Can I Text and Email my Patients?

What are the medico-legal risks associated with the use of email or texting?

We use email and texting as it is a quicker and more convenient way of sending information. It can improve efficiency and expedite care. We can alert patients about test results, check on them after appointments, send reminders to get lab tests done, and even schedule appointments.

Therefore the compelling reasons for email and text include efficiency and avoiding unnecessary consults. However, there are risks including documentation, misdirection, miscommunication, distractions, privacy, and boundary issues.

Documentation

As a physician the onus is really on you to keep your patient's privacy front and centre.

It is always better to obtain consent from a patient. When using an electronic medical record some physicians use "macro" features to document consent. Macros are becoming more of a medico-legal issue and should be individualized when possible. Be careful responding to queries from other physicians without following the proper standard of care you would normally uphold.

Misdirection & Miscommunication

In 2016, loss of information comes from theft of laptops, USB keys, portable hard drives, smart phones, and electronic communication. Patients need to know that email is not a fool proof way of communication and it can be misdirected accidentally and unintentionally. Institutional emails are often subject to freedom of information request that could require a breach in privacy.

Privacy

As a health care provider your first and foremost responsibility is the privacy of your patients' information. It is important to consider potential privacy issues when sharing any form of patient data through electronic means. Removing all identifying patient data is the first step. But be careful as other identifiers (tattoos, piercings, rings etc) could potentially result in a breach in patient confidentiality.

Boundary Issues

You would never provide a patient with your home phone number or personal cell phone number, therefore, you should think twice before providing the patient with your personal email address. Health care professionals should be very careful with social media from the perspective of boundary issues and professionalism.

A Patient Emails You - What to do? A patient may not recognize the inherent risks of emailing their health care provider. So what is your responsibility when a patient emails you with a potentially serious issue?

Responsibility: You are held at a higher level of responsibility and you will be liable for any information a patient sends you. You must deal with the urgent situations as it is your professional, ethical, and moral responsibility to do so. Anything a patient tells you whether it is by email or in person you are technically liable for.
Documentation: The email should be copied into your medical record as a means of documentation.
Privacy & Confidentiality: Remember that nothing is completely safe. So-called secure University email systems are, in fact, not secure.

If you want to email your patients you may do so but do so with care. The CMPA offers a good article on Electronic Communications and Protecting Privacy on their website.

More reports from 2016 CRA & AHPA