Is It Safe to Send That Text? The Patient Safety and Liability Risks Associated withText Messaging. November 14, 2023 Health Information Technology (HIT), Physician Wellness, Practice Management, RCMA, Resources, Risk Management , Riverside County Community Physicians, ProAssurance, RCMA, RCMA Docs, Risk Management, Texting Safety 0 This informative article is provided by ProAssurance. Download Article Texting in a healthcare environment has risks and benefits. Among the benefits: texting is convenient, and it can enhance patient engagement and team communication. But the benefits must be weighed against patient safety and liability risks, which include: Failure to retain texts in patient records can disrupt continuity of care, violate record retention laws, and make it difficult for defendants to refresh their memories in malpractice lawsuits. “Textese” may be considered unprofessional or too casual for medical record documentation―texts can be accessed by plaintiffs in malpractice litigation through the legal discovery process. Autocorrection, typos, and text-typical abbreviations can result in misunderstanding. Brevity may be inappropriate when a situation calls for detail. Unsecure messaging platforms can result in HIPAA violations, and non-compliance with Centers for Medicare & Medicaid Services (CMS) and accrediting organization (e.g., The Joint Commission) requirements for secure text messaging. If something about patient care is important enough to be texted, it should be saved in the medical record and retained for the period required by law. Using a personal device that does not automatically load text messages into the patient record can result in gaps in the medical record that can be difficult to fill without access to the text messages in the phone. On the other hand, the content or tone of a text message may not be appropriate for a medical record, even though it may be considered protected health information (PHI). It is important to critically review any healthcare-related text message. Do not send it if it presents you in a poor light, is critical of a patient or colleague, or is not professional. Sometimes the brevity of texting that makes it convenient will make it inappropriate in a healthcare setting. When complex information needs to be discussed, opt for an in-person or telephone conversation as an alternative to text messaging. Ensuring the privacy and security of PHI in texts can be challenging because cellphones are easy to lose, are frequently stolen, and because they are often a personal device, users may not think of wiping stored text messages containing PHI when disposing of their phones. Messages on phones are also at risk for unauthorized access through eavesdropping and interception, and a sender can never be certain that a message sent in compliance with privacy and security practices will be viewed by the intended recipient. For these reasons, text messaging should be included in a covered entity’s risk analysis and security measures implementation required under HIPAA.* Administrators can create and enforce text messaging policies and protocols designed to improve patient safety and reduce professional liability. But ultimately, patient safety, liability risk reduction, and HIPAA compliance depends on the individuals doing the texting. When engaging in patient care and treatment, it is important to consistently weigh the risks and benefits of using text messaging as a mode of communication. *Greene AH. HIPAA Compliance for Clinician Texting. AHIMA website. https://library.ahima.org/doc. Published April 2012. Accessed February 14, 2023. The information provided in this article offers risk management strategies and resource links. Guidance and recommendations contained in this article are not intended to determine the standard of care, but are provided as risk management advice only. The ultimate judgment regarding the propriety of any method of care must be made by the healthcare professional. The information does not constitute a legal opinion, nor is it a substitute for legal advice. Legal inquiries about this topic should be directed to an attorney. Comments are closed.
