits in the last year.

Willing and able to receive text messages from the VA Patient Engagement, Tracking, and Long-term Support (PETALS) platform

Able to provide informed consent

Exclusion Criteria

I do not have a diagnosis of mild cognitive impairment, dementia, or a psychotic disorder.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Control Period

Usual care is provided to participants to establish baseline measures

6 months

Intervention

Participants receive the optimized ADViSE intervention with interactive text messages and point-of-care information

6 months

Follow-up

Participants are monitored for changes in healthcare perceptions and outcomes post-intervention

4-8 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Clinician Coaching Sessions
• Personalized text messages to patients

Trial Overview The study tests an intervention called ADViSE, which includes sending personalized text messages to patients and providing coaching sessions for clinicians. The goal is to inform about the benefits and costs of various primary care modalities through surveys, interviews, and interactive messaging.

How Is the Trial Designed?

Group I: Receiving the optimized ADviSE Intervention Experimental Treatment 2 Interventions

6 months of selected text messages from a library developed and refined in previous study aims.

Group II: Control period Active Control 1 Intervention

Usual care.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7508315/

Towards an Effective Patient Health Engagement System ... The study suggests that cloud-based text messaging is a feasible low-cost and personalized patient engagement strategy.

2. researchgate.net researchgate.net/publication/390676056_Impact_of_Personalized_Healthcare_Messaging_on_Patient_Outcomes_and_Medical_Communication_Effectiveness

Impact of Personalized Healthcare Messaging on Patient ... The personalised message group had notably higher responses rates (82.5% vs. 55.3%), drug adherence (89.4% vs. 67.8%), and patient contentment ( ...

3. ahajournals.org ahajournals.org/doi/10.1161/CIRCULATIONAHA.116.021182

Text Messaging and Patient Engagement in an ... Patient adherence to medications improved after the SMS interventions, but the results were mixed in terms of other outcomes, including glycemic ...

4. journals.lww.com journals.lww.com/jaaosglobal/fulltext/2021/06000/evaluating_the_utility_of_using_text_messages_to.11.aspx

Evaluating the Utility of Using Text Messages to... A total of 3,032 texts were delivered. Engagement rates averaged 90%. Survey responses (n = 111) demonstrated that 98.2% of patients liked the text messages and ...

5. shmpublications.onlinelibrary.wiley.com shmpublications.onlinelibrary.wiley.com/doi/10.1002/jhm.13334?af=R

Patient engagement with an automated postdischarge text ... Response rate to individual texts decreased over time (Figure S2), going from 55% on Day 1 postdischarge, to 42% on Day 6, to 33% on Day 25. In ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6393161/

Evaluation of Secure Messaging Applications for a Health ... Due to security and privacy concerns, many hospital systems are evaluating secure text messaging applications. This paper highlights our evaluation process, and ...

7. norcal-group.com norcal-group.com/library/patient-safety-and-liability-risks-associated-with-texting-in-healthcare-case-studies-and-best-practices

Patient Safety and Liability Risks Associated with Texting in ... Text messages between members of the healthcare team and with patients can be used as evidence in malpractice litigation.

8. jointcommission.org jointcommission.org/en-us/knowledge-library/support-center/standards-interpretation/standards-faqs/000002483

Use of Secure Text Messaging for Patient Information and ... Therefore, CMS states that when certain conditions are met, organizations may choose to text patient care information and orders. While there is ...

9. rcmadocs.org rcmadocs.org/news-events/news/is-it-safe-to-send-that-text-the-patient-safety-and-liability-risks-associated-with-text-messaging.aspx

RCMA News & Information | Is It Safe to Send That Text ... Unsecure messaging platforms can result in HIPAA violations, and non-compliance with Centers for Medicare & Medicaid Services (CMS) and accrediting organization ...

10. hipaajournal.com hipaajournal.com/texting-violation-hipaa/

Is Texting in Violation of HIPAA? 2025 Update Even when a text message is sent by a HIPAA regulated entity via SMS, it is not a HIPAA violation if the content of the message does not contain ...