BIGTXt is a text messaging system comprised of a web based front end developed by University of Texas Biomedical Informatics Group (UTH-BIG) which interfaces with a third party SMS application (Twilio) for sending text messages to study recipients. The application is the brain child of Dr. Kevin Hwang from the UTHealth’s Medical School. With seed funding from Drs. Kevin Hwang, Sean Blackwell, and Belinda Reinginger, a pilot application was created to send and receive text messages. The pilot was launched in 2011, providing text message support to participants of a weight loss study. Since then the application has gone through a major rewrite to consolidate the database and improve on-going support. New features such as message scheduling, custom researcher defined data fields and message customization have been added.
Baylor College of Medicine Teen Health Clinic (BTHC) utilizes the BIG TXT system to disseminate health-related information to patients who have signed a consent. BTHC sends one text message per week regarding general health, reproductive health, and upcoming events to raise awareness among text message recipients. Currently, 712 patients are receiving texts. Feedback obtained from recipients suggests that patients appreciate the information shared especially if it pertains to their immediate neighborhoods. They feel that the texts are an extension of the BTHC and help in reinforcing health behaviors.
- Dr. Belinda Reininger – requested input
- Dr. Kevin Hwang – requested input
The BigTxt system employs a ‘multi-layer’ security process to ensure only authorized individuals have access to the system and that the data within the system is protected from misuse. As a first line of defense, any user attempting access to the BigTxt system must first access the university network. Secondly, the BigTxt system supports multiple instances; one instance per study. This configuration protects the confidentially of the data and ensures the instance is accessed only by staff authorized to work on the study. No cross instance authorization is permitted without the owner PI’s approval. The UT-BIG team works closely with the university’s IT Security Team to ensure BIGTXt is compliant with university’s IT security policy and HIPAA requirements.
Twilio, the third party SMS provider, uses Amazon’s Web Services (AWS) a highly scalable cloud computing platform. AWS employs processes ensuring compliance with Sarbanes Oxley (SOX) requirements, maintain certifications for Statement on Auditing Standards No. 70: Service Organizations Type II (SAS70 Type II), and meets the industry-specific requirements of Health Insurance Portability and Accountability Act (HIPAA).