StartUp Health company Sense Health, which makes text messaging software for Medicaid care managers, has completed a randomized controlled trial. The results are still forthcoming, but CEO Stan Berkow shared a few with MobiHealthNews.

Care managers are social workers or registered nurses assigned by Medicaid or other healthcare stakeholders to work closely with the highest-cost patients. Sense Health uses pre-scripted but customizable text messaging to help overloaded care managers work with a large number of patients, while still making those patients feel they're getting individual attention. Sense Health sends out educational and motivational content as well as specific appointment and medication reminders and check-in messages to solicit patient feedback.

"One of the big problems we're seeing in the space is there are too few care managers and far too many patients that are in need of their support," Berkow said. "So we built a technology platform that's really designed to leverage the care manager, to reach much larger numbers of patients and extend to them the relevant educational, motivational, reminder-based support they need to become more active and engaged with their health."

In the pilot, sponsored by Pilot Health Tech NYC, Sense Health worked with University Behavioral Associates at Montefiore Medical Center in New York City. 

"We wanted to see if there was actually improvement in people attending appointments and taking medication more, or are they more confident [in their health management] and knowledgeable [about their health]?" Berkow said. "And a lot of these things key into 'are we enabling their activation as a patient?' Because that's been a metric that's been really tightly linked to reducing costs in the long run. The other side to the trial was on the provider side, understanding does integrating a system like ours into the workflow of a care manager ultimately make their providing of services easier to their clients or does it become more of a burden?"

The study found that 90 percent of patients said they were extremely interested in using the technology to keep tracking health plan goals and appointments, and over 90 percent of care managers said Sense Health made it "usually or almost always" easier to support their clients.

Patient feedback suggested that the motivational messages especially were very effective in patients with comorbid depression, who make up a sizable part of the managed care population.

"One of the things that we found that's somewhat surprising to us is how well received the motivational messages have been within the population that we're working with. They can come off as super corny, when you're reading them in isolation. But when you see how the patient interacts with them and how they make them feel in that moment, it's profound how a simple quote sent at the right time can help someone get out of the house in the morning."

Berkow said Sense Health has signed one full customer and has completed two pilots and is in the process of talking to those groups about becoming full customers. He said what makes them stand out is that the system facilitates more efficient communication, but that communication still ultimately comes from a person.

"The big difference between what we do and some of the other people out there is we're really focused on building this platform that's effectively creating a conversation between the provider and the patient," he said. "When people realize they're speaking to an automated system and just sort of getting automated reminders and what not, they tend to stop listening to that and ignore you."