Home Forums Discussions General Discussion Secure Texting

This week I decided to start the free trial of secure texting with Updox and wondering if anyone else has been doing this and if so, how are you using this feature?

I have made several templates, such as lab results, office visit summary, appointment reminder, first time secure test messaging back to office instructions, thank you note for my nurse.

The small amount of feedback thus far is that it is easier than the portal to message back and forth, with texting the patient knows when a text message comes thru, and easier to access info via the cell phone this way. So I think this mode of communication may over time replace the portal messaging, and those that did not want to do the portal may find the texting a bit more palatable, easier.

And if the legislators ever make video chatting a worthwhile reimbursable use of our time, sounds like the texting may be the pathway to secure video chatting, but will talk to the Updox folks more about the video chatting next week to learn more.

I do think that the texting will more than likely be a bit more practical than the portal for communication all round, but time will tell.

I suppose there are technical reasons behind it, but it still seems odd to me that texting is HIPAA compliant, but email is not.

With the texting application via Updox there are two ways to text, non-secure and secure. The latter has to have the patient enter their date of birth and last name then create a 5 digit code to receive or send any future texts with the office, the former does not require this extra step. I have decided to set up texting through the office as secure, which is a bit more cumbersome than non secure texting but easier than the Portal. I would rather text this way to avoid any mistakes, where PHI gets accidentally sent through non-secure texting.

Several glaringly obvious differences between the portal and texting that I have noticed thus far.

1. The point of contact education is much easier with texting. While my nurse is talking about the texting and they agree, I enter their cell phone in the Updox address book if it is not there, and send them a text right away, and then she can show how to save the link to contacts and enter the 5 digit code they just created for future texting TO the office. Takes maybe 1 to 2 minutes. It is just plain easier.

2. Texts alert the patient when a message from the office comes in, the portal does not, and most patients check their email inbox at most maybe once a day. Most people carry their cell phones and texting is just more natural than looking thru all the crap in the email inbox these days to find a message from the doc's office.

3. The patient can help out in real time much easier with texting. Such as the other day we sent a patient for a CT scan, they texted us right away while in radiology department, and nurse was able to get missing info in right away. I realize this could have been done via the portal too, but with the texting, most patients are much more adept texting because they are use to this mode of communication.

My prediction is that as more people are integrated into secure texting, the portal will fall by the wayside, because they will gravitate to the path of least resistance. Also, I bet the folks that did not want to start a portal for whatever reason will be more likely to text because it is more like using the phone than the computer or tablet.

I realize I am stating the obvious here, but until I tried out this option, I have never really thought much about comparing the portal to secure texting.

Jim, I think there is little doubt that texting is the way of the future - just look at our younger patients and that is obvious. I agree with your prediction.
I assume Upodox texting is all done at your PC/Chromebook, rather than with you actually entering messages in a phone, right?

One concern... when I am talking to a patient about results from a referring doc, it is nice for them to be able to pull it up on their phone. On the other hand, endlessly scrolling on a small screen through the details of the CBC differential when all I want is the hematocrit is a pain. How do results look on the screen? Or would you still use email for this?

Jon,

Yes, the Updox texting looks just like a portal message in the Updox inbox except it has a purple rectangle instead of yellow. So both my nurse and I have dual monitored screens for our respective desktops that we co-manage the Updox inbox, but she does most of the heavy lifting. So then the dilemma comes up how best to get a hold of the patient in the future, texting or portal. I think the easiest solution is to look in the address book and you can easily see how the patient last contacted you, either portal or text and I think the best way will be to use the mode they last contacted you by.

I actually think the viewing of results may be easier on the cell phone. I don't know for sure but I suspect most of my patients use a non touch screen device, likely desktop computer to use the portal. The cell phone can be held vertically and can get right to a lab result or report, turn the phone horizontally and expand the letter size by expanding with their touch screen. So I don't think that will be a problem. I would use whatever mode the patient prefers or we had last contact by.

Any idea how much secure text will cost, once the trial is over?

The issue with texting, as with other forms of electronic communication with patients, is knowing whether & when the patient got the message, especially if you expect them to take some action. If you have to call anyway to see if the recipient got your text, or appointment reminder, or email -- that's just an extra step.

(This comment courtesy of my practice partner, who is a caveman still using paper charts)

John,

An extra $60 per month is the cost of the secure texting. The secure text conversation expires after 48 hours so I am instructing my patients that if they want to save an attachment like an xray or office summary to take a screen shot. I have asked Updox why the secure text conversation expires after 48 hours and will give an update once I hear the rationale why.

Still getting the "feel" of how the secure texting works, maybe it is because it is another new way to connect directly with my nurse, but I think it has to do more with when a text is sent the phone alerts the patient, and there seems to be a quicker response back from the secure text than compared to the portal. Also it is definitely easier to text us than to portal us from the feedback I am getting from patients.

I still have my nurse call the day before the appt for a reminder, but as we transition more patients into texting that may change to a text with a form letter to let us know when they get the message and if they plan on coming to the appt.

I got an update from Updox, the secure text thread is limited to a 48 hour of access to ensure security and HIPAA-compliance. The history never goes away for the patient-they only lose their ability to view it without an active link. The history for the Updox user never goes away and can be viewed once the user initiates a new Secure Text with the patient. So I am still going to have the patient screen shot any document or report they want to keep, because otherwise I will have to send a secure text prompt to view the report after 48 hours to get the history to show up on the patients phone.

I also envision using the secure text as the doorway to secure video chat, and see the text and video chat as a way to help with my more complex patients to capture the chronic care management reimbursement.

Almost 2 months into the secure texting, much easier than the portal by far!!! Worth the extra $ per month IMHO. Patients love it.

Does secure texting allow more than 140 characters per post? The standard (free) texting to patients with Updox is limited to 140, which is close to worthless.

Yes, 1000 characters per text, and also attachments can easily be added, like lab report or mammo report. And the secure video chat link can be included in a secure text, just copy and paste the video link in a text and in seconds the video chat is started.