Italian researchers have shown that aftercare and patient communication might be improved if patients are asked to fill in daily questionnaires using WAP on their mobile phones.

The research, published in BioMed Central’s journal, found that a Wireless Health Outcomes Monitoring System (WHOMS) greatly increased the flow of information between cancer patients at the Istituto Nazionale Tumori of Milan and their doctors.

Windows-based WAP emulator running the questionnaire

After each subject was given an explanation of the technology, each day a text message was sent informing them of the survey and giving a link to a WAP site (emulated in the above picture) accessible through a standard GPRS connection. Users were then able to rate symptoms such as ‘Pain’, ‘Lack of energy’ and ‘Difficulty sleeping’ from ‘Not at all’ to ‘Very much’. The collected data for each patient was viewable by their doctor.

Over half (58%) of patients who were sent text and e-mail messages asking them to complete a simple weekly questionnaire about their symptoms responded and followed the instructions.

The study found that the reasons why the other 42% failed to fill in the questionnaire were mainly down to neophobia and unfamiliarity with the technology. Comments given to researchers include “I can’t understand these things” and “I’m afraid I’ll break it".

WAP was chosen because 82% of patients had compliant mobile phones, whereas only 37% had regular internet access. Interestingly, 27% of the people who filled the questionnaire in by WAP failed to give any answer to a question rating their ability to concentrate.

The researchers hope that if the system is developed to use more types of communication media, the take-up rate will be higher. Further studies are being planned into what health benefits the patients receive from WAP questionnaires and the kind of conditions that are most likely to be improved by the scheme.

The full report and research is distributed under an OpenAccess licence, meaning verbatim copying and redistribution is permitted for any purpose. For more details and to download the report, visit

A demonstration of both the WAP and the web version of the system can be sampled at

Mobile phones have been used before to improve patient-doctor communication. In  2002, Homerton Hospital introduced a text messaging appointment reminder system entitled “Meditext", designed to cut missed appointments by texting outpatients the day before they were due to visit the hospital.