According to a study authored by the University of Toronto in 2018, smartphones with their almost instant communication, has made texting popular in Canadian hospitals. Routine patient information being relayed by texting from surgeons to trainees was more likely than email or phone. And 72 per cent of surgeons felt texting enhances their patients’ care.
There can certainly be huge benefits — especially in a team-based care environment like a hospital — but also serious risks. A doctor in British Columbia was suspended and fined $20,000 a few years ago for texting a photo of a patient. Physicians need to ensure they’re avoiding privacy risks and negative perceptions while clearly communicating their messages.
Some important things to keep in mind include knowing and understanding the privacy legislation in your province or territory, guidelines from your Colleges, individual facility policies, and whether or not you use encryption for your device.
If you don’t have a secure network or encrypted device, here are some tips:
- Making sure group texts only include people in the patient’s circle of care
- Only use your contact list to avoid sending anything to the wrong recipient (and turn off auto fill)
- Use an instant messaging application that is secure and encrypts data on transfer (equally important for communications with your Canadian medical transcription service) and that follows Canadian privacy laws and regulations
- Avoiding sharing identifiable personal health information entirely
- Restrict text use to things like setting up appointments or phone calls
- If a message is ever sent to the wrong recipient, quickly manage it; notify them of the error and request they delete it. If necessary, report it to the appropriate federal or provincial privacy officer, as well as to your facility.
- Be able to delete sensitive information on your device if it is lost or stolen, and remote wipe your phone if you believe it is unrecoverable. Turn on these features before the device goes missing.
- Create policies and training on privacy requirements, and have all staff members sign a confidentiality agreement specifying their responsibilities in dealing with personal health information
There may also be a danger in miscommunication among doctors who use text messages. These messages can be considered evidence in legal proceedings or complaints to Colleges, and are subject to the same clear and professional communication standards as patient care records. The Canadian Medical Protective Association has outlined some issues and recommendations on electronic communication relating to patient care.
Tips for clear communication include:
- Using full words and avoiding most acronyms
- Avoiding text for complex circumstances in need of explanations
- Being wary of autocorrect on iPhones (which can be turned off); re-read all messages before sending
- Document (including screengrabs) any professional opinions given on clinical cases as you would in documenting a consult note or conversation via phone or email
- At least, summarize the text exchange and document the summary in the patient’s medical record. Some hospitals or facilities may have policies or protocols for documentation in these circumstances.
- Always assume the content of a text exchange is being deemed a consult
Aside from the obvious suggestion that you refrain from texting photos or anything unprofessional or inappropriate, the perception of professionalism is essential to maintaining a solid reputation as an individual health professional, clinic or facility.
Keep your language appropriate and your style professional on a medium that lends itself to the casual. Keep the phone in your pocket when dealing with patients, unless there is an emergency or you’re using it as a tool as part of a discussion.
As it is with texting, clarity is also critical for physician’s doctor dictation. Save time by taking advantage of dictation services for physicians, and only use a secure and trusted medical transcription service.
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