Resident Use of Text Messaging for Patient Care: Ease of Use or Breach of Privacy?

Prochaska, Micah T.; Bird, Amber-Nicole; Chadaga, Amar R.; Arora, Vineet M.

doi:10.2196/medinform.4797

Cited by 28 publications

(25 citation statements)

References 9 publications

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“…2,4,5 Many clinical staff prefer text messages over other communication methods such as e-mail and paging. 6 The mobility of SMS communication, 7 better integration into workflow, 8 ability to communicate more clearly and efficiently, 8 ease of use, 6 perception of improved efficiency and communication with other clinical staff, 6,7,9 and actual improved workflow efficiency 10 are commonly cited reasons for the popularity of SMS in clinical care.…”

Section: Background and Significancementioning

confidence: 99%

“…2,5,12 In the routine delivery of patient care, ePHI such as initials, patient names, room, and medical record numbers are commonly included in such text messages. 4,6,12,13 Accidental or unintended disclosure of ePHI through insecure text messaging located on portable devices puts health care organizations at risk for monetary penalties in addition to the direct risk to patient privacy. 12 Although there have not been any reported HIPAA breaches due to insecure SMS to date, many cases of lost or stolen devices have resulted in breach notifications and corrective action plans from the Office for Civil Rights.…”

Section: Background and Significancementioning

confidence: 99%

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Evaluation of Secure Messaging Applications for a Health Care System: A Case Study

et al. 2019

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Objective The use of text messaging in clinical care has become ubiquitous. Due to security and privacy concerns, many hospital systems are evaluating secure text messaging applications. This paper highlights our evaluation process, and offers an overview of secure messaging functionalities, as well as a framework for how to evaluate such applications. Methods Application functionalities were gathered through literature review, Web sites, speaking with representatives, demonstrations, and use cases. Based on similar levels of functionalities, vendors were grouped into three tiers. Essential and secondary functionalities for our health system were defined to help narrow our vendor choices. Results We stratified 19 secure messaging vendors into three tiers: basic secure communication, secure communication within an existing clinical application, and dedicated communication and collaboration systems. Our essential requirements revolved around functionalities to enhance security and communication, while advanced functionalities were mostly considered secondary. We then narrowed our list of 19 vendors to four, then created clinical use cases to rank the final vendors. Discussion When evaluating a secure messaging application, numerous factors must be considered in parallel. These include: what clinical processes to improve, archiving text messages, mobile device management, bring your own device policy, and Wi-Fi architecture. Conclusion Secure messaging applications provide a Health Insurance Portability and Accountability Act (HIPAA) compliant communication platform, and also include functionality to improve clinical collaboration and workflow. We hope that our evaluation framework can be used by other health systems to find a secure messaging application that meets their needs.

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Section: Background and Significancementioning

confidence: 99%

Section: Background and Significancementioning

confidence: 99%

Evaluation of Secure Messaging Applications for a Health Care System: A Case Study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Respondents identified SMS text messaging as their preferred method of communication despite the security concerns because of the perceived benefit in coordination and delivery of care. 4 Requiring users to download and use a new application can be a considerable barrier to deter widespread and sustained adoption. Additionally, the secure messaging platform was not integrated within the current electronic medical record system, and had to be introduced to well-established workflows, further burdening providers.…”

Section: Discussionmentioning

confidence: 99%

“…3 As a result of this, there is increasing concern about communicating sensitive patient information within the confines of the Health Insurance and Portability Accountability Act (HIPAA) and recommendations laid out by the Joint Commission. 1,4 As Drolet et al explain-HIPAA is technologically agnostic and does not specifically comment on communication through text messaging platforms. Instead, the Joint Commission has made attempts to identify guidelines for "secure text messaging" that allows for the communication of sensitive patient information through an encrypted platform (notably, texting physician orders is prohibited).…”

