The amount of resources you have available and the level of customization necessary for your text messaging intervention will determine how you approach the SMS system set up and the storage of your data. The main decisions will be your choice of 1) text messaging application, 2) SMS gateway, and 3) hosting locations for the software and data necessary for your system. Many vendors can provide all of the components, often acting as a reseller and providing professional development and support services.
Participant data and message content may be stored, or hosted, either in a vendor’s database or cloud, or in an internal database. The advantages of storing information with a vendor are minimal effort and cost for initial set up, and less required database integration capability. However, vendors usually charge service fees, and their systems may not meet your security requirement, so care must be taken to ensure that protected health information is only stored on a secure server. Hosting messages internally requires more database capability and initial set up, but service fees are lower and the system has more flexibility and control over the security.
Options for SMS platforms include off-the-shelf applications for simple text messaging interventions, customizable existing platforms for somewhat complex interventions, and completely customized systems for interventions requiring sophisticated integration with other health information technology systems such as electronic health records. In this section we describe several common system solutions categorized into three levels of customization.
- none to minimal customization,
- moderate customization, and
- advanced customization.