Texting In The Hospital Rocks and That's No Joke. Well, Sometimes It Is.

I love texting other doctors in the hospital.  With every passing year, more and more physicians are turning to smart phones to manage their time more efficiently.  Between Walmart $4 drug list apps and the iPad touchscreen technology,  hospitalist efficiency is rapidly entering a new era.  Now add texting in the hospital to the growing list of ways to improve communication with patient care.

Unfortunately,  we have government regulations that claim to protect patient privacy, but end up obstructing patient care.  Is texting patient information a violation of HIPAA?  Perhaps. But so is having a family conference in a busy hallway.  There is a lot of stuff we do every day that is technically against the law that happens in the interest of patient safety and care, The unintended consequences of these government regulations are under appreciated.  I'm  willing to communicate patient information I feel is necessary to make my patients better and I think patients and families will generally agree as well.

I leave voice mails at doctors' office all the time telling them their patient    is going home, describing in great detail the specifics of their patient's hospital care.  Often the doctor is unavailable for direct communication or they are too busy and hurried in the office to stop what they are doing to talk with a fellow physician about their patient.  And sometimes, they just don't care.    When I get sent to a nurses line, I always end up in voice mail.  I can only assume the nurses are eating lunch.  They are always eating lunch.     So I leave a voice mail.  Is that a HIPAA violation?    Beats me.  I'm communicating patient information to a provider who needs to know.  If they have voice mail for me to communicate, I'm going to communicate with their voice mail. If they have texting available, I'm going to text them.   Imagine how silly this voice mail would be.
This is Dr Happy. It's 4:50 pm on Friday.   Your communication system has landed me in your voice mail box.  I was unable to talk to a real live doctor to discuss discharge plans.  Unfortunately, HIPAA says I can't tell you the patient's name so you'll just have to trust me when I say you have a patient that left against medical advice after a 46 day hospital stay for septic shock and multi organ failure.  They may show up in your office today.  I discharged them appropriately but have recommended they get twelve send out labs to clarify their likely cancer diagnosis.   The patient told me he would rather have the lab drawn in your office because he didn't want to stay any longer.  I can't tell you what they are due to HIPAA regulations.     You'll just have to trust me.  Unfortunately, I'm done with my  block of hospitalist days and will be unavailable for the next 20 days.  I will be available for the next ten minutes, should you hear this by then.  Thanks.  Have a great weekend!
Doctor-to-doctor communication is better  than the old standard of no communication in patient care.  I carry on multiple texting conversations every day with doctors in the interest of patient safety. Common sense guides the description of care.   If a name and a room number happens to make their way into the mix of the texting conversation, it happens in the interest of patient care and I don't believe my patients would object. 

Texting in the hospital is especially great with surgeons since I never know if they are in the operating room or in some small town drumming up more business.  I text them a message regarding mutual patients or new consults  and they get back to me, often rapidly, at their convenience.  It's an excellent way to keep the lines of communication open.  I wish all physicians would text in the hospital.

Unfortunately, government rules are written without the future in mind.  Technology can change rapidly and things that make patient care better may go against the intent of the twenty year old regulations meant to protect patients.    The hand of  Big Borther doesn't understand that if we are going to take care of patients efficiently, we need to communicate in ways that saves time for all of us.  And texting is one of those methods.  Texting rocks and that's no joke.  We'll, sometimes it is, like this texting conversation I had with a surgeon once.
Surgeon:  Plan amputation for John Smith room 709 on Tuesday, or should I say "Toesday".
Happy:  I didn't know surgeons could be funny.  That was hilarious, or should I say "Heelarious".
Texting is better than the alternative, which is a plan not to communicate, as these original Happy Hospitalist communication ecards help explain.

"My doctors are great at communicating their plans not to communicate."

My doctors are great at communicating their plans not to communicate nurse ecard humor photo.

"Instead of writing another order for 'if okay with surgeon', please consider a trial of getting off your lazy ass and calling them yourself."

Instead of writing another order for "if okay with surgeon", please consider a trial of getting off your lazy ass and calling them yourself nurse ecard humor photo.

This post is for entertainment purposes only and likely contains humor only understood by those in a healthcare profession. Read at your own risk.

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