Pediatricians increasingly favor SMS over pagers, but HIPAA concerns loom

By Neil Versel
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Female Doctor with TabletIt has been years in the making, but text messaging is finally overtaking the antiquated pager as a means for physicians and hospital staff to communicate with each other, at least within children's hospitals.

In a survey of 106 physicians at pediatric hospitals, researchers from the University of Kansas School of Medicine in Wichita found that 27 percent named texting their preferred method for brief communications, compared to 23 percent that favored hospital-issued pagers and 21 percent that said face-to-face conversation. Among the survey pool, 57 percent reported sending or received work-related text messages.

The Kansas team presented their findings this week at the American Academy of Pediatrics (AAP) annual meeting in New Orleans.

"We are using text messaging more and more to communicate with other physicians, residents and even to transfer a patient to a different unit," lead investigator Dr. Stephanie Kuhlmann said in an AAP press release.

"The way that physicians are communicating appears to be shifting away from the traditional pager method," Kuhlmann also told Medscape Medical News. "Personally, I probably get 50 to 100 text messages during a shift," she added. "But unlike many physicians, I don't carry a pager, so everything comes to my cell phone."

Nine in 10 survey respondents said they regularly used a smartphone and 96 percent participated in text messaging, whether with colleagues or just friends and family. Twelve percent were like Kuhlmann in that they send at least 10 messages per shift and only only 5 percent said they received more than 20 messages each time during a typical shift. About half received work-related texts even when they were not on call, according to AAP.

It was a rather young survey pool, as 62 percent had been in practice for no more than 10 years, and 68 percent were women.

Still, the use of text messaging lagged behind face-to-face discussion and telephone conversations for communicating with other healthcare professionals in the hospital, each of which were named by 92 percent of the surveyed physicians.

Despite the growing popularity of SMS, only 10 percent of respondents said that their hospitals offered software that encrypts text messages. This is an important issue because 27 percent reported receiving protected health information, as defined by HIPAA, via SMS, and 41 percent worried that texting could violate HIPAA privacy standards.

"We think it's a quick method of communication, but there are concerns over HIPAA rules," session moderator Dr. Daniel Rausch, a pediatrician at Mount Sinai Medical Center in New York City, told Medscape.

"We need to learn how to use text messaging effectively, because we know this is happening," Rausch added.

"We are still behind the curve. Technology has jumped ahead of our ability to understand it and regulate it. This study is an attempt to acknowledge our use of text messaging, and it's great that these investigators took time to document this. Hopefully, we will start to look at this more systematically."