Do you text your patients?

Jules A, MSN · Aug 11, 2015

I have only given 3 parents or grandparents my cell number over the years due to complicated cases and the need to communicate often. I used to text with one grandmother but figured since she was willing to text and it was two way communication that consent was implied. Thankfully they never abused it.

I have never given my number to an adult patient and have no plans to in the future. My thought is the parents of sick kids might need and deserve a bit more hand holding than I'm willing to give adults who I expect to have more self reliance and the ability to contact my secretary if they have a question or message for me.

RiskManager · Aug 12, 2015

From a risk management and compliance perspective, I am generally not a fan of making or receiving patient texts containing clinical information. Texting them about appointment reminders or the like is fine. Texting does not appear in the chart, raising concerns about continuity of care and documentation, and unless you are using a secure texting service, HIPAA issues for texts containing PHI are a concern. TJC has taken a dim view of texting going back to late 2011 and continuing to the present: To Text or Not to Text? | Joint Commission

scottaprn · Aug 12, 2015

I swore I would never give my number out again after a patient drove me crazy for 2 years.

That said I gave it out 3weeks ago to a patient. It was an important situation and this patient has been very respectful.

So I am pretty wishy washy.

scottaprn · Aug 12, 2015

From a risk management and compliance perspective, I am generally not a fan of making or receiving patient texts containing clinical information. Texting them about appointment reminders or the like is fine. Texting does not appear in the chart, raising concerns about continuity of care and documentation, and unless you are using a secure texting service, HIPAA issues for texts containing PHI are a concern. TJC has taken a dim view of texting going back to late 2011 and continuing to the present: To Text or Not to Text? | Joint Commission

Joint commisions list of problems with texting from 2011 when they were first against it are all problems that are easily overcome. Now they have a blog post worrying about abbreviations in texting?

I can can name a few more pressing matters if they are interested.

Jules A, MSN · Aug 12, 2015

Joint commisions list of problems with texting from 2011 when they were first against it are all problems that are easily overcome. Now they have a blog post worrying about abbreviations in texting?
I can can name a few more pressing matters if they are interested.

Lol yeah.

Something Riskmanager mentioned that I do feel is worth noting is that any time I communicate with a patient whether on the phone or in the rare case via text I add a brief note in the chart for continuity of care.

PG2018 · Aug 12, 2015

I do not use my personal phone to communicate with patients. I'm even skeptical of giving out my work email to school nurses. My stance is if things get bad they can call 911, go to the ER, or if able walk-in to my shop. The therapists are notorious about contacting patients via personal cell. I cannot imagine getting texts from patients because they can't sleep or something. Ugh. I don't want to set limits or boundaries other than communicate with me through the office staff or the after hours call number that some therapist answers. They rotate or something...idk.

Trauma Columnist · Aug 12, 2015

Our practice uses Perfect Serve which has encrypted texting and is HIPAA compliant. We also have secure phone messaging...ie we use our personal cell phones to call pts but when it rings at their end, it shows the name of our practice and when they answer they here: "a provider from XYZ is trying to reach you, will you accept the call?"

Our pts love it!

Perfect Serve also allows us to send pictures to other providers and again its encrypted.

We love it.

allnurses Guide · Aug 12, 2015

I do give my cell phone number out at times and I do occasionally text message with patients under extenuating circumstances. I do transcribe any/all conversations into the medical record via a telephone encounter. I never text identifying information.

I have only once had a patient that abused it, I was direct with the patient about the action that would follow if the abuse continued, and it stopped.

I do find it helpful and time-saving for me and providing good care for the patient, most of the time

automotiveRN67 · Aug 12, 2015

Thanks for all of the responses. I use my cell phone every day to contact patients, and have never had one abuse it. My cell phone is on my card, so they already have it. I do tell them "If you have a question, and it is a reasonable time during the week, I will probably answer. But don't take that as a guarantee. At night, we share call, so use our main number if your question can't wait." Patients are always respectful.

I do text some of my most common patients, but not medical information. Only vague discussions. If it gets too detailed, I ask them to wait until I can call them. I will text things like "OK, called in your refill". Or "Got your message, I will call you when I get a chance."

sunnyharbor · Aug 13, 2015

I would be afraid of the first scenario and also possible HIPAA issues.

Jules A, MSN · Aug 13, 2015

I do text some of my most common patients, but not medical information. Only vague discussions. If it gets too detailed, I ask them to wait until I can call them. I will text things like "OK, called in your refill". Or "Got your message, I will call you when I get a chance."

No secretary to shield you from general questions or handle refill requests?