Do the benefits of medical text messaging outweigh the risks?
The first text message was sent in 1992. And most people, increasingly including doctors, have never looked back.
Many doctors, however, have been hesitant to text with patients given the maze of HIPAA regulations to worry about and the potential to violate patient privacy. Writing recently In a JAMA Viewpoint article, Brian Drolet, MD, an assistant professor in the department of plastic surgery and biomedical informatics at Vanderbilt University School of Medicine, says that while an increasing number of physicians are using text messaging to communicate with patients, it remains a delicate balancing act.
Still, he says “the efficiency and convenience of (text messaging) is undeniable, and it is easy to understand the popularity of texting . . . Text messaging has essentially replaced telephone calls for many people; and messaging and other forms of asynchronous, electronic communication will only become more prevalent as the tech-savvy millennial generation enters the health care workforce. Why should a clinician leave a meeting to take a phone call or ask a patient to come to clinic, when non-urgent questions can be answered electronically, in messages that can even include photographs and dialogue?”
At the same time, doctors are often reluctant to use text messaging as the relevant HIPAA rules can often be vague. But as Drolet sees it, “it is important to acknowledge that rules for this technology may be intentionally vague and even best left that way. Currently, the onus is on covered entities to maintain a reasonable standard of privacy and security. This means clinicians should remove, or at least limit, protected health information in electronic communication. Whenever protected health information must be transmitted, clinicians should utilize available features, such as message encryption and strong passwords, to maintain security.”
In the end, he says, “although the risk of breach with electronic communication exists, the benefits of (text messaging) for physician, staff, and patient communication are substantial.”