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By Athena Mandros

How individuals communicate is changing – where once telephone calls were the dominate form of communication, text messaging is now used more frequently. And this phenomena has spilled over into the business environment – consumers want quick instantaneous communication and prefer to use personal devices to get it.

For managers of health plans and provider organizations this can be a nightmare. Unsecure text messaging is a direct violation of The Health Insurance Portability and Accountability Act (HIPAA) requirements and could have serious consequences for the organization.

Randall Holley

A solution for this problem – secure Direct messaging – is now widely available. How to use secure Direct messaging was the focus of the presentation, Direct & Secure Messaging: Using New Tech To Improve Communication & Connectivity, by Ben Oesterling, Network Administrator at Concordia Community Support Services, Randall Holley, Director of Information Technology at Commonwealth Care of Roanoke, and Matt Keener, M.D., Founder & Director, Blackbird Health, at the 2016 OPEN MINDS Technology & Informatics Institute.

Ben Oesterling

First a quick definition. Direct messaging is not a method of communication, but a protocol for sending messages. It is a secure encrypted communication mechanism used to exchange sensitive clinical and administrative data. Direct messaging can take place via text messaging, email, web-based portals, and smartphone applications. And it has been widely adopted by health information exchanges (HIE) (see 66% Of Health Information Exchange Organizations Use Direct Messaging).

Matt Keener, M.D.

But provider organizations are finding great benefits in adding secure Direct messaging to their service delivery processes. One example is Concordia Community Support Services’ home health program, where staff members are spending nearly all their on-the-job time in the field. The organization uses an offline electronic medical record because many of their clients either do not have Wi-Fi, or live in rural areas out of reach of cellular towers. This was causing many problems for the organization, as staff members were not receiving scheduling changes or receiving necessary messages. To solve the problem, the organization decided to provide staff members with HIPAA compliant smart phones. But, that in itself didn’t improve communication. The phones still need a secure text messaging platform. Concordia went with the multi-platform model, Tiger Text, which allowed office staff to use the program on their computers, while staff could use the program on their smartphones. Thus far the program has been successful with a return-on-investment (ROI) that has provided the scheduling department $15,000 a year savings.

Another example is Commonwealth Care of Roanoke, an operator of twelve long-term care centers in Virginia. The organization contracts with medical directors and physicians to provide medical care at the facilities. What they found was the physicians preferred to communicate with staff via text message and, as a result, non-HIPAA compliant text messages were being sent on personal devices between staff members. To address this situation, Commonwealth Care chose to move to secure Direct messaging. In their first initiative, a Direct messaging app was downloaded onto staff personal devices and used to communicate. This caused a number of problems, as personal cellphones had not been allowed on the floor in the past and it was difficult to regulate whether staff was working or sending personal messages. To address these problems, Commonwealth Care developed a second and more successful approach, working with their electronic health record (EHR) vendor to integrate the Direct messaging software into the EHR. This solved a number of problems as staff were already carrying computers around all day and eliminated the need for personal devices. It also ensured that Direct messages were being entered into the EHR as needed.

Both Mr. Oesterling and Mr. Holley agreed that there were some key considerations when implementing direct messaging. HIPAA compliance, ease of use, encryption methods, multi-platform compatibility, and cost topped their list. But despite the challenges, both thought that Direct messaging was a positive – giving staff the ability to communicate through their preferred methods, be more efficient in completing daily tasks, and meet organizational compliance standards.

If you couldn’t join us in person this week, check out our archived event coverage on Twitter @OpenMindsCircle#OMTechnology. And stay tuned in the coming weeks as we take an in-depth look at our sessions from The 2015 OPEN MINDS Technology & Informatics Institute.

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