This week, we're concluding our four-part series on texting appointment and medication reminders. After talking about why, how, and costs, today's post addresses privacy.

What are some of the potential privacy concerns around texting appointment and medication reminders?

Texting appointment reminders is a new way of communicating, and therefore brings up concerns about HIPAA compliance. Our colleagues suggested the following important things to remember:

• Always ask your clients to opt-in to receive text message reminders. As with other communication methods, you must get your clients' consent to contact them by text message - and to make sure they understand that their regular text messaging fees will apply. At their first visit, ask your clients how they would like to be contacted (call, text, etc.). It's important to follow HIPAA-compliant protocols and guidelines.


• Text messages are not completely confidential. A cell phone can be picked up and a message read by parents, partners, or friends. There are also concerns that cell phone companies have access to, and a record of, the messages. Even if clients have indicated they can and want to receive your reminders, use the HIPAA-compliant guidelines you've developed for leaving voicemail messages - don't identify the type of service, or even necessarily the clinic name. Simply give the appointment time, clinic phone number, and your clients can take it from there.

• Understand how third-party contractors handle privacy concerns. Whether you are contracting with an organization to integrate text message reminders into your system, or encouraging clients to check out free online reminder programs, check out what the organization says on its website and/or ask how it handles privacy.


• Do not send diagnostic information such as test results by text. It may seem obvious, but this is the main point in ensuring HIPAA compliance. Have diagnostic information to communicate? Simply text your client to "please call," and then follow your general agency guidelines.


• Think about letting your clients choose their own message. Dr. Nadia Dowshen of Children's Memorial HospitalExit Disclaimer told us that the youth with whom she is planning to work will choose their own message. "The message could say something like 'Do ur thing,'" she said, "and that would be enough of a reminder."

This concludes our series on using text messaging for appointment and medication reminders. Part I focused on why use text messaging reminders, Part II on how they work, and Part III on the costs of various options. Looking for more information on using text messages for appointment and medication reminders? Interested in other applications of text messaging for health? Check out "Mobile Phones: Changing Health Care One SMS at a TimeExit Disclaimer (PDF, 3.22 MB) in The South African Journal of HIV MedicineExit Disclaimer and the resources from the 2008 Texting 4 HealthExit Disclaimer conference. Have other resources to share? Still have questions? Decided to give texting a try? We'd love to hear from you!