I text a lot. Sure, sometimes a phone conversation is the only way to go, like with a serious topic or close friend. But otherwise, texting is often easier than email and faster than phone for coordinating plans, updating the status of work events, or even touching base with family.
So I certainly understand when colleagues say that they often text about, or to, patients. I know that my colleagues are more burnt out, hurried, and frustrated than ever before in the history of medicine in the US. And I know that anything that seems like a shortcut is tempting. In fact, it’s more than tempting — it may feel like an imperative.
We’ve spoken pretty extensively about the penalties and punishments for texting about or with patients. Texting patient’s information is very rarely, and only in certain circumstances, compliant with HIPAA. But the more I've observed texting in action in medical contexts, and for use in healthcare collaboration, the more I've realized that the biggest problem with texting isn't even HIPAA...
Yes, despite the huge penalties for texting in ways that aren't HIPAA compliant, I believe that the biggest problem with texting is actually that it's failing our patients and putting us at risk for malpractice lawsuits. Let me explain...
Texting had its 25th anniversary this past December. Over those 25 years, we've become used to communicating via text, such that in some social circles, it's more polite to text than to call. So as healthcare providers, we naturally tend to want to text in a medical context, especially when we have a quick question for a colleague. More recently, like over the past 5 years, there's even been a shift from emails to texts, as it better fits our hyper-fast lifestyle.
The problem is that texting on behalf of, or to, our patients gives the illusion of adequate care coordination and collaboration, but simply does not deliver. So the biggest mistake you may be making when you text in a medical context is that you are shortchanging yourself and your patients.
Texting in a medical context, or for healthcare collaboration, is:
- Enmeshed with all of your personal communication.
When you text a colleague, those messages are in the same place as texts about your daughter's recital. The truth is that it becomes very difficult to be responsive and responsible when there is no separation between personal texts and medical texts. - Not archived.
If you text a colleague about a patient, you may get a quick answer now, but what happens in a day, week, year or decade when you need to refer to that message, either to inform care or to share the case with a colleague? - Not organized.
We feel that organization, structure and amplification are important components of true collaboration. It is not enough to yell “fire” in an movie theater. One most also show and help theater goers to the exits and prevent panic. Ultimately, texting doesn't allow messages about a case to be sequenced, organized, and accessible so busy providers can use the information well. - Not collaborative among multiple people on a team.
Texting is between two people, not among multiple members of a team. - Words only.
Secure texting is almost always just text -- not voice or videos -- because it becomes very difficult to keep that information secure in a text message. - Usually not HIPAA compliant.
In order to text in HIPAA compliant ways, you need to have the permission of the patient (if you are texting them), not using any PHI, not using the patient's first and last name in the text thread, etc. In other words -- if you're texting, you're probably not HIPAA compliant.
So what is a person to do, when texting is so convenient, but doesn't truly meet our needs as medical providers? You may have interesting ways of collaborating you'd like to share, but we're certainly passionate about iClickCare as a solution. iClickCare allows all of the ease and speed of texting, but in a way that allows the entire team to collaborate using chat-like messages, videos, and photos -- and that collaboration is organized, archived, and HIPAA secure.
What you do is too important to use tools that don't meet your needs. Demand more for yourself, and more for your patients.
If you're looking for ways to use your smartphone to do medical collaboration, but without all of the downsides of texting, download our free white paper on BYOD (Bring Your Own Device) Policies here:
