BOSTON -- Smartphone Short Message Service, or SMS, texting isn't suitable for healthcare providers communicating HIPAA-protected health data between each other or back and forth with patients for a number of reasons. It's unencrypted and there's no way to validate the person on the receiving end of a text is the recipient for whom it was intended, thus fouling HIPAA-mandated audit trails.
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But at its 2013 user conference, athenahealth Inc. announced a plan to integrate secure, no-cost physician-to-physician SMS texting into Epocrates, a smartphone drug reference app it recently acquired. The Epocrates app is said to have a user base of 300,000, or 50% of U.S. physicians, who claim to use it at least once a month.
While it's still in development, the company demonstrated an early version of the messaging system at the user conference. Jonathan Bush, CEO, said next year the company plans to integrate basic health information exchange (HIE) into the app, where Epocrates customers who use athenahealth's EHR product will be able to send medical records to other physicians via the Epocrates app, regardless of what vendor's EHR system the recipient uses. Athenahealth, a Web-based EHR, practice-management software and billing systems provider, caters to solo physician offices and small group practices.
The idea, Bush said in his keynote address, is to enable better coordination of care between primary care physicians and specialists. Bush said athenahealth customers will likely find resistance to using the Epocrates messaging system from physician recipients on more traditional EHR systems.
You've just used athenaClinicals. Hopefully, you'll say, 'This is way better.'
Malpractice concerns, on top of privacy and security issues, keep clinicians from using messaging systems, said Carrie Peacock, administrator for Pulaski Surgery Clinic of Little Rock, Ark., while speaking on a panel at the athenahealth user conference. She said her surgery center's attorneys advised their physicians to avoid texting because there's no way to integrate what could be crucial information into the EHR, missing potential critical documentation.
But that type of exchange is what athenahealth hopes to accomplish with the Epocrates app. Bush told SearchHealthIT the company did not acquire Epocrates earlier this year because of the potential to expand the popular reference app into a messaging system. But when the company brain trust saw Epocrates had been working on such a system, it struck them as a fascinating idea with much potential.
"We found out they'd been working for two years on secure text," Bush said, adding that athenahealth had "fantasized" about making Epocrates somehow play a role in its suite of care-coordination tools. "So we're rolling out their secure text and a national provider directory we've been working on, as well."
Put together, along with a hashtag chart in the text message, the system will eventually be able to point the recipient physician to the specific patient's file in the athenahealth EHR, called athenaClinicals, viewable on the mobile app.
What does athenahealth get out of hosting these free services? Specialists, mainly, will see the primary care docs' charts and field questions about mutual patients, Bush said. When they reply to the primary physicians' questions, they're exposed to athenaClinicals; their responses will be entered directly into the patient records.
"You've just used athenaClinicals," Bush said. "Hopefully, you'll say, 'This is way better.'" Also, he added, the company hopes the new tools will help create new efficiencies for present athenahealth customers, cutting current phone call, fax and pager volumes.
CPOE secure texting banned under Joint Commission rules