American Medical Association To Tackle Texting With Patients

by Roetzel & Andress

This June, the American Medical Association (AMA) House of Delegates will take up the issue of patient-physician texting at its annual meeting. With respect to physician-patient communications, the AMA has already issued guidelines for physicians on email exchanges, privacy and confidentiality, and the confidentiality of computerized records. The forthcoming AMA Board of Trustees report and recommendation will likely expand its guidelines on email communications to include text-based messaging and address those circumstances where texting with patients is appropriate and how to remain HIPAA compliant.1

The AMA’s move to issue guidance on the use of texting in the patient-physician context follows on the heels of The Joint Commission’s recent reversal of its prior authorization of secure clinical texting to issue patient care orders. In its December 2016 statement, The Joint Commission, along with Center for Medicare and Medicaid Services, prohibits texting to issue patient care orders, and makes clear that even though technology has advanced to the point where secure text messaging platforms now provide sufficient privacy and security safeguards to meet HIPAA requirements, concerns remain around patient safety, the increased burden on nurses when entering text orders into the EHR and the possibility of confusion due to the inability to seek immediate clarification.

Among and between health care providers, the use of text messaging is becoming more common and is increasingly seen as an essential tool in clinical communications and patient care. Patients are starting to expect that they can text with their providers, rather than adopting other forms of communications, such as logging on to patient portals to retrieve and share information. Providers may feel compelled to respond in kind, but should proceed with caution.

Texting between physicians and their patients directly raises significant HIPAA privacy and security concerns. While some provider organizations try to limit texting to basic uses, such as reminding patients of their appointments or that lab results are available, it is easy for “individually identifiable information” to be captured in a text, thereby becoming patient Protected Health Information (PHI) under HIPAA. Once PHI is included, it becomes subject to HIPAA rules and regulations. Some also fear that texting might diminish the foundational relationship between a patient and his or her physician – a foundation that has traditionally considered to be built on face-to-face communication and dialogue. 

Providers who are currently texting with patients or thinking about doing so should consider the following guidance:

  • Adopt a text messaging policy at your practice that addresses the issues noted above
  • Do not use standard SMS services that are standard on mobile phones, as those violate HIPAA privacy and security standards
  • Use a secure texting platform from a reputable third-party vendor to ensure HIPAA compliance
  • Get the patient’s consent for the use of text messaging and include a statement regarding the risks of disclosure and lack of security
  • Any text containing PHI must be incorporated into the medical record and then deleted from the mobile device
  • Include only non-urgent information in any text message
  • Include a verification process to verify who received the message 
  • Text messages need to be able to be audited, monitored, and easily accessed
  • Devices should be password protected and encrypted
  • The secure texting platform should permit a “data wipe” option in case the mobile device is lost
  • Consider purchasing a cyber-insurance policy

Providers who may be texting using basic SMS service should cease usage and instead, consider adopting a secure texting platform to communicate with patients that will help ensure they are meeting the security and privacy safeguards of HIPAA. The fact that the AMA will be issuing guidance on physician-patient texting reflects an acknowledgment that it is becoming increasingly common, and the associated HIPAA risks with using an SMS platform are significant. 

We encourage you to contact one of the listed Roetzel attorneys to discuss the legal challenges associated with communicating with your patients via text messaging or other electronic means.

1 Robert Nagler Miller, When patients want to text: HIPAA, OMG! See you L8R, privacy? AMA Wire (2017),

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Roetzel & Andress | Attorney Advertising

Written by:

Roetzel & Andress

Roetzel & Andress on:

Readers' Choice 2017
Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Custom Email Digest
Privacy Policy (Updated: October 8, 2015):

JD Supra provides users with access to its legal industry publishing services (the "Service") through its website (the "Website") as well as through other sources. Our policies with regard to data collection and use of personal information of users of the Service, regardless of the manner in which users access the Service, and visitors to the Website are set forth in this statement ("Policy"). By using the Service, you signify your acceptance of this Policy.

Information Collection and Use by JD Supra

JD Supra collects users' names, companies, titles, e-mail address and industry. JD Supra also tracks the pages that users visit, logs IP addresses and aggregates non-personally identifiable user data and browser type. This data is gathered using cookies and other technologies.

The information and data collected is used to authenticate users and to send notifications relating to the Service, including email alerts to which users have subscribed; to manage the Service and Website, to improve the Service and to customize the user's experience. This information is also provided to the authors of the content to give them insight into their readership and help them to improve their content, so that it is most useful for our users.

JD Supra does not sell, rent or otherwise provide your details to third parties, other than to the authors of the content on JD Supra.

If you prefer not to enable cookies, you may change your browser settings to disable cookies; however, please note that rejecting cookies while visiting the Website may result in certain parts of the Website not operating correctly or as efficiently as if cookies were allowed.

Email Choice/Opt-out

Users who opt in to receive emails may choose to no longer receive e-mail updates and newsletters by selecting the "opt-out of future email" option in the email they receive from JD Supra or in their JD Supra account management screen.


JD Supra takes reasonable precautions to insure that user information is kept private. We restrict access to user information to those individuals who reasonably need access to perform their job functions, such as our third party email service, customer service personnel and technical staff. However, please note that no method of transmitting or storing data is completely secure and we cannot guarantee the security of user information. Unauthorized entry or use, hardware or software failure, and other factors may compromise the security of user information at any time.

If you have reason to believe that your interaction with us is no longer secure, you must immediately notify us of the problem by contacting us at In the unlikely event that we believe that the security of your user information in our possession or control may have been compromised, we may seek to notify you of that development and, if so, will endeavor to do so as promptly as practicable under the circumstances.

Sharing and Disclosure of Information JD Supra Collects

Except as otherwise described in this privacy statement, JD Supra will not disclose personal information to any third party unless we believe that disclosure is necessary to: (1) comply with applicable laws; (2) respond to governmental inquiries or requests; (3) comply with valid legal process; (4) protect the rights, privacy, safety or property of JD Supra, users of the Service, Website visitors or the public; (5) permit us to pursue available remedies or limit the damages that we may sustain; and (6) enforce our Terms & Conditions of Use.

In the event there is a change in the corporate structure of JD Supra such as, but not limited to, merger, consolidation, sale, liquidation or transfer of substantial assets, JD Supra may, in its sole discretion, transfer, sell or assign information collected on and through the Service to one or more affiliated or unaffiliated third parties.

Links to Other Websites

This Website and the Service may contain links to other websites. The operator of such other websites may collect information about you, including through cookies or other technologies. If you are using the Service through the Website and link to another site, you will leave the Website and this Policy will not apply to your use of and activity on those other sites. We encourage you to read the legal notices posted on those sites, including their privacy policies. We shall have no responsibility or liability for your visitation to, and the data collection and use practices of, such other sites. This Policy applies solely to the information collected in connection with your use of this Website and does not apply to any practices conducted offline or in connection with any other websites.

Changes in Our Privacy Policy

We reserve the right to change this Policy at any time. Please refer to the date at the top of this page to determine when this Policy was last revised. Any changes to our privacy policy will become effective upon posting of the revised policy on the Website. By continuing to use the Service or Website following such changes, you will be deemed to have agreed to such changes. If you do not agree with the terms of this Policy, as it may be amended from time to time, in whole or part, please do not continue using the Service or the Website.

Contacting JD Supra

If you have any questions about this privacy statement, the practices of this site, your dealings with this Web site, or if you would like to change any of the information you have provided to us, please contact us at:

- hide
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.