Drolet Brian C, Marwaha Jayson S, Hyatt Brad, Blazar Phillip E, Lifchez Scott D
Department of Plastic Surgery, Department of Biomedical Informatics, Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN.
Warren Alpert Medical School of Brown University, Providence, RI.
J Hand Surg Am. 2017 Jun;42(6):411-416. doi: 10.1016/j.jhsa.2017.03.023.
Technology has enhanced modern health care delivery, particularly through accessibility to health information and ease of communication with tools like mobile device messaging (texting). However, text messaging has created new risks for breach of protected health information (PHI). In the current study, we sought to evaluate hand surgeons' knowledge and compliance with privacy and security standards for electronic communication by text message.
A cross-sectional survey of the American Society for Surgery of the Hand membership was conducted in March and April 2016. Descriptive and inferential statistical analyses were performed of composite results as well as relevant subgroup analyses.
A total of 409 responses were obtained (11% response rate). Although 63% of surgeons reported that they believe that text messaging does not meet Health Insurance Portability and Accountability Act of 1996 security standards, only 37% reported they do not use text messages to communicate PHI. Younger surgeons and respondents who believed that their texting was compliant were statistically significantly more like to report messaging of PHI (odds ratio, 1.59 and 1.22, respectively).
A majority of hand surgeons in this study reported the use of text messaging to communicate PHI. Of note, neither the Health Insurance Portability and Accountability Act of 1996 statute nor US Department of Health and Human Services specifically prohibits this form of electronic communication. To be compliant, surgeons, practices, and institutions need to take reasonable security precautions to prevent breach of privacy with electronic communication.
Communication of clinical information by text message is not prohibited under Health Insurance Portability and Accountability Act of 1996, but surgeons should use appropriate safeguards to prevent breach when using this form of communication.
技术提升了现代医疗服务水平，尤其是通过获取健康信息以及借助移动设备短信（文本信息）等工具实现便捷沟通。然而，短信已给受保护健康信息（PHI）的泄露带来了新风险。在本研究中，我们试图评估手外科医生对于通过短信进行电子通信的隐私和安全标准的了解及遵守情况。
2016年3月和4月对美国手外科协会会员进行了横断面调查。对综合结果以及相关亚组分析进行了描述性和推断性统计分析。
共获得409份回复（回复率为11%）。尽管63%的外科医生报告称他们认为短信不符合1996年《健康保险流通与责任法案》的安全标准，但只有37%的人报告他们不使用短信来传达受保护健康信息。年轻外科医生以及认为自己的短信通信符合规定的受访者在统计学上更有可能报告发送受保护健康信息（优势比分别为1.59和1.22）。
本研究中的大多数手外科医生报告使用短信来传达受保护健康信息。值得注意的是，1996年《健康保险流通与责任法案》法规以及美国卫生与公众服务部均未明确禁止这种电子通信形式。为符合规定，外科医生、医疗机构和机构需要采取合理的安全防范措施，以防止电子通信过程中的隐私泄露。
1996年《健康保险流通与责任法案》并未禁止通过短信传达临床信息，但外科医生在使用这种通信形式时应采取适当的防护措施以防止信息泄露。
