Secure Texting for Healthcare — the Time Has Come

Physicians are every bit as mobile physically as smartphone-driven communications have become virtually. When your "office" on a given day might be a dozen patient rooms at a hospital or two clinics 20 miles apart, the temptation to ask nurses to boil down their message to 160 characters and send via standard text messaging services is tremendous.

Physicians at 17-bed Mammoth Hospital in Mammoth Lakes, Calif., were doing just that, says Greg Young, information security officer for the critical-access hospital, located near Yosemite National Park. A former chief of staff at the hospital described a tedious and time-consuming process to Mr. Young for responding to phone messages or pages: As there isn't a direct line to the medical-surgical department of the hospital, calls were routed through the switchboard, then to the right department, where the right nurse had to be tracked down. By then, the physician who initiated the call might have been interrupted by other matters.

Belinda Setters, MD, director of hospital services for the department of family and geriatric medicine at the University of Louisville, says residents and students reject the hoary old standby of earlier generations of physicians: pagers. "They already refuse to use the pager system unless there is absolutely no other means of communications available. They hate it," she says. "Texting and simpler means of communication are coming whether we as providers embrace them or not."

It's clear that something like texting is needed for quick, direct communications for hospitals and medical groups, but the problems are clear, too:

•    Standard text messaging using the common Short Message Service available on most phones is not secure. SMS does not comply with HIPAA.

•    Using SMS puts protected health information on a variety of SMS servers from all the different mobile operators that employees contract with, leaving the PHI completely out of the control of the hospital or group practice.

•    A hospital or group practice has no control over these personal devices and no way to audit compliance with privacy regulations.

•    When devices are lost, the hospital or group practice has no way to wipe PHI from the devices or lock them remotely.

It's a dilemma: Hospitals and physician groups must find a way to speed communications to ensure that decisions are made quickly for the patient's benefit and to make their workflow as efficient as possible, but without jeopardizing the safety of private patient information.

The only way to do that is with a secure, real-time mobile messaging system that complies with patient privacy standards and offers hospitals and physician groups enterprise-level control over the personal mobile devices that employees and physicians will default to using because they are always at hand.

The compliance aspects of this dilemma shouldn't be minimized – the Joint Commission has announced that using standard text messaging services is "not acceptable" and HIPAA audits conducted by HHS now include a review of an organization's mobile compliance — but the value of such a platform to a healthcare provider goes well beyond compliance.

Using antiquated communication devices such as pagers and fax machines contributes greatly to the $150 billion that healthcare organizations waste on administrative inefficiencies each year. Nurses waste an average of one hour each day tracking down physicians, according to research published by the Robert Wood Johnson Foundation.

The need from a workflow standpoint already has been demonstrated. Clinicians are using unsecure communications like standard texting when enterprises don't provide an appropriate channel — 73 percent of physicians acknowledge texting about their work, according to our company's research.

Nurses and physicians gain faster response times at every step in the process of caring for patients, making decision-making more efficient and timely and thereby reducing the cost of care. A secure communications platform also increases the accuracy of messages — 66 percent of sentinel events are linked to communications breakdowns, according to the Joint Commission.

Secure, real-time messaging can allow for greater communications than a phone call-based system in which physicians might choose to skip a consultation with a fellow physician in the interest of time, U of L's Dr. Setters says.

Reading the message right on a smartphone — 81% of physicians reported having a smartphone in a 2011 survey by Manhattan Research — also eliminates misunderstandings that can occur on a phone call, Dr. Setters says. For example, physicians are often in noisy environments, such as a crowded hospital unit or clinic setting or while outside walking between buildings on a medical complex. Another source of miscommunication can come from sharply accented English spoken by foreign physicians, she adds.

Secure, real-time mobile messaging that works across both smartphones and traditional computers – like those found at nursing stations — ensure that physicians and nurses can stay in touch despite the wide variety of devices they are using. A robust mobile messaging system for healthcare also should be able to connect to third-party systems, such as electronic health records. It should improve accountability, as users can see whether their message was received.

All of these improvements should help with a major strategic goal of executives running hospitals, health systems and physician group practices — boosting physician satisfaction.

Changes in the healthcare industry, such as the pressures of reform and the continuing weak economy, are putting a greater premium on doing more with less. A HIPAA-compliant, real-time communications platform — controlled by the enterprise itself — is one way to accomplish this.

Jeffrey Evans and Brad Brooks are co-founders of TigerText, Inc., based in Santa Monica, Calif., the leading provider of secure, real-time mobile messaging for healthcare enterprises

More Articles on HIPAA-Compliant Texting:

7 Ways to Secure Physician Text Messages
Text Message Use Among Providers Raise HIPAA Concerns
Study: Healthcare Organizations Slow to Integrate SMS Texting, Social Media

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