Section: Background and Significancementioning

confidence: 99%

A Bottom-Up Approach to Encouraging Sustained User Adoption of a Secure Text Messaging Application

Kalra¹,

Sevilla

Cho

2019

Appl Clin Inform

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Background Inpatient providers are increasingly utilizing alternative communication modalities outside what has traditionally been used, including short messaging service text messaging and application-based chat tools. Text messaging that meets the recommendations of the Joint Commission (“secure text messaging”) allows for the communication of sensitive patient information through an encrypted platform. Objective In this quality initiative utilizing the Plan-Do-Study-Act (PDSA) model, we attempted two rollout designs to maximize user adoption of a secure text messaging application. Methods Our institution launched a secure text messaging application (Cureatr) using a top-down approach during the first PDSA cycle, defined as communication and outreach through department chairs and administrative leaders throughout the hospital. After inadequate user adoption, we transitioned to a bottom-up approach in the second PDSA cycle, defined as direct communication and engagement with end users. This campaign targeted the hospital medicine and inpatient social work department, and used discharge planning as a use case to encourage adoption. Results Over a 6-month period, we observed an increase in active users in the hospital medicine department (7.5 unique users per month to 29 users during the first and second PDSA cycles, p < 0.01). Additionally, we saw an increase in messages sent and received by the medicine (687 messages on average per month and 7,367 messages per month in each respective PDSA cycle, p < 0.01) and social work departments (350 messages on average per month and 6,083 messages during the first and second PDSA cycle, p < 0.01). We did not observe a significant change in active users or messages sent in the surgery department, which did not participate in the second PDSA cycle. Conclusion We believe that a bottom-up approach is important to introducing mobile applications to the inpatient setting and can contribute to sustained user adoption.

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“…Physicians and nurses are using short messaging services (SMS) to communicate patient information and smartphones have been reported to increase the connectedness of medical trainees' with their supervisors. [7][8][9] Smartphones are also improving communication between providers and patients. The use of videos on personal devices has been reported to be an efficient and effective way to educate patients on their disease that resulted in increased medication compliance and physicians are using smartphones to monitor patients remotely.…”

Section: Introductionmentioning

confidence: 99%

Use of Personal Devices in Healthcare: Guidelines From A Roundtable Discussion

Vearrier¹,

Rosenberger²,

Weber³

2018

JournalMTM

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Background: In recent years, smartphone use in professional settings has been increasing, particularly with physicians. There are benefits and drawbacks that result from this increase. Despite this, there is relatively limited peer-reviewed medical literature on the subject. Thus, suitable guidelines for smartphone use in the health care setting is needed. Aims: This article present guidelines for professional conduct related to the use of personal devices, such as smartphones, in the healthcare setting. Methods: These guidelines were developed through an interdisciplinary roundtable discussion at the 2016 Academy for Professionalism in Health Care Conference in Philadelphia, PA. Results: As a result of the roundtable discussions, several guidelines were developed. First, healthcare providers should be trained on the danger of distractions caused by personal devices and how to minimize them in a clinical setting. Second, the use of smartphones for personal use should be limited to specified use areas; however, if they are present during a patient encounter, they should be set to a mode that eliminates or minimizes interruptions. Third, providers should seek permission from patients prior to integrating smartphones into the provider-patient relationship. Finally, smartphone photography, while being a potential tool to improve patient care, should be used with caution concerning patient autonomy and privacy. Conclusion: The guidelines serve as a foundation from which professionalism with regard to personal device use can be further developed.

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Resident Use of Text Messaging for Patient Care: Ease of Use or Breach of Privacy?

Cited by 28 publications

References 9 publications

Evaluation of Secure Messaging Applications for a Health Care System: A Case Study

Evaluation of Secure Messaging Applications for a Health Care System: A Case Study

A Bottom-Up Approach to Encouraging Sustained User Adoption of a Secure Text Messaging Application

Use of Personal Devices in Healthcare: Guidelines From A Roundtable Discussion

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