Issue link: http://viewer.e-digitaledition.com/i/556451
T EXTING'S NOT JUST for folks striving to keep up with the Kardashians; it's become a mainstay for how we com- municate — outpacing fax, phone calls (yes, you can even talk on a smartphone) and email. No wonder: Texting may offer the fastest, most convenient and efficient way for us to communicate directly with one another. It eliminates the sometimes time-consuming task of searching through a stuffed inbox in order to ferret out a pertinent email. Lines of appropriate usage blur, however, when folks use employer-provided devices to send personal texts or, conversely, use personal devices to send business texts. The danger of mixing business with pleasure breathes new technological life into an old adage. More and more physicians are text messaging their offices, colleagues, hospitals and patients. Imprudently used, texting could also result in HIPAA Privacy and Security violations, as well as increasing civil liability exposure. Ohio law defines medical record as "data in any form that pertains to a patient's medical history, diagnosis, prognosis, or medical condition that is generated and maintained by a health care provider in the process of the patient's healthcare treatment." Clearly, sending or receiving clinical information by text fits within this statutory definition. That, consequently, creates legal obligations for physicians to retain messages, which may be instrumental for treating and billing, as well as for providing evidence to support a doctor's defense against patient malpractice claims predicated on the exchange of text messaging. HIPAA's Privacy and Security rules obligate covered entities, including physicians, to implement technical safeguards, such as password protection and encryption in compliance with national standards, to render protected health information secure. Unauthorized access to unsecure ePHI may result in HIPAA "breaches" that can result in substantial monetary fines up to $1.5 million. It is a particularly dangerous practice to send and receive personal and clinical messages by text on the same phone. Physicians who text need to use a separate device dedicated solely for clinical messaging. In 2011, The Joint Commission issued a statement, still in force today, that: "It is not acceptable for physicians or licensed independent practitioners to text orders for patients to the hospital or other healthcare setting. This method provides no ability to verify the identity of the person sending the text and there is no way to keep the original message as validation of what is entered into the medical record." Doubtless, vendor solutions to these concerns are already here or in the works. What physicians still need to guard against is human error. Texting can be distracting, which causes mishaps, not only when driving. Reportedly, a resident was entering a stop order for anticoagulant therapy, when she was interrupted by a personal text. The resident responded to the text, but forgot to complete the stop order, causing the patient to have to undergo surgery. Physicians also need to resist the temptation to use abbreviations or acronyms, which can be misunderstood or transformed into something other than intended by autocorrect, and they must remain vigilant about checking that all medications and dosages are properly entered and accurate. Proofreading texts before they are sent is not optional. Texting is another communication tool in the physician's arma- mentarium that can benefit a practice if used wisely. Joe Feltes is an attorney with Buckingham, Doolittle & Burroughs in Canton and a member of its Health & Medicine Practice Group. He is also the managing partner of Buckingham Canton. For more information about the law firm, go to bdblaw.com or email Feltes at JFeltes@BDBLAW.com. n Tweet Me in the Morning By Joseph J. Feltes, JD LOOK AROUND MEETINGS AND RESTAURANTS. CHANCES ARE PRETTY GOOD THAT PEOPLE ARE TEXTING (CREATING A FUTURE BOON FOR PHYSICIANS TREATING CARPAL TUNNEL SYNDROME OR "TEXT CLAW"). Take Two Texts and 2 8 | Cleveland/Akron/Canton MD NEWS n M D N E W S . CO M n S E P T E M B E R /O C T O B E R 2 0 1 5