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How to Choose Secure Text Messaging Software: The Messages You Can’t Ignore

Many health care organizations have already deployed secure email software but don't realize that their providers are still sending sensitive patient information to each other via SMS text messages. Text messaging is king, especially in the hospital setting where highly mobile physicians need fast answers about the sickest patients and aren't always in front of a computer.

But secure text messaging solutions aren't all the same. SMS text messaging is very easy to use and everyone already has it installed on their phone, so if you expect a secure replacement to get widespread adoption, the secure texting software actually has to be better than SMS in some way. In this series, I will share some areas of opportunity that we've discovered at pMD while helping our customers deploy our secure text messaging software. If you're in the market for something like this, I hope you find this series informative and that it inspires you to seek the best solution on the market for your needs!

This scenario may sound familiar: you send someone an SMS text message about something important and you're waiting to hear back. Some time later, you realize that you haven't heard back. Maybe the recipient didn't get your message. You decide to open up your text messaging app, but it doesn't say one way or the other. You start to wonder if you should send another text message, or maybe even call the other person. Then something distracts you and you lose the thread. It could be a while before you think to check again, and your phone won't bring the unread message to your attention. The recipient might not have received your message, or might not have noticed when it arrived; either way, the thread of communication stopped there.

Most secure text messaging software on the market actually makes this problem more severe. Unlike SMS text messages, you need a data signal (WiFi or cellular data) in order to get notified about a secure text message that was sent to you. Most hospitals are riddled with dead zones where you can't find out right away that a secure text message was sent to you because there isn't enough data signal for push notifications to reach you. This is dangerous in the hospital setting where providers are sending time-sensitive clinical information and they expect it to work like SMS.

To solve this problem, seek a solution that will automatically follow up on your behalf. Replaying the scenario described above, if the recipient hasn't received or hasn't read your message after a period of time, the software should automatically follow up with an SMS text message reminding them that they have a secure text message from you. Even if they don't have a data signal, they can get this text message reminder - you don't have to remember to text them to see if they got your first message because the system does it for you.

Ideally the software should follow up again, this time with an automated voice call, if the recipient still hasn't read your message in pMD after even more time has passed. Though more intrusive than an SMS, the voice call is appropriate for time-sensitive messages like a stat consult - in other words, situations where you yourself would call the recipient if you didn't get a quick reply... if you remembered to. Automation makes this consistent and saves you the trouble.

If the recipient got distracted or was unreachable and never read your message, at a certain point you want to know that. Most secure and non-secure messaging systems require you to actively keep checking the status of the message to see if it was read. You should look for a system that instead closes the loop by actively letting you know that the recipient hasn't read it yet after more time elapsed. This way you don't have to check the status of the message and you can't forget to check it.

Putting all these reminders together, you should seek a secure text messaging solution that acts like a concierge or assistant for your communication. It should follow up for you, using different types of reminders that don't rely on data and that become increasingly hard to ignore. Finally, if your message still wasn't read, the system should let you know so you can try to reach the person a different way, or find someone else to contact. That way if your message wasn't read, you'll be the first to know.

These follow up actions shouldn't be needed most of the time, but when they kick in, you’ll be relieved to know that your message isn't just sitting out there in limbo. Hospital-based physicians can find great peace of mind in knowing that their messages are not only secure, but also persistent.
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