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Texting with Patients: How to Do It Safely and Effectively

Texting with Patients: How to Do It Safely and Effectively

​Texting with Patients: How to Do It Safely and Effectively

Have you ever said…
“If only I had someone to ask!”

Each month, we tackle real questions from clinic managers, healthcare providers, and privacy officers inside Practice Management Success.

This month’s question:

Can you text your patients?

The short answer is:
Yes.

The better answer is:
Yes—but only if you do it thoughtfully, with the right safeguards in place.

Why This Matters

Texting is no longer “new.”

Patients expect it.
Staff rely on it.
And many EMRs now offer built-in messaging tools.

But here’s the problem:

👉 Texting is not always a secure communication method.

It’s difficult to:

  • Confirm who is sending or receiving the message
  • Control where the message is stored
  • Prevent miscommunication or disclosure

That means one quick message can turn into a privacy breach or medical error.

Start With Purpose (Not Technology)

Before you implement texting, ask:

Why do we want to use it?

Common reasons include:

  • Appointment reminders
  • Scheduling changes
  • Improving patient access
  • Reducing phone volume

These are all valid—but they are not all equal in risk.

From the Patient to the Clinic

Some clinics allow patients to text:

  • Appointment requests
  • Questions about care
  • Follow-ups

In some cases—especially remote or higher-risk populations—this may improve access to care.

But you must weigh this carefully.

👉 Sometimes the risk of not communicating is greater than the risk of using an unsecured method.

This is where your professional judgment—and policies—matter most.

What Are the Risks?

As the custodian, you assume the risk of using unsecured communication.

So your job is to:

  • Define acceptable use
  • Set clear boundaries
  • Train your team
  • Communicate expectations to patients

One of the most practical ways to do this?

👉 Create scenarios

  • When is texting appropriate?
  • When is it not?
  • What should staff do instead?

Document these decisions as part of your implementation plan.

Workflow Matters More Than You Think

If a patient texts your clinic—what happens next?

You need clear answers to:

  • Who receives the message?
  • On what device?
  • How is it verified?
  • How is it documented in the patient record?

If it’s not documented, it didn’t happen.

From the Clinic to the Patient

This is where most clinics start—and where risk is easier to manage.

Best use cases:

  • Appointment reminders
  • Basic instructions
  • Non-sensitive communication

Higher-risk uses:

  • Test results
  • Clinical advice
  • Sensitive health information

👉 Keep texting administrative, not clinical, unless you have a secure solution.

Consent and Patient Understanding

Patients must understand:

  • How texting works in your clinic
  • The risks to their privacy
  • Their role in protecting their information

This includes:

  • Using a personal phone (not shared or work devices)
  • Keeping their phone secure
  • Updating their contact information

Consent is not just a form—it’s a conversation and an agreement.

Use the Right Technology

Whenever possible:

  • Use EMR-integrated messaging
  • Avoid personal devices
  • Implement role-based access
  • Enable audit logs
  • Use multi-factor authentication (MFA)

These tools help you:

  • Maintain control of patient information
  • Improve workflow
  • Reduce manual documentation

Don’t Skip the PIA

Before you implement texting or email communication:

👉 Complete or update your Privacy Impact Assessment (PIA)

This doesn’t have to be overwhelming—but it is essential.

Your PIA should describe:

  • What you are implementing
  • How information flows
  • Risks and mitigation strategies
  • Policies and procedures

Practical Take-Aways

If you’re thinking about texting patients:

  • Start with low-risk uses (appointment reminders)
  • Use approved systems—not personal phones
  • Define clear rules and workflows
  • Train your team using real scenarios
  • Document everything
  • Review and adjust regularly

Want Help Getting Started?

If you want to go deeper, I’ve created tools to help you implement this safely:

✔ Sample texting authorization forms
✔ Step-by-step procedures
✔ Training resources for your team
✔ PIA guidance and templates

👉 Download the FREE report:
Can You Use Text Messaging with Patients?

👉 Get ongoing support:
Practice Management Success Membership

👉 Join me live:
Q&A with Jean –  2nd Tuesday of each month at 12 noon MT

Don’t Miss the Next Q&A!

Final Thought

Texting can absolutely improve access, efficiency, and patient satisfaction.

But it must be done with intention.

Because when it comes to privacy:

When we know better—we can do better.

Jean L. Eaton is constructively obsessive about privacy, confidentiality, and security especially when it comes to the handling of personal health information. If you would like to discuss how I can help your practice, just send me an email. I am here to help you.

Jean L. Eaton
Your Practical Privacy Coach
INFORMATION MANAGERS

How to Prepare Patient Records for a Court Order in Your Healthcare Practice

How to Prepare Patient Records for a Court Order in Your Healthcare Practice

How to Prepare Patient Records for a Court Order in Your Healthcare Practice

You are working at the reception desk of a healthcare practice. Suddenly, there is a police officer giving you a court order! Do you know how to prepare patient records for a court order?

panic button

Don’t Panic!

Take a deep breath. Then, follow these steps to help you to respond to a request for patient records for a court order with confidence!

Listen to the Design Your Practice Podcast with Kayla Das!

Episode 76: How to Prepare Client Records for a Court Order with Jean Eaton

 
designer practice podcast logo court order

Listen to the Podcast Here

You can also find the podcast on Apple Podcast, Spotify, and YouTube. Simply search for “Designer Practice Podcast” on your preferred platform.

 

Follow These Steps

In this article, I am not discussing a situation which relates to a life-threatening situation that requires an immediate response. I am also not discussing when the order relates to the type or quality of healthcare provided to the patient or when the actions of the healthcare provider or clinic is being challenged or reviewed. These are topics for a different article.

Your reception staff should not accept the court order but, instead, immediately ask the officer to wait for a few minutes so that they can request their supervisor or privacy officer meet with them.

When the court order is an administrative request for information, the supervisor or privacy officer will accept the court order from the officer. Before the officer leaves, make sure that you read the court order carefully and ensure:

  • Who is named in the court order.
    • This is often the clinic manager of the clinic. Your clinic should be specifically named or, perhaps, the name of your lead physician or healthcare provider.
  • Record the date and time that you received the order.
  • Clarify when the response is required.
  • Name and contact information.
    • This could be of the officer that delivered the court order (if possible).
    • At minimum, it should include the contact information of the court, for example, the court clerk’s office or the witness co-ordinator, or the sheriff’s office.
  • The province or jurisdiction of the court.
  • In general, this should be the same province where your clinic operates. If not, contact your lawyer for advice on how to respond.

Review Your Policies and Procedures

This is not a routine request from a patient to access their health records or a request to disclose their records to a third party like a lawyer or insurance company. In those routine requests, patients are generally required to provide a written, signed consent before you can disclose their records.

When you receive a court order or subpoena to produce patient records at a court or other legal proceeding, you are not required to get a signed consent from the patient.

Each healthcare practice should have detailed policies and procedures on how to prepare patient records for a court order. Review these now.

If you don’t have up-to-date policies and procedures, see the Practice Management Success Tip, How to Prepare Patient Records for a Court Order.

Validate the Court Order

Read the court order carefully. In particular,

  • Phone the contact number on the court order.
  • Confirm the date, time, and location that you are required to appear.

Locate the Patient Record

Find the patient information maintained in an electronic database, electronic medical record (EMR) and/or paper records. Remember to look for both active and inactive patient records as needed by the court order.

Read the patient record carefully, line by line, to ensure that the record is complete. For example, make sure that all lab reports, prescriptions, consultation