Friday, September 11, 2015

In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was enacted by Congress and signed into law by President Clinton. This legislation was designed to improve the continuity of information across the medical industry including insurance coverage for groups and individuals, as well as to fight against fraud and bureaucratic waste.

HIPAA, however, was written before the full breadth of the Internet had been realized and was well before the mass digitalization of personal records.

There are few things more personal to a family than a primary health physician, and gaining access to these individuals certainly became easier thanks to the digital age. But how do doctors feel about these changes? Is it safe to discuss sensitive medical information in an email—or a text?

That’s exactly what groups like the American College of Physicians and American Academy of Family Physicians are debating. For years, similar organizations have looked unfavorably on the idea of doctors and patients connecting over social media, particular through personal accounts. For example, in 2010, the American Medical Association warned doctors to “maintain professional boundaries” with regards to their online identities. Most of these warnings stem from HIPAA and its focus on protecting patient confidentiality.

A Changing Social Landscape

But the doctors aren’t necessarily the ones driving the social shift. In a recent study published in the Journal of General Medicine, 20 percent of patient respondents reported trying to connect with their doctors via Facebook, and 40 percent via email.

Some patients may view this casual interaction as a necessary evil to ensure they get the attention they need if faced with a serious prognosis. Others, however, do recognize the safety issues faced by social platforms, many of which have very few safeguards in place to protect sensitive personal data.

Patient portals are one alternative that has been used to circumvent the standards put forth by HIPAA. Still, there are studies suggesting that social media and smartphone features like SMS could play a positive roll in connecting patients to their medical providers.

In 2011, the University of California and Cal State San Marcos evaluated a program developed by the Department of Human Health Services called Text4baby. Free health information was sent to women during their pregnancies and throughout their babies’ first few years of life. The research reported that the mothers gained helpful information during their pregnancies and valued the reminders for vaccinations and flu shots as well as the convenience of scheduling via text.

Those are just a few of the ways patients can use SMS texting to better communicate with their medical providers. A list of practical uses for medical professionals is virtually endless. But is it safe?

There are services available that offer text encryptions claiming to be HIPAA compliant, leaving the service option up to individual medical practices.

For now, the camp is still somewhat divided. Aside from the obvious security issues, physicians are apprehensive to make themselves so readily available to patients. In a world increasingly accustomed to instant access, the personal space of a doctor’s cell phone may end up being one in which we’re not welcome.