The benefit of using read receipts in healthcare text messaging

The purpose of the read receipts feature in text messaging is to notify the sender when the recipient has read their message, confirming message delivery and acknowledgment. In healthcare, this feature benefits by ensuring timely communication between providers and patients.

What are read receipts?

Based on an RIT Digital Institutional Repository thesis on the uses of the read receipts feature, “Read receipts are a tool used by the mobile instant messaging applications to indicate the delivery of messages. This feature becomes one of the main features of mobile instant messaging applications, and it has an impact on people’s relationships and their attitudes.”

Read receipts are features in messaging apps and email services that notify the sender when the recipient has opened or read their message. When you send a message with read receipts enabled, the app monitors when the recipient opens the message and then sends back a confirmation to you. 

This confirmation usually appears as a small check mark or a "seen" notice near the message, indicating that the recipient has viewed it. 

How do read receipts work?

1. Activation: The sender must have read receipts enabled in their messaging or email application settings. The recipient's application must also support and not block the read receipts feature for it to work correctly.
2. Message sending: When you send a message, it is first transmitted over the internet from your device to the server that hosts the messaging service. The server then forwards this message to the recipient's device.
3. Message delivery: Upon reaching the recipient's device, the message is marked as delivered. Most services show a first checkmark or a similar indicator when the message is successfully delivered to the recipient's device.
4. Opening the message: When the recipient opens the message to read it, their device recognizes this action. 
5. Sending the read receipt: After the message is opened, the recipient's device sends a signal back to the server indicating that the message has been read. 
6. Notification to the sender: The server then updates the status of the message on the sender's device to show that the message has been read. 
7. Privacy options: Most modern messaging services allow users to choose whether or not to send read receipts. If a recipient has disabled read receipts, the sender will only see a delivery indication (such as a single checkmark) and will not be notified when the message is actually read.

See also: The guide to HIPAA compliant text messaging

The benefit of using read receipts in healthcare text messaging

When read receipts are activated, medical professionals can instantly verify when their messages are seen by their colleagues. This real-time confirmation is particularly helpful in urgent situations or when managing critical care, where quick and effective communication can directly influence patient outcomes. 

Knowing that a message has been read helps eliminate the uncertainty of whether information has been received, reducing the need for follow-up calls or additional messages and saving valuable time. This feature is also beneficial in coordinating complex care scenarios involving multiple team members. 

For instance, when a message about a patient's updated treatment plan is sent, read receipts ensure that all relevant parties, such as doctors, nurses, and specialists, are aware and have acknowledged the new information. This leads to more synchronized teamwork and can improve the efficiency and accuracy of patient care.

How can the read receipts feature be used in healthcare?

The read receipts feature assists healthcare organizations by providing: 

1. Timely follow-ups: With read receipts, healthcare providers can see whether their messages regarding patient care or medication instructions have been read. 
2. Coordination among care teams: In situations where multiple specialists are involved in a patient’s care, read receipts ensure that all parties are aware that important information has been received. 
3. Emergency situations: In emergencies, the ability to confirm that a message has been read can be crucial. For example, if a doctor sends urgent patient information to a nurse or another specialist, knowing the message has been seen helps streamline the next steps in patient care.
4. Scheduling and logistics: For operational messages, such as scheduling surgeries or tests, read receipts help administrative staff confirm that the recipient has seen the schedule change or request, aiding in efficient planning and resource allocation.
5. Verification of secure receipt: In secure messaging platforms that are HIPAA-compliant, read receipts also verify that the message has been received through secure channels.
   
   

Read receipts and privacy laws

HIPAA

When it comes to read receipts in healthcare messaging applications, these features can potentially reveal who accessed a patient’s information and exactly when it was accessed. This type of data could be classified as PHI because it provides indirect information about the patient's care and the personnel involved. This may create the requirement for compliance with HIPAA when using this feature. 

This might include:

• Ensuring encryption
• Limiting access
• Obtaining consent
• Audit controls
  
  

Electronic Communications Privacy Act (ECPA) 

Title I of the ECPA provides, “Title I of the ECPA, which is often referred to as the Wiretap Act, prohibits the intentional actual or attempted interception, use, disclosure, or "procure[ment] [of] any other person to intercept or endeavor to intercept any wire, oral, or electronic communication." Title I also prohibits the use of illegally obtained communications as evidence. 18 U.S.C. § 2515.”

The ECPA is primarily concerned with unauthorized access and the interception of communications as they are transmitted or stored. Read receipts in messaging apps or email systems can potentially fall under the scope of the ECPA because they involve the transmission of electronic signals indicating that a message has been read.

The application of the ECPA to read receipts could involve several considerations:

• Interception concerns: If a read receipt function entails any form of interception of communications (such as capturing the exact time a message was read without consent), it might raise issues under the ECPA.
• Consent: One of the key defenses against allegations of ECPA violations is the consent of the parties involved. Service providers must ensure that all parties in a communication exchange have agreed to the use of read receipts, preferably through clear disclosures and consent mechanisms.
• Storage: Since the ECPA also covers stored communications, the way read receipts are stored (e.g., time logs and recipient identifiers) needs to be secure against unauthorized access and breaches.
  
  

Why common text messaging services have inadequate security for healthcare

Text messaging typically provides inadequate security for healthcare communications because it does not incorporate essential security features needed to protect sensitive patient data. Standard text messaging services usually do not have secure encryption, meaning that the messages sent between healthcare providers are not encrypted from the point of sending to the point of reception. This lack of encryption makes it possible for unauthorized individuals to intercept and read the contents of a message as it travels through various network points, such as servers and routers.

Paubox read receipts 

Paubox Texting is a messaging service that provides HIPAA-compliant text messaging capabilities, allowing healthcare providers to send secure texts to patients' iPhone and Android devices. Initially launched at the ViVE 2024 Los Angeles conference, it offered the ability to send texts via API. 

Recently, Paubox Texting has added a read receipts feature, which enhances communication by confirming to the sender when a message has been read by the recipient. This feature is particularly important in healthcare as it ensures that sensitive information has been received and seen by the intended party, helping in maintaining effective and timely communication. 

The security of Paubox Texting, including its read receipts, protects patient data by adhering to HIPAA guidelines, which require that any electronic transmission of health information be secure to prevent unauthorized access. 

See also: Read receipts added to Paubox Texting

FAQs

Do read receipts work in group chats?

In many apps, read receipts in group chats show when each participant has read the message, often indicated by their profile picture or initials next to the read indicator.

Are read receipts available on all messaging platforms?

Not all messaging platforms support read receipts, and the availability can vary based on the app version or the device used.

Is it possible to read a message without sending a read receipt?

Some apps offer modes or settings (like turning on flight mode) that allow you to read messages without sending a read receipt, though this may not work consistently across all platforms.