More than 70 percent of adults in the United States use text messaging, and health practitioners are taking advantage of this trend to communicate with clients and encourage engagement with their health care. The Network was recently contacted by a local health department for information — specifically examples of policy and practice from other jurisdictions — on using text messaging to communicate on matters such as immunization and appointment reminders, emergency notifications, and client care.
The Network located several examples of text-messaging policies. A local health department in Illinois developed a procedure for text messaging sexually transmitted infection (STI) test results that includes opt-in consent forms from each client. If the client’s testing results are negative, they are texted with a special phrase. If the results are positive, the text message contains the phone number for the clinic where the client can call for the results. The policy also contains guidelines for following up on unanswered text messages and on tracking text message response rates.
A local health department in Michigan adopted a texting policy that covers general health communication (rather than STI test results specifically) and also requires affirmative opt-in from the client. The policy identifies some of the risks associated with text message communication, including that cell phones do not have a guarantee of confidentiality and may be subject to subpoena and Freedom of Information Act requests. Further, the policy dictates that texts must not include information that would clearly identify the client and in-depth information should be communicated over a phone conversation rather than a text message.
Public health authorities in Seattle and the State of Washington’s King County have policies providing a great deal of information on texting in health care contexts, including dealing with logistics, discussion of legal implications, and a toolkit for use by other public health organizations: Texting for Public Health: Emergency Communication, Health Promotion, and Beyond.