Text Messaging Featured Article
The Challenge of Text Messaging in Healthcare
There are more efficient communications methods than the pager, but for many healthcare providers, this is as cutting edge as their communications systems get for now.
This is a shame, because more than 60 percent of sentinel events (unanticipated events not related to a patient’s illness that result in death or serious injury) are the result of a breakdown in communication, according to a 2011 report by The Joint Commission.
One obvious way to cut down on communication issues is the user of text messaging. Text messaging can shorten response times, improve the accuracy of decision making by having better information, allow multiple parties involved with clinical decision making to be looped in on the same message and allow for quicker interventions and improve patient outcome.
Text messaging also can help communicate lab results, imaging results, patient procedures and medical histories, allowing the physician to have more information readily available. Further, text messaging could speed up on-call notifications, eliminate the hassle of callbacks and integrate with scheduling systems to create automatic notifications of pending events.
The problem is that text messaging is inherently non-secure and non-compliant with safety and privacy regulations under the Health Information Portability and Accountability Act (HIPAA), according to Andrew A. Brooks, MD, an orthopaedic surgeon and co-founder of a text messaging company for the healthcare industry.
“Messages containing electronic protected health information (ePHI) can be read by anyone, forwarded to anyone, remain unencrypted on telecommunication providers’ servers, and stay forever on sender’s and receiver’s phones,” he noted in an article for American Academy of Orthopaedic Surgeons.
“As a result,” he added, “The Joint Commission has effectively banned physicians from using traditional SMS for any communication that contains ePHI data or includes an order for a patient to a hospital or other healthcare setting.”
Not all text messaging is banned, however. It just must be secure before it can be used.
The Joint Commission has established Administrative Simplification Provisions (AS) that serve as guidelines for developing secure communication systems. Four criteria are necessary for healthcare providers to use text messaging.
According to the Joint Commission, texts must use secure data centers, they must have encryption both in transit and during rest, they must use recipient authentication, and there must be audit controls built in so an audit trail can be established.
So while text messaging is not exactly banned for healthcare workers, its viability certainly is curtailed.
Edited by Rachel Ramsey