Confidentiality

However, if you decide to text patients individually, you should bear in mind that there a number of potential pitfalls. Foremost amongst these is the issue of confidentiality. It is rarely possible to tell if a text has been read, and never possible to tell by whom.

Family or friends may easily access an unlocked mobile phone, and phones are often passed on to family members or sold and your text could end up being received by a stranger. This issue is especially acute amongst 18-24 year olds, statistically the highest users of text messaging.

As such, there is a risk that a text message, even when sent to the correct number, will not be as secure a route of communication as you might wish. Therefore, when you take the phone number and obtain the patient's consent, make sure to stress the importance of keeping you updated to any changes to that number.

On the subject of children and young adults, while texting 16 and 17-year olds is acceptable, be aware that this age group is also particularly prone to frequent changes in phone numbers. The use of text messages for the under-16 age group can be complicated.

On the one hand an older child with capacity to make decisions about their health (and considered Gillick competent) might wish to have some aspects of their care managed confidentially. The same child might in some instances wish their parents to be involved in communications about their health.

Care should be taken to update the contact details of all competent young persons to make sure their parents/guardians don't receive confidential information if the parental contact numbers are stored in the child's records.

For example, a parent might not know their child had attended the surgery, but because of a misplaced or mis-sent text they could still inadvertently receive test results or a text saying the child's prescription was ready. This would alert them to the attendance; something the young patient may not want them to know about.

Remember also that the phone's messages might be linked to other devices such as tablets. Depending on the settings chosen by the user such messages might be displayed as notifications, even when the device is locked. This means in practice that a text message sent to a mobile telephone number could also pop up and be visible on another device belonging to the patient, even when the device is locked.

Making the most of messaging

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Dr Helen Burnell

Making the most of messaging