Providers can tailor HIPAA compliant text messages to help diabetic patients manage their condition, reducing the likelihood of complications like amputations and improving the overall quality of life.

Amputation risks in patients with diabetes

"Patients with diabetes… are at increased risk of foot complications, which may eventually result in lower extremity amputations, resulting in the loss of parts of toes, feet or even legs,” explains a study on routine foot checks in patients with diabetes on hemodialysis.

Why are diabetic patients at risk?

• Nerve damage: Diabetes can damage nerves in the feet, reducing sensation and making it harder to feel injuries.
• Poor circulation: Dialysis can affect blood flow, making it harder for wounds to heal.
• Immune system compromise: Diabetes and chronic kidney disease can weaken the immune system, making it harder to fight infections that could lead to foot ulcers.

A comprehensive review of the vascular consequences of diabetes in the lower extremities states, “When infection and tissue death progress unchecked, amputation may be the only option to save the individual's life. [Therefore,] amputations significantly impact a person's mobility, independence, and overall quality of life.”

Preventing diabetes-related amputations 

The review suggests the following interventions to prevent amputations:

• “Foot examinations
• Vascular assessments
• Neurological assessments
• Regular self-examinations
• Lifestyle modifications (like exercise and physical activity)
• Pharmacological interventions”

How can HIPAA compliant texting help?

HIPAA compliant text messaging is a convenient and engaging way to improve patient participation in their foot care routine. Providers can incorporate these interventions into the texts, helping patients reduce the risk of developing complications that could lead to amputation and ultimately help improve their quality of life.

Read also: Improve patient engagement with HIPAA compliant text messages

Using HIPAA compliant text messages

Foot examinations

Appointment reminders: Providers can use HIPAA compliant text messages to remind patients of their regular foot checks, for early detection and intervention, if needed.

Pre-exam reminders: Providers can also send pre-appointment texts reminding patients to remove nail polish or bring a list of any foot concerns they might have, allowing the provider to address issues effectively.

Vascular assessments

Educational messages: HIPAA compliant text messages can explain the importance of vascular assessments and what they entail, promoting patient understanding.

Post-assessment follow-up: After a vascular assessment, providers can text patients with activity restrictions or compression stocking recommendations.

Neurological assessments

Self-care education: Providers can use HIPAA compliant texts to provide instructions on simple neuropathy self-assessment techniques, allowing patients to monitor their sensations at home. If patients observe any changes, they can then text their provider for clarification and timely interventions like scheduling an in-person visit.

Regular self-examinations

Daily/weekly reminders: HIPAA compliant educational text messages can deliver bite-sized information on daily foot care routines, like proper inspection and cleaning. For example, providers can send instructions on how to do a thorough foot inspection, checking for any breaks in the skin, swelling, or discoloration, helping patients take charge of their foot health, and identifying any potential problems early on.

Photo instructions: HIPAA compliant texts can include pictures with instructions to guide patients on proper foot examination techniques, ensuring they inspect all areas thoroughly.

Lifestyle modifications

Motivational messages: Providers can use HIPAA compliant texts to send encouraging messages with diabetes-friendly exercises to promote physical activity, helping patients stay on track with their lifestyle goals. Additionally, texts can include secure links to additional resources, like healthy recipes and educational articles, to further support patients in managing their diabetes and making informed decisions about their health.

Pharmacological interventions

Medication reminders: Providers can send medication reminders, helping patients adhere to treatment plans, leading to better health outcomes.

Refill reminders: Providers can also send refill medication reminders, helping prevent treatment gaps that could compromise patient health.

FAQs

Can providers use text messages to send medical advice?

Yes, providers can text medical advice as long as they use a HIPAA compliant platform, like Paubox, and the patient has consented to receive such information.

Go deeper: A HIPAA consent form template that's easy to share

Do patients need to consent to receive text messages?

Yes, patients must give explicit consent to receive text messages that may contain protected health information (PHI).

Are encrypted text messages automatically HIPAA compliant?

No, while encryption is necessary, it is not sufficient alone. Providers must use a HIPAA compliant text messaging platform, like Paubox, which offers encryption, secure user authentication, and a business associate agreement (BAA).