Using regular SMS for patient communication presents significant risks like security vulnerabilities due to lack of encryption, privacy concerns from potential misdelivery or unauthorized access via lost or stolen phones, and the potential for miscommunication due to character limits and lack of context. These risks can lead to privacy violations, legal repercussions, and negative health outcomes, making it challenging to maintain HIPAA compliance. Secure messaging platforms and clear communication guidelines help mitigate these risks and protect patient information.
The inherent risks of using regular SMS for patient communication
Security vulnerabilities
Regular SMS messages travel unencrypted across networks, making them highly vulnerable to being intercepted by hackers or unauthorized personnel. That is particularly concerning when messages contain protected health information (PHI) such as test results, medication details, or diagnoses. The lack of encryption means that any intercepted message can easily be read and misused, leading to significant security breaches.
Privacy concerns
A recent study, titled Human Factors in Electronic Health Records Cybersecurity Breach: An Exploratory Analysis, found that most data breaches in healthcare are caused by human error. Sending messages to the wrong recipient due to human error or typos is a privacy risk. That can inadvertently expose someone else's health information, violating patient privacy and potentially causing distress. Additionally, if a patient's phone is lost or stolen, anyone accessing it can view their medical information in SMS threads. This lack of control over who accesses the messages further heightens the risk of privacy breaches.
Miscommunication and incomplete information
SMS messages have a character limit, making it challenging to convey complex medical information accurately. Important nuances and details might be omitted due to the brevity required by the character limit. Moreover, SMS threads often lack a clear context for medical discussions, leading to misunderstandings and misinterpretations. Patients might not have the full background to understand the message, which can negatively impact their care.
Related: Is SMS messaging HIPAA compliant?
Potential consequences of SMS risks
- Privacy violations: These can have severe consequences for patients and healthcare providers. Unauthorized disclosure of PHI can result in emotional distress for patients and damage their trust in the healthcare system. For healthcare providers, privacy breaches can lead to significant legal and regulatory repercussions, including hefty fines and damage to their reputations.
- Negative health outcomes: Miscommunication due to incomplete or misunderstood SMS messages can lead to negative health outcomes. For instance, a patient might misinterpret a medication dosage instruction or miss a critical follow-up appointment, adversely affecting their health.
How to mitigate the risks of using regular SMS
Use secure messaging platforms
Healthcare providers should use HIPAA compliant text messaging platforms with encryption and other security features to mitigate these risks. These platforms ensure that PHI remains protected during transmission, significantly reducing the risk of interception and unauthorized access. When choosing a secure platform, look for features such as encryption, secure login, and audit trails.
Obtain explicit patient consent
Obtain explicit patient consent before initiating text communication, especially when PHI is involved. The consent should clearly outline the risks of texting health information, such as potential privacy breaches. Documenting patient consent effectively ensures that both parties understand and accept the risks involved.
Limit the use of SMS for non-sensitive information
Healthcare providers should limit the use of SMS for non-sensitive information only. For example, appointment reminders or general wellness tips can be safely communicated via SMS, whereas detailed medical information should be conveyed through more secure channels like HIPAA compliant email. Establish clear guidelines on what can be communicated via SMS to avoid accidental breaches.
Provide clear communication guidelines
Establish best practices for text messaging within the healthcare organization. Train staff on secure communication practices and ensure they understand the importance of using secure messaging platforms. Providing clear communication guidelines helps maintain consistency and reduces the risk of privacy violations.
Regular risk assessments and audits
Ongoing monitoring and regular risk assessments help maintain secure communication practices. Conduct regular audits to identify potential vulnerabilities and areas for improvement. Implementing corrective actions based on audit findings ensures continuous enhancement of communication security.
FAQs
What should I do if a patient initiates a text conversation about their health?
You can respond to the patient's text but inform them about the security limitations of regular SMS and suggest switching to a secure communication platform.
How can healthcare providers document patient consent for SMS communication?
Healthcare providers can use consent forms that clearly outline the risks of SMS communication, which patients can sign either physically or electronically to give their informed consent.
What should be included in an SMS communication policy for healthcare staff?
An SMS communication policy should have guidelines on what information can be sent, patient consent requirements, procedures for handling potential breaches, and instructions for using secure messaging platforms.
Liyanda Tembani
