How To Navigate the New Role of Text Messaging in Healthcare

The COVID-19 pandemic escalated the popularity of text messaging in healthcare facilities, becoming the “new normal.” It’s now recognized as an efficient and productive way to communicate with patients and exchange patient information between healthcare providers.

But, if not done correctly, medical text messaging between providers could violate CMS guidelines or HIPAA. CMS has not kept up with the times or updated its recommendations on text messaging in healthcare facilities since 2017. While CMS Conditions of Participation (CoPs) do allow some texting in healthcare on secure platforms, it forbids texting physician orders in any fashion. Instead, physician orders must be entered via a computerized provider order entry (CPOE).

Healthcare Text Messaging and the Patient Experience

The use of text messaging in healthcare has revolutionized the patient experience by improving efficiency in patient care and patient communications with healthcare providers.

By sending text messages to patients, healthcare facilities and physician’s offices are:

• Facilitating asynchronous communication with the physician and staff
• Reducing patient wait times in the physician’s office
• Texting appointment reminders to reduce no-shows

A 2021 survey by Medical Economics found that almost 80% of patients surveyed said they wanted to receive communication via text from their healthcare provider. The same survey also reported that 84% of respondents found automated communication automation as a faster and more efficient method of getting responses from their doctor’s office.

Medical Text Messaging Between Healthcare Providers

Texting between healthcare providers and hospitals has improved communications by:

• Decreasing “phone tag” between providers when communicating patient conditions or needs
• Improving hand-off communication between providers
• Accelerating clinical workflow between healthcare facilities and on-call physicians
• Reducing misdiagnosis and improving patient outcomes

Since text messaging is easy and convenient right from our personal cell phones, staff and physicians must understand that text messaging in healthcare is allowed but must be done via a secure messaging platform, including secure apps on personal mobile devices. Text messaging of physician orders is not allowed under any circumstances.

Significant risks exist if texting is not completed through a secure system. Unsecured messaging has the potential to allow electronic personal health information (ePHI) to be viewed or transmitted to incorrect individuals.

Risks can also include the following:

• There is no independent verification that information was received by the intended party.
• There is no timeline for viewing or responding to the message.
• Messages can easily be deleted by the end user.

HIPAA-compliant secure text messaging platforms feature restricted access, safeguards to prevent message tampering, and systems to make sure messages cannot be accessed by unauthorized individuals if a mobile device should be lost or stolen. These mechanisms protect ePHI and prevent its disclosure to unauthorized healthcare staff or others.

Text Messaging at Your Organization

Text messaging lies at our fingertips every day — a tempting tool when working in healthcare. Fortunately, text messaging in healthcare is allowed under the HIPAA Security Rule and CMS so long as healthcare staff members and physicians abide by specific guidelines.

The latest CMS memo summary regarding the use of text messaging in healthcare should be reviewed and incorporated into all healthcare organization policies and training.

Read the CMS memo here.

Want more information about healthcare communication? Read our recommendations for social media use best practices.

About The Author

Stacie Jenkins, RN, MSN, CPSO
Vice President of Patient Safety and Risk, LHA Trust Funds

Stacie Jenkins is a registered nurse with a master’s degree in nursing informatics. She has more than 20 years of experience in healthcare, working in patient care and quality/performance improvement positions. As the Vice President of Patient Safety & Risk at LHA Trust Funds, she works closely with hospital administrators, risk managers, and nursing staff to improve patient safety and establish best practices. She conducts on-site assessments and gives presentations designed to help clients address their patient safety risk management challenges.