Does Secure Texting Add to Clinicians’ Cognitive Workload?–Perhaps You Want Context-Aware Communication.

Text messaging has become fantastically popular for all types and ages of users. In health care delivery organizations clinicians eagerly grasp at text messaging to facilitate their workflow and care coordination with consultants, home care by nursing services and support for family caregivers. Facilitating clinician-to-clinician and clinician-to-caregiver communication about patients requires “secure text messaging” which meets HIPAA requirements including security of the message, an audit trail and confirmation of delivery and sender identity among other features. Even secure text messaging has it’s limitations for while patient context is maintained within a message thread and some vendors expose the entire care team to the message exchange, text messaging by itself conveys limited information to the recipient. It encourages an information-poor reactive response, rather than a well informed decision and reasoned action (practitioner order).

While text messaging has enabled clinicians to close some communication gaps, thereby improving care delivery, it has not yet ushered in the ideal of anytime, anywhere access to the right people and the right information. Secure text messaging doesn’t entirely fulfill the primary goal of clinical communication: generating a shared mental model of a patient and transferring responsibility for some aspect of care from the communicator to the recipient. Secure text messaging alone adds to the fragmented, siloed environment driving the clinician to a hunting and gathering slog through the medical record and beyond. As an alternative to adding to the clinicians’ cognitive workload and anxiety through time pressure and information deficiency, HIPAA secure communication with clinical context integration lightens clinicians’ cognitive workload because pre-selected relevant clinical information is available to the message recipient in the same application on the same device at the time of message receipt. No hunting and gathering through the EHR is necessary for at least a basic level of information that could include problem list, involved caregivers, consultants and ancillary staff, laboratory results, medication regimen and recent record of medication administration could all be made available with context integrated communication. More information about context-aware communication can be found in my white paper authored on behalf of PatientSafe Solutions.