Although MPOTA was associated with substantially higher patient engagement levels compared to unprompted patient reporting, neither demonstrated significant differences in hospitalizations or emergency room visits across engagement levels or between programs.
The text-based prompting system (MPOTA) achieved dramatically higher patient engagement rates than unprompted electronic medical record flowsheets (PEF).
Mean hospitalizations declined after program initiation in both groups, but the reduction was statistically significant only in the PEF group.
Mean emergency room visits did not significantly change in either the MPOTA or PEF group after program initiation.
Regression analyses found no significant association between engagement level and hospitalization or emergency room utilization.
The study was conducted among patients in the University of Michigan Advanced Heart Failure Program using two distinct remote monitoring modalities.
This research suggests that sending patients text message prompts to record their vital signs (weight, blood pressure, and pulse) dramatically increases how often they actually do so compared to leaving it up to patients to voluntarily enter data into an online health portal. Among nearly 900 patients with advanced heart failure, those receiving text prompts reported their vitals about 67% of the time on average, while those using the self-directed online portal did so only about 2% of the time. Despite this large difference in participation, the two approaches did not produce meaningfully different rates of hospital visits or emergency room use. Both groups showed small reductions in hospitalizations after joining their respective monitoring programs, but these reductions were modest and only reached statistical significance in the self-directed portal group. The text-messaging group showed a 21% decline in hospitalizations that did not reach statistical significance, possibly because the study did not have enough participants to reliably detect such an effect. Emergency room visits did not change significantly in either group, and the level of engagement (how often patients reported their vitals) was not linked to better or worse hospital outcomes in either program. This research suggests that mobile text-based communication is a promising tool for keeping heart failure patients engaged in remote monitoring, solving a longstanding problem of low participation. However, whether that improved engagement actually leads to better health outcomes — fewer hospitalizations or emergency visits — remains unclear and requires larger, more rigorous studies to determine. The findings highlight that getting patients to participate is only one piece of the puzzle; future research needs to examine whether consistent monitoring translates into meaningful clinical benefits.
Wu J, Chen J, Min L, Paul B, Keedy J, Ellimoottil C. (2026). Prompted Text-Based Vital Sign Recording Versus Unprompted Electronic Medical Record Entries in Patients With Advanced Heart Failure: Observational Study.. JMIR formative research. https://doi.org/10.2196/71641