Carolyn Buppert, MSN, JD


April 25, 2014

What About Texts?

Texts are problematic because they cannot be encrypted. E-mails can be encrypted, but not all e-mails are. Most smartphones aren't encrypted. Usually, no password is required to access data on a phone's SIM card or memory chip. Data flowing through wi-fi may be flowing through an unsecure network. And because the data transmitted through a smartphone are stored in the phone, it would be accessible to someone who stole the phone, or found it, if the owner lost control of the phone.

The Joint Commission has advised physicians against using text messages for information about patients, suggesting that they use mobile applications that incorporate message encryption.[1]

Verbal communication would seem to be the safest, in that there is no record of it on the phone. However, the communicators would need to be mindful of the setting, how voices carry, the identifiability of the information, whether the communication is necessary for treatment or operations purposes, and whether both parties need the information to care for the patient. Because there is no record of verbal communication, nurses need to remember to document verbal communications and actions in the medical record.

Facilities are responsible for establishing technological and administrative safeguards, including safeguards relating to use of smartphones. Such safeguards are addressed in an article by Catherine Barrett, titled "Healthcare Providers May Violate HIPAA by Using Mobile Devices to Communicate with Patients."[2]

At this time, it is risky to use a personal smartphone for communicating patient information. On the other hand, it is efficient. The marketplace usually finds a way to solve a technology problem, and this is one problem that may be solved in the near future. Ideally, healthcare providers will weigh the benefits of transmitting patient information against the risk of breaching privacy and confidentiality.


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