Irish College of General Practicioners warns of Privacy Issues associated with Doctors sending SMS

Forum Journal of the Irish College of General Practitioners Advice on SMS

Q. We are considering sending SMS text messages to our patients to remind them about appointments and give them the results of laboratory tests. Are there privacy and confidentiality issues we should be aware of?

A. The use of text or SMS messages to patients can appear an efficient and attractive way of communicating with patients. However, there are difficulties with sending confidential information in this way as text messages can be read by others and mobile phone numbers can change. It is advisable therefore to restrict messages by text to non-clinical matters such as appointment reminders, vaccine recalls, smear recalls, etc. It is important to get patient consent in order to communicate by text message. For further information on communicating information to patients refer to the ICGP publication A Guide to Data Protection Legislation for Irish General Practice on

My thoughts:

Was the question really about sending confidential information?

I think the advisor has in a roundabout way suggested that an appointment reminder OR lab test result notification are in some way more clinical than what is suggested would be “non-clinical matters”.

To make it clear here’s what a typical appointment reminder looks like:

“Hi David. Your appointment tomorrow is at 3 pm. If for any reason you can’t make it please text/call the office.”

Here’s what typical lab result notices look like:

“Hi David. Your lab results are back please visit our website to book an appointment:

“Hi David. Your lab results are back please ring the clinic for the results”

Of course the use of a secure patient portal would be preferable (and a message informing the patient that their record has been updated and they need to sign in to read it) but I fail to see how these messages would be considered to be more clinical than messages informing a patient that they have a recall for a vaccine or smear.

How would a Doctor have a mobile number but not have Patient consent?

The response states that “It is important to get patient consent in order to communicate by text message” but I wonder if this is a real world problem.

How would a Doctor go about getting a Patients mobile number without consent? Surely it’s the same process Doctors use for getting any patient information eg. just like with a postal address a Patient would be entering this information and ticking a box agreeing to how their Doctor’s practice will be using it.

Why is anyone concerned about a SMS GP appointment Reminder or Notification?

On a more practical note would it really be that bad if someone got your mobile phone and there was a GP appointment reminder in the inbox? Wouldn’t there be much more private and confidential information than info that I went to a certain GP Clinic and I had a test?

and mobile phone numbers can change

Is this a bigger issue than postal addresses to which Doctors and Hospitals send comprehensive letters to? Mobile numbers might change but unlike postal addresses it’s very very rare for them to be immediately passed onto someone else.

Advice I would give to a GP thinking about this opportunity?

> Go for it, it will make the lives of your Patients easier & some will love it
> Fewer cancelled appointments will ensure your time is used more effectively
> There is plenty of evidence of the benefits and cost effectiveness
> There are companies that are specialised at providing SMS services to GPs eg. iPlato serve 5 million patients in the UK
> It will work great with a secure surgery website and it’s a great first step for you towards rolling out secure patient portals, interactive patient history taking tools and documented consultations, leveraging the increasingly powerful mobile tech that’s already in your patients pockets, etc.

What advice would you give to GP’s who are considering sending SMS text messages to their patients?

About David Doherty
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