Secure Texts Improve Clinician Response Time

Two years ago, Beaufort (S.C.) Memorial Hospital became a beta site for new secure text messaging software, called Cortext, which was being developed by user authentication and access management software vendor Imprivata.

When the need arose to alert clinicians quickly, paging was a dying technology and not quick enough, recalls Ed Ricks, CIO at the 197-bed hospital. When a heart attack patient was being sent to the catheterization lab, pages were sent to team members, but then there were waits for callbacks that created delays in coordinating next steps. Or, when a radiology report was ready, the radiologist would call or page the appropriate physician, who would have to find a workstation to view the report.

Critical lab results were sent to physicians’ electronic health records system, but what if the physician wasn’t using the EHR at the time? And, anesthesiologists needed a better way to receive information as they move between operating rooms and cath labs. “We just recognized we had a problem and all of the doctors have cell phones,” Ricks says.

What he and others quickly learned was that secure text messaging is all about workflow. Physicians need to talk to other physicians, and to nurses, to unit secretaries and others. While physicians carry phones, most of those they talk to do not, so a desktop version of the messaging software also was implemented. Consequently, Ricks says, a pilot of six to eight participants quickly escalated to about 50. “This was the first lesson, it’s not about the technology but about understanding the workflow--who’s calling who?”

Beaufort Memorial actually started looking at messaging vendors three years ago and Ricks learned from peers elsewhere that many of their organizations did not permit texting of protected health information. In reality, that’s not a practical policy, as physicians are texting anyway with their phones. “I can guarantee you it is happening.”

The beauty of secure messaging, either to one individual or a group, is that they get the message quicker than pagers--with a group getting it at the same time--and with more information, Ricks notes. An individual may get a page but not understand the urgency of it and not immediately check and respond, but there is text with the notification when using secure messaging. And unlike pagers, text messages can be tracked to see when an individual got a message, saw it and responded, which improves accountability.

To better secure information after it is on the phone or computer as a text message, users are required to enter a PIN to access the message. Even with the PIN requirements, it was easy to ask clinicians and staff to make the change to secure messaging because the product is easy to use, Ricks says. The text messaging also brought an unexpected benefit, as some physicians live in remote areas such as barrier islands that get poor cellular coverage, but they can be alerted through the Wi-Fi at home.

Beaufort Memorial now has about 350 users of the secure messaging software, which was implemented with no capital investment absent a little time for engineering assistance from the vendor. Customers pay a monthly fee based on the number of users, a fee that Ricks considers to be “very affordable.”

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