The idea of improving communication in healthcare is always a hot one. For fear of HIPAA and other factors, healthcare seems to lag behind when adopting the latest communication technologies. The most simple examples are email and text message. Both are simple and widely adopted communication technologies and most in healthcare are afraid to use them.
At the core of why people are afraid is because native email is not HIPAA secure and native SMS is not HIPAA secure either. Although, there are a whole suite of communication products that are working to solve the healthcare communication security challenges while still keeping the simplicity of an email or text message. In fact, both of the other companies I’ve started or advise, Physia and docBeat, are focused on the problems of secure email and secure text. Plus, there are dozens of other companies working to improve healthcare communication and hundreds of EMR, PHR, and HIE applications that are integrating these forms of communication into their systems.
As we enter this brave new world of healthcare communication, it’s worth considering some of the intricacies of email vs text. The following tweet is a good place to start.
@danmunro – A1: Email is an interesting place to start, but much ignored – only 5% to 20% open rates. Text msgs opened at a 97% clip. #HITsm
— Ken Congdon (@KenOnHIT) April 5, 2013
This is really interesting to note and I can confirm those are the general statistics for most email campaigns out there today. I’m not sure of the number of texts that are open, but it’s clear that the number of text messages that are opened is very high.
The reason this is the case is because of the expectation of what’s inside a text message vs an email. When you receive a text, you can be sure that it won’t take up more than a moment of your time. You can consume it quickly and move on with your life. The same is usually not the case with email (especially email lists). Most of the emails that are sent are lengthy because they can be. We try and pack every option imaginable into an email and so people have an expectation that if they start with the email they’re going to need time. I know this is the case because my email subscribers often thank me for my emails because they know they can get something of value quickly.
I think it was Dan Munro that pointed out an exception to the email open rate. His idea was that if the email contains an action item, then open rates are much higher. This was a good insight. There’s little doubt that if an email contains something that you have to do, then more people will open it and do the action. I don’t get a bill in my email and then don’t open it. I have to open it so I can pay the bill. I’m sure this principle can be applied in a number of ways to healthcare.
As we finally bring these common communication technologies to healthcare we need to be thoughtful about which ones we use and when we use them.
There’s no point in wasting money on paid services. Industry standard encryption for email & chat is free and readily available for *every* operating system, tablets & phones included. Only texting cannot be made secure (unless *both* you & the patient have military grade secure phones).
Good luck getting your patients email system to support encryption. Same for IM, but I don’t know any doctors who will IM their patients. Internally you can sometimes get it done, but even getting doctors you refer to to be able to use secure email using industry standard encryption is near impossible. Plus, most doctor won’t know when the email is secure and when it isn’t which causes its own problems.
John, great points made here. I think you left out one about text messages though and their open rates and trustworthiness. For me, texts are more personal and believed to be coming from a trusted source because in order to connect, you need to have my phone number which I hand out a lot less frequently and handily than I do with my email address. I do believe that to be another important factor. Nonetheless, it still may not contain the necessary security just yet. Who knows, perhaps the iPhone 5S’ new fingerprint sensor will be a gamechanger in this respect…
Good point. People don’t share their cell number as much as they do their email. So there is a different trust factor there.