Asthma UK has launched a WhatsApp chat service where people with asthma can get support from its team of nurses through the messaging service. The aim is to engage a younger audience who are at a higher risk of an asthma attack. Many younger people don’t like chatting on the phone – and using the Asthma UK helpline to get help – but they do like to message.
In this article Asthma UK’s clinical lead, Dr Andy Whittamore, explains how this has worked, the challenges they’ve faced, and how patients are benefiting from this new way of communicating
Technology is changing the way healthcare professionals and patients interact. Patients can book their appointments and order prescriptions online, doctors and nurses can signpost patients to websites where they can access health advice and watch videos to better-manage their conditions and, by the end of this year, all patients should be able to access their medical records online.
At Asthma UK we have also embraced technology to deliver a new WhatsApp chat service where people with the condition can get support and personalised health advice through messages from our respiratory nurses.
The ambition to create the new service stemmed from the knowledge that those under the age of 25 can be complacent about the seriousness of asthma and, therefore, at greater risk of having an asthma attack. Young people also wanted a different way to communicate with health services.
Online engagement
While our telephone helpline receives more than 6,000 calls every year from people with asthma, only 4% are under the age of 25. How could we reach this group of people more effectively? We read that people in this age group prefer interacting through text messages rather than over the phone. We needed to use a channel that was convenient and familiar to this age group and, as WhatsApp is used by 80% of people under 25, it was the obvious choice.
The Bupa UK Foundation supported us with a grant to pilot a WhatsApp chat service. Our first priority was to ensure that our information governance was robust. To protect our service users’ privacy, we offered an anonymous service and did not retain anyone’s personal information. We then set about training our team of 10 respiratory nurses.
We quickly found that communicating through a messaging service was very different to offering advice over the phone. While a call might last 20 minutes, WhatsApp conversations could span a number of hours – or even days. We managed the WhatsApp service by reallocating staff from our telephone helpline. To ensure we were handing over to each other effectively, and that the people we spoke to were triaged, we developed ways of communicating with each other using text and emojis.
We discovered that, when we spoke to people over the phone, we could sometimes tell by their breathing that they were having an asthma attack and urge them to get emergency help; we didn’t have this cue through WhatsApp so we had to put new safety nets in place! We used automated messages to remind people of the signs of an asthma attack and when they should get urgent medical help.
On the phone, someone might say something in passing that we could offer them additional information on; for example, they might mention that pollen is one of their asthma triggers. Using WhatsApp, people expected us just to answer the specific question they had asked; so we adapted, using clever questions to help unpick the deeper needs of the person with asthma and give them the right, targeted advice.
Our communication style changed too. The WhatsApp messages we received from people with asthma contained short phrases and we had to mirror this style in our answers, otherwise we found that people would disconnect.
We also shared visual infographics on topics such as ‘What to do in an asthma attack’ with the people who use our service, which has been very popular. Infographics are better at relaying advice than step-by-step, written instructions and can be stored on someone’s mobile ‘phone and referred to whenever they want – even in an emergency. Some people have told us they have gone on to share the infographics with their family and friends.
Ongoing improvement
We have learnt a huge amount from running this pilot service. It has now been running for just over a year and we have had more than 2,400 conversations. A quarter of those have been from people under the age of 25 – the high-risk group we wanted to reach – and more than nine-in-10 of our customers were satisfied with the service. We are now planning to scale up the service to help even more people with asthma.
Our WhatsApp chat service is proof that embracing technology, and using popular platforms, can help us engage with younger or harder-to-reach audiences. It requires adapting your approach to delivering care, an acknowledgement of the barriers and advantages of technology, persistence and team work.
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