Get consent 2 txt - MDU

Tags: MDU Texting

16 Mar 2010

GP practices are being advised to get patients’ explicit consent before communicating with them via text message.

Latest advice from the Medical Defence Union warns GPs that sending text messages to patients who have not opted-in to such a service could lead to complaints.

The defence body said GP practices were increasingly looking at text messages as another way of communicating with patients, with uses including reminders about appointments or to take medication, communicating test results or checking on a patient’s progress.

Dr James Armstrong, MDU medico-legal adviser, said that some hospitals have implemented text messaging schemes on an opt-out basis but that they had the resources to deliver the “considerable publicity” that was needed for such schemes.

He added: “While GPs may publicise a text message service to patients on the practice website, practice leaflet and through posters in the waiting room, many patients may still not be aware of the service.

"They might be surprised to receive a text message from the surgery if they have not given their specific consent and this could lead to a complaint, particularly if the unexpected message is somehow picked up by somebody else.”

Dr Armstrong advised practices to err on the side of caution to ensure confidential information is protected in line with General Medical Council guidance.

He said seeking explicit consent would also give the GP an opportunity to reassure the patients about the security arrangement in place and to check they have the correct mobile number to avoid confidentiality breaches.

A spokesperson for the MDU told EHI Primary Care that the MDU was not aware of any complaints it had received as yet about text messaging but said it did get occasional queries from practices planning to set up such services and wanted to offer pre-emptive advice.

The MDU, which has included the advice in its March journal, also suggests that practices using texte messaging systems consider extra security measures if sensitive information such as test results are to be communicated by text.

The defence body said patients could be asked to respond to a message confirming their identity by using a pre-arranged password before transmission.

The MDU said details of text messages sent to or received from patients should also be documented in the patient’s record and practices should consider alternative or additional methods of communicating important information to patients such as requests for urgent follow-up.

Fiona Barr

Reader's Comments

Texting Patients is very positive and they like the service?

16 Mar 10 20:03

The reality here is if you are sending patient text messages, then you need to consider what you are sending. By default patients have to "opt-in" because they will need to provide the GP practice with a mobile phone number, at this point informed consent can be given along with information about the service offered.

Most Text reminder services for GPs are now automated specifically for simple appointment reminders which look up the patient appointment database (therefore should not get directed to the wrong patient as patient ID is used) that can have an inpact on reducing DNA's where the practice has high penetration of mobile numbers recorded in patients records. Other text services include health promotion and QOF related texting such as "Smoking Status" which can prove to be very useful tool.

Advice is out there in terms of best guidance from CFH, that incorporates the information governance concerns which is quite useful http://www.connectingforhealth.nhs.uk/systemsandservices/infogov/whatsnew/shortmessageservice.pdf

Keep it simple - delivers result

22 Mar 10 11:03

Text messaging works, the level of data compliance should match the type of service delivered. I appreciate the need to adhere to data protection, this should not over burden any organisation with an OPT IN from all patients when looking to send text messages for appointment reminders or general test results.

Most sites take the point view of having implied consent when in possession of the patient mobile for sending appointment reminders and general test results. We have sent over 15 million message s to patients throughout the UK on this basis.

Users can become over burdened with data protection adherence that can stop real benefits being delivered such as reduced DNA rates.

I do agree where services are looking to deliver more detailed services there should be either an OPT IN requirement or mobile to patient matching undertaken. Taking the smoking survey programs being run by various PCT’s, here is a real example of issues raised.

The GP text smokers requesting they reply with an update to their status. If the mobile is not matched to the relevant patient before sending the smoking survey status requests, a patient's record could be logged with an incorrect status reply.

Where the message goes out to the wrong patient any reply will be incorrectly logged into the original patient’s record. This can happen where a member of a family may have passed the phone to someone else.

Following the scenario through, where medical information is requested for insurance purposes the potential for inaccurate information to be provided is very real.

It would be good to see the advice looking to match the level of compliance on the various service levels.