Communicating with patients by text message - Wales

Text messaging allows practices to target and contact hundreds of patients within minutes. Patients can respond by text with replies automatically forwarded to a specified email address. Many practices are signing up to using a text messaging service to inform patients of appointments, flu vaccinations, etc.

How is consent taken?

Do not assume that just because you hold the patient’s mobile telephone number on the patient’s record, they have provided consent for text messages to be sent. Only send text messages to those patients where consent has been recorded for you to undertake this form of communication.

During an appointment or other communication, ask the patient 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. Patients who consent should be advised of the importance of informing the surgery of any changes to their contact details.

This is important because patients may change their mobile phones at regular intervals, and if they choose to give their old phone to a friend or family member there is obvious potential for a breach of confidentiality. The consent should be revisited and updated at regular intervals.

What should practices be wary of?

Whilst the use of text messages can offer greater convenience and flexibility for patients and doctors, it is essential for practices to review the systems in place relating to this. This is to ensure that they are as secure as possible and compliant with the relevant legislation and professional guidance. Remember that text messaging in this context is a professional communication, hence “text-speak” should be avoided.

What information needs to be provided?

Inform patients of the practice’s text messaging service and the limitations, via the practice leaflet, website or notice in the waiting room. 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. Practices would be well advised to liaise with the Local Health Board and other practices that have instigated a text messaging service, and find out what information they provided.

Does it form part of the medical record?

The text message would be considered part of the patient’s medical records, hence it is important that the consent for the text message is recorded in full, as well as the date and time that it was sent and the content of the message. Any response received should also be recorded in the patient’s record in the same way.

What information is not appropriate to send by text message?

Be careful about 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.

Practices should not rely on text messaging alone in relation to the issuing of reminders; it should simply form part of a wider strategy.

There is a risk that patients may respond to the text and seek other information (for example, clinical advice). Careful consideration should be given to this potential problem, particularly given that there is a possibility that a patient may seek urgent advice outside the practice opening hours.

Further information

• Communicating with patients
  
• Confidentiality: good practice in handling patient information
• GMC, Confidentiality 2009
• NHS, Connecting for Health Information Governance Toolkit
• GMC, Making and Using Visual and Audio Recordings of Patients – Guidance for
  Doctors 2011.
• MPS, Practice Matters, Issue 7, October 2014, Digital Dilemmas