Various text messaging services are being used by practices in order to notify patients of appointments, flu vaccinations etc. and include a variety of apps such as WhatsApp, SMS and Facebook Messenger. Although a quick and simple process for both patient and practice, there are medicolegal issues to consider with this method of communication.
Obtaining proper consent
Text messaging is covered by the General Data protection Regulation (GDPR) and Data Protection Act and therefore patient consent must be obtained prior to communicating by text message. In many cases you may already have the patient’s mobile phone number but this does not necessarily mean they want you to contact them in that way.
During an appointment or other contact with the patient, ask if he/she would be happy to receive a text message via mobile phone, eg, for an appointment reminder. The patient’s consent or refusal must be clearly recorded on the patient’s computer record where it is easily visible.
Obtaining consent for this type of communication must not be an isolated event. You should check, at regular intervals, that patients who have opted to use the text service are happy to continue to receive messages from the practice. Patients should be able to opt out of the text messaging service at any time. These reminders are also a useful opportunity for patients to inform the surgery of any changes to their contact details.
What information needs to be provided?
Patients should be informed of the practice’s text messaging service and the limitations of the service, eg, via the practice leaflet, website or notice in the waiting room. The leaflet should explain what types of information they may receive eg reminders about repeat prescriptions or appointments, vaccination clinics etc.
The leaflet could be given to the patient when they consent to receiving text messages. The content of the leaflet should be reviewed at regular intervals and adapted to reflect any changes in the service and/or advances in technology. The information should be tailored to patients’ needs as far as possible. Written information might be of limited use to patients with sight impairment, for example.
Be wary
It is important to regularly review the systems in place for text message communications – this is to ensure that they are as secure as possible and compliant with current data protection legislation.
The text message should be considered part of the patient’s medical records and therefore consent to communicate by text message must be recorded in full, as well as the date, time and content of any messages sent to the patient. Any response received should also be recorded.
Remember that text messaging in this context is a professional communication, hence “text-speak” should be avoided.
What information is not appropriate to send by text message?
Be sure to revise the information contained in text messages; in general terms, text messaging lends itself to sending out generic reminders to specific target groups. However, it is not an appropriate way to deal with clinical queries and patients should be made aware of this.
Text messaging should form part of a wider communication strategy and practices should not rely on it alone in relation to the issuing of reminders. There is a risk that patients may respond to the text seeking other information, such as clinical advice. Patients can be made aware of the limitations of the text message service as well as the appropriate way to respond via the practice leaflet, website or notice in waiting room.
The content of each text message must be generic and only include essential information. It is unnecessary to state the nature of the appointment or any personal details other than the date and time of the appointment – providing any further information may be seen as an indiscreet disclosure.
Frequency of messages
Have a clear strategy in place for the frequency of text messages that are sent to patients – too many messages may become intrusive. Also consider the timing of each text message and how this will benefit the patient. It may be worth reviewing the timing and frequency of the service with patients from time to time in order to ensure its effectiveness.
Always provide patients with clear information on how to opt out of the service and ensure these are logged in their records.
Further information