In addition to why and how an organization might set up texting reminders, we're often asked about the cost. In tight economic times, this is a significant concern for many organizations. Can the cost of text messaging reminders ultimately save your organization time and money? Here's some information to help you decide.

What does implementing and maintaining texting reminders cost?

There isn't one answer when it comes to the cost of setting up text-messaging appointment reminders––it depends on what program you use and who is involved. As Whitman-Walker Clinic'sExit Disclaimer Director of Medical Adherence, Justin Goforth, told us (and as we discussed in our post on how to use text messaging ), if you're encouraging your clients to use free online appointment reminders, the cost is really the staffs' time to learn the program and show it to your clients. But if you are planning to use texting as part of your appointment reminder system, you may want to consider using software that integrates the reminders with your clients' medical records and ensures that texts are delivered and kept private.

So how much does the software/interface cost? There are some companies that work with local non-profit agencies for free or reduced costs such as IntelecareExit Disclaimer. Other companies charge varying amounts - Patient Prompts' ROI CalculatorExit Disclaimer shows a cost per reminder of about 20 cents, depending on patient volume. Dr. TxtExit Disclaimer advertises its system at $199 a month.*

Note: Your clients' mobile service providers may charge to send and/or receive text messages. The costs vary from service to service -- some plans charge ¢25/text while others charge $5/month for unlimited texts. When you ask for your clients' consent to send them text messages (we'll talk more about privacy next week), it is a good idea to ask your clients how they want you to communicate with them and, if they prefer text message reminders, that regular text messaging rates will apply.

What are ways to help reduce the costs of using text messaging for reminders?

Here are a few things you might want to consider:

• Could you start by running a pilot program? Instead of starting with a full-scale clinic or agency-wide program, consider text messaging for one program or aspect of your work. Dr. Nadia Dowshen and Dr. Robert Garofalo of Children's Memorial HospitalExit Disclaimer in Chicago told us their planned pilot adolescent HIV medication adherence study was eligible for free services from their vendors, and they plan to scale up later as part of a nationwide clinical study.
• Are there partnerships you can form? You may share a similar funding source with other clinics, and your funder may be in a better position to purchase software for you as a group. Some vendors may also offer a group rate.
• What are some other possible ways to use text messaging reminder systems? If you're thinking of purchasing a system for a particular purpose or program, think about additional ways you might use it - and get the most for your money. Nadia mentioned that the drop-in clinic they work with, Howard Brown's Broadway Youth CenterExit Disclaimer, plans to use the texting software (with their vendor's knowledge) to schedule text reminders for clients with a positive Chlamydia test to come in to be re-tested in three months. Check out 101 Thing To Do With A Mobile Phone In HealthcareExit Disclaimer for more ideas and resources.

What's up next?

We'll conclude our texting series next week with a focus on privacy. In the meantime, what do you think? Do the benefits outweigh the costs? Do text messaging appointment and medication reminders seem like a viable solution for your needs? And if you haven't had a chance to read Text Messaging for HIV Appointment and Medication Reminders - Part I (why use text messaging reminders) or Part II (how they work), we hope you will take a look and let us know what you think.

* As HIV.gov, we do not endorse any particular vendor or product. These are simply some of the many options!