If you’ve had a colonoscopy, you might not have fond memories. If you’ve never had one, you’re probably not looking forward to it. And yet, a colonoscopy is a powerful tool for the prevention and early diagnosis of colorectal cancer, the third-leading cause of cancer-related death among Americans.
Many fear the colonoscopy preparation
Much of the worry surrounding a colonoscopy centers on the preparation or “prep,” a series of time-sensitive steps and dietary changes in the days leading up to the procedure. The preparation ensures that the bowels are clear during the examination, but it’s not uncommon for patients to forget a step or misunderstand an instruction. In some cases, patients choose not to show up for their procedure.
“Colonoscopy preps aren’t the easiest thing to do, even with instructions. It’s unfortunate because if the prep is inadequate, we often have to abort the colonoscopy or not even start, which means the patient has to reschedule and do the prep all over again,” says Jennifer Nayor, MD, a gastroenterologist in the Division of Gastroenterology, Hepatology and Endoscopy at Brigham and Women’s Hospital.
A mobile-based colonoscopy prep guide
The Endoscopy Center at the Brigham is using technology to make that less likely to occur. They are using a texting tool, developed by a company called Medumo, to provide patients with a digital colonoscopy prep guide in advance of their procedure.
At predetermined intervals, patients receive automated instructions and reminders via text message explaining what steps they need to complete at that time. These include timely notifications about when to stop eating solid food or when to consume the laxative prep solution. On the day of their procedure, patients also receive a text with directions to the Endoscopy Center.
The technology dramatically improves bowel preparation
Prior to implementing the mobile technology, 11.5 percent of patients had inadequate prep quality within a three-month period. After this period, that fell to 3.8 percent. In addition, the no-show rate dropped from 6.1 percent to 4.3 percent.
“I anticipated that we would see an improvement, but these results were beyond what I expected, and it continues to be successful. The feedback has also been very positive from patients. They like the idea that we’re helping them through this,” says Dr. Nayor.
Patients praise the new text message system
Patients who participated in the three-month intervention rated their satisfaction with the digital reminders highly, 9.07 on a scale of one to 10. “I felt like someone cared,” noted one patient in a feedback form. Another wrote, “I really love the reminders. I don’t think I could go through the process without the instructions program.” One participant praised the clear, step-by-step instructions and real-time reminders via text message as a “great system that makes the patient feel cared for.”
“Innovative projects such as this help ensure we’re doing everything we can to optimally prepare patients for their procedures,” says Beth McDonald, MBA, RN, executive director of Surgical and Procedural Services. “It’s not only about using our resources efficiently. It’s just as important that we provide the best possible experience for our patients and staff.”