Text Messaging in the ICU... What Do You Do?

Do you use text messages (sms) in your ICU? Of course you do... we all do! It seem sometimes a little worrying to see how text messaging has secretly creeped into clinical life in hospitals. Apart from simply talking to each other on the phone clinicians increasingly use text messaging to exchange patient informations.

Recent revelations by whistleblowers like Edward Snowden have made us very aware of the fact that exchanged text messages can be easily intercepted and therefore read by a third party. The worst case scenario would be the publication of confident patient information. The chance, that patient information will leak in that sort of way is not very big, but 'Medical Identity Theft' happens and now slowly starts to find it's way into medical publications. The World Privacy Forum estimates, that 250'000 to 500'000 people have already been victimised by this sort of crime since 1995. So this kind of threat should be taken seriously.

The Society of Critical Care Medicine has just recently published an article on this issue that nicely shows the different challenges we encounter by using all different sorts of mobile devices. Medical societies have not yet specifically given any recommendations on this topic, but it is clear that all private health information must be protected against any threat on confidentiality.

The Joint Commission, an institution involved in the accreditation of medical institutions all around the world, gets very specific on the use of text messages: “Physicians who need to quickly communicate time-sensitive information about their patients should no longer use text messages.”

So what can we do in clinical practice? One option is to start using encrypted services (e.g. Threema). But then again technical issues between different sort of mobile devices might be problematic. And different people might use different applications. The question remains if simple text messages can be considered safe by simply using de-identified information.

What do you do in your hospital...?

Christine C. Toevs, SCCM on Communication, February 2014

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