Obtaining patient consent for text message communication

Text messaging is a convenient communication channel between healthcare providers and patients. However, healthcare providers must ensure the privacy and security of patients' protected health information (PHI) and obtain patient consent for text messaging communications according to HIPAA regulations. 

HIPAA and text messaging

While HIPAA does not explicitly mention text messaging, it provides guidelines for electronic communications that encompass text messaging. PHI includes any individually identifiable health information transmitted or maintained in any form, including electronic media.

Text messaging poses unique challenges in terms of privacy and security. Unlike phone calls or in-person interactions, unauthorized individuals can easily intercept or access text messages. Additionally, once a message is sent, the recipient's device may retain a copy of the message, potentially posing a risk if the device is lost, stolen, or accessed by someone other than the intended recipient.

Related: What are the 18 PHI identifiers?

Why patient consent is necessary

• Obtaining patient consent for text messaging communications addresses privacy and security concerns associated with transmitting sensitive health information through unsecured channels. By obtaining consent, healthcare organizations can ensure that patients are aware of the potential risks and are willing to accept them.
• Patient consent upholds the principle of patient autonomy. It allows individuals to make informed decisions about the use and disclosure of their healthcare information. Consent allows patients to have control over how and when they receive communication from their healthcare providers, promoting a patient-centered approach to care.
• HIPAA mandates that healthcare organizations protect PHI and obtain patient consent for certain types of communication. The Privacy Rule recognizes the importance of patient autonomy and encourages organizations to obtain permission for electronic communications, including text messaging.

The process of obtaining patient consent

1. Develop a HIPAA compliant consent form: The form should clearly explain the purpose of text messaging communications, the types of information that may be transmitted, any potential risks associated with electronic communication, and the patient's rights.
2. Provide a notice of privacy practices (NPP): Before obtaining consent, provide patients with an NPP that outlines how their PHI will be used and disclosed. The NPP should include information about text messaging communications and patient rights regarding their PHI.
3. Educate patients about text messaging: Offer educational materials or sessions to inform patients about the benefits and risks of text messaging communications. Explain the security measures to protect their information and address any concerns.
4. Present the consent form: Present the consent form to patients, ensuring they have sufficient time to review it. This can be done in person or via HIPAA compliant email. Encourage patients to ask questions and seek clarification if needed.
5. Obtain patient signature: Patients should sign the consent form to indicate their understanding and agreement to receive text messaging communications. 
6. Document consent: Maintain a record of the patient's consent in their medical record or a designated consent management system. Include the signed consent form, the date of consent, and any specific preferences or restrictions expressed by the patient.
7. Implement security measures: Implement appropriate security measures to protect PHI during text messaging communication. Use secure messaging platforms or encryption methods to safeguard patient information. Regularly review and update security protocols to stay abreast of evolving technology and potential vulnerabilities.

Recommended approaches for obtaining patient consent

1. Ensure clear and understandable consent forms: Use plain language and avoid complex medical jargon to enhance patient understanding of the consent form. Make sure the form is easy to read and comprehend.
2. Transparency about the purpose and limitations of text messaging communications: Clearly communicate the purpose of text messaging communications to patients, including the types of information that may be transmitted and any limitations or exclusions. This transparency promotes trust and helps patients make informed decisions.
3. Educate patients about their rights and options to revoke consent: Provide clear information about patients' rights regarding their healthcare information and their ability to withdraw consent for text messaging communications at any time. Ensure patients know how to revoke consent if they no longer wish to receive communication via text messaging.
4. Regularly review and update consents as needed: Periodically review patient consents to ensure they remain current and accurate. If there are any changes to the text messaging communication process or the patient revokes consent, update the records accordingly.
5. Incorporate consent management into electronic health record systems (EHRs): This ensures that consent documentation is easily accessible and can be linked to the patient's electronic health record for comprehensive information management.

Obtaining patient consent for text messaging communications in healthcare helps safeguard patient privacy and security while facilitating effective communication.