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    Electronic devices have become the norm for most of our daily communications, making them crucial components of reaching patients in an increasingly consumer-centric healthcare environment. Practices and other healthcare organizations that effectively communicate with patients through text messaging and other electronic methods have advantages in the market and improved patient compliance: Many practices indicate that texting reduces no-shows and staff time spent confirming appointments, which improves efficiency and productivity.

    A recent MGMA Stat poll with 1,615 responses asked, "Does your organization use text messaging to communicate appointments with patients?" The majority (68%) responded “yes,” while only 24% said “no.”  Another 7% said they were “considering it” and the remaining 1% were unsure.

    Respondents whose organizations use text messaging for patient appointment communication noted:

    • They offer patients the option to confirm, cancel or ask to reschedule via text
    • Patients first give their permission to text as their primary method for reminders
    • The practice may use multiple options to remind patients but texting often is the patients’ preferred method
    • Text messaging is normally the most effective method over email, phone calls or mailings

    Common responses from those whose organizations do not offer text messaging included:

    • Not having a setup to offer text communications
    • Exclusively using phone calls or emails for reminders
    • Relying on a hospital’s texting capabilities if part of a larger system
    • Physician reluctance to move to text messaging

    As Susan L. Moerschbacher, MA, professor of psychology, Polk State College, Lakeland Campus, noted in her September 2017 article, “Millennials and organizational change,” in MGMA Connection magazine, today’s patients “quickly find information and answers via their mobile devices, and … expect their communications in the workplace to follow a similar pattern and have less patience for delayed response times.”

    An important consideration when text messaging patients is the security behind these communications; SMS messages are not secure messages. According to HIPAA Journal, “Recent changes to HIPAA have introduced new rules relating to how Protected Health Information (PHI) should be communicated and many healthcare organizations and other covered entities are at now risk of financial sanctions and legal action should an avoidable breach of PHI occur.” As text messaging is not typically a fully secure channel for the communication of PHI, practices must be vigilant when sending information via text messages.

    Tips for sending appointment reminders by text message:

    • Only send necessary information; e.g., patient first name and last initial along with the appointment day/time
    • Obtain consent from patients for reminders via text, email or phone and honor these agreements (while reminding patients that text messages may not be fully secure)
    • Verify patient contact information each visit
    • Avoid including any PHI in a text, potentially including practice name (i.e., ABC Oncology Center)
    • Consider secure texting options for communicating PHI internally between staff members

    Additional resources:

    • Access a myriad of MGMA resources and guides to The Health Insurance Portability and Accountability Act (HIPAA) 
    • The Centers for Medicare & Medicaid Services has published a document, Security Standards – Technical Safeguards, outlining HIPAA’s requirements for safeguarding PHI.
    • Read more about recent court decisions on the Telephone Consumer Protection Act (TCPA) and exemptions for healthcare communications.
    • Learn more about how practices use various methods of patient communication to reduce no-shows based on a March 2017 MGMA Stat poll.
    • Learn more about assessing an overall policy on mobile devices in your practice and how to handle employees spending time on their personal devices.
    • Learn new strategies for improving appointment scheduling, increasing patient portal adoption, reducing appointment waiting times, and staffing for optimal patient access. Download the MGMA Research & Analysis report: Maximizing Patient Access and Scheduling.

    Nick Fabrizio, PhD, FACMPE, FACHE
    MGMA Consulting

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