Evaluating Fax, Email and SMS Delivery of Alerts: Public Health REACH-Ing Healthcare

The effectiveness of public health (PH) emergency preparedness and response systems depends, in part, on the timely communication of essential PH messages to healthcare providers. Although much attention has been paid to the importance of communication of clinical data from healthcare providers to PH agencies for early event detection and the need for alerting providers of PH events, no studies to date have systematically identified the most effective methods for PH emergency and response communications between these partners. Currently PH relies on the following delivery mechanisms:  Internet, e-mail, telephone and broadcast fax. However, growth in cell phone use and Short Message Service (SMS) text-based messaging have increased the potential utility of SMS for communicating health information. Despite this potential, SMS is currently an uncommon mode of communication in emergency preparedness.

With CDC funding through the Preparedness and Emergency Response Research Center at the University of Washington's Northwest Center for Public Health Practice, the REACH (Rapid Emergency Alert Communication in Health) study is a randomized controlled trial that is evaluating and comparing the effectiveness of email, fax and SMS for sending PH alerts to healthcare providers—physicians, pharmacists, nurse practitioners, physician’s assistants, and veterinarians. The primary aim of this project is to determine the relative effectiveness of these different delivery mechanisms for communicating PH alerts to providers and compare their effectiveness in urban and rural communities. Providers are randomized into three message-type groups and a control group that receives no alerts. Phone interviews conducted 5-10 days after each alert evaluate the utility, timeliness, provider awareness of the message content, and perceived credibility of the message across the communication media. This presentation will describe our experience to date, approach and methodology used, including system design and protocols for delivery and tailoring of message format to delivery device.