- Comply with your obligations regarding security, privacy and confidentiality when using messaging apps to send
and receive patient information.
- Check if there are any policies about the use of messaging apps at your hospital, health service or practice.
- Consider if any messages are part of the clinical record and if so, ensure you save them to the record.
Using messaging apps
Online communication and messaging platforms are
increasingly being used in clinical practice, beyond traditional
SMS. There are a few very popular platforms, but this is a rapidly
changing area, and some messaging apps are being developed
specifically for healthcare settings.
Messaging apps in healthcare are mainly used to communicate
with colleagues about patient care or workplace matters. Some
- Sending messages between different clinicians treating a
patient to share updates or seek input into the patient’s care.
- Sharing clinical images – e.g. a photo of a patient’s wound,
or investigations like an ECG.
- Specialists forming a group chat to arrange rostering or on
- Adding students and junior doctors to the team’s messaging
group when they start a new term or at a new hospital.
Using messaging apps can facilitate doctors asking for help and
improve the quality of communication between clinicians. It
may also mean responses will be more immediate which can
benefit patient care. Group chats may also create a positive and
inclusive culture within teams or departments and help break
down some historical hierarchies.
There can be uncertainty about when and how to use messaging
apps, including how they fit in with other communication about
patients and with your professional obligations.
Any time you share information about a patient using a
messaging app, consider your duty of confidentiality and privacy
and security obligations, and whether the information needs to
be included in the patient’s medical records.
Privacy and confidentiality
Privacy legislation allows you to share a patient’s health
information without specific consent where the purpose for
sharing is the same as or directly related to the reason that you
obtained that information.
This means you can share patient information via a messaging
app within the treatment team to provide clinical care without
having to obtain specific consent from the patient.
If you want to share any photographs or images, see Avant’s factsheet on clinical images for more information.
Messages sent using messaging apps are written records and
they should be treated in the same way as any other written
record. This means that obligations under privacy and health
records legislation apply. Therefore, there may be requirements
under legislation regarding:
- Whether information shared using the app needs to be
copied into the patient’s medical records.
- How long you must keep the messages.
Whether and how long messages must be kept depends
on the requirements in your specific state or territory and
your organisation. There may be differences between public
and private organisations. Ensure that you are aware of the
requirements in your workplace.
The person sending a message about a patient should ensure that
all clinically relevant information is copied into the patient’s medical
records to ensure continuity of care and long-term availability of
that information. It is important to document who was involved in
the messaging conversation and when it took place.
You are required to take steps to ensure the security of
information that you exchange using messaging apps. This is
complex and includes considerations about the features of the
app and the settings of your own device.
Some of these issues will be covered in the app’s terms and
conditions. You should review them and consider how well
the platform will protect the information you send and receive
and how it will support you in complying with your legal and
Your organisation may have considered these issues. Ensure
you find out whether there is a particular messaging app that is
approved by your hospital or practice.
You should also review the settings on your own device.
For more information about security of digital platforms
including messaging apps, see the Australian Digital Health Agency’s guide: Online conferencing technologies – Connected, secure consultations.
Most hospitals or public health services will have a policy about
whether and how you can use messaging apps. These will often
be provided at the start of your employment so you may need
to review or ask for a copy of the policy. Ensure you do this, or ask
if there is a preferred platform, before using messaging apps to
communicate about patients or with your colleagues.
The same principle applies in practices and other healthcare
settings as many workplaces have introduced policies about
what sorts of information can be communicated using
messaging apps. If your workplace does not have a policy
but does use messaging apps, it can be unclear what is or is
not permitted so we recommend you follow this up with the
appropriate person within your organisation.
Have a policy
If you are in a position to create a policy for your healthcare
organisation, it should address:
- whether or not messaging apps can be used
- any preferred platforms, and any platforms that are not
allowed to be used
- what types of communication the messaging apps can be
used for e.g. information about patients, staff arrangements,
- what messages should be kept and how this should be done.
Given the speed at which technology changes and regular
changes to the settings of different messaging apps, it is good
practice to review this policy every year when you review your
Managing your communication
Beyond the policy, put in place some practical steps. We suggest
having different groups for different purposes. For example, use
separate groups to send a message to your colleague about a
patient’s condition and the social event the team is organising.
Appoint someone as the administrator and review and update
this as needed. Be clear about that person’s role, which would
include removing people from the group who are no longer
part of the team or do not have an ongoing need for the
information. This can be addressed in the policy.
If you receive a message in error, for example after you moved to
a different team within the hospital, let the administrator of the
group know and delete the message, or remove yourself from
the group if you can.
Remember to always be professional in how and what you
write. Ensure you are always respectful towards colleagues and
patients in your messages.
Be aware that, like any record, messages sent via an app could be
relevant to and used in a later claim or complaint involving a patient.
Checklist before communicating about a patient via a
- Is this communication important for the care of
- Is there a more appropriate way of communicating
(e.g. phone call, in-person)?
- Am I only sending patient information to the people
who need it?
- Is the message professional and restricted only to the
information needed to directly benefit the patient’s care?
- Do I need to document in the medical records the
exchange had via a messaging app, and any important
clinical decisions arising from it?
- If sending a clinical image, do I have consent from
the patient to take and send the image? If so, have I
documented this consent in the notes?
For more information or immediate medico-legal advice, call us
on 1800 128 268, 24/7 in emergencies.
Disclosure: Avant is affiliated with and has a shareholding in myBeepr, a communication tool specifically designed for the healthcare setting. Find out more at myBeepr.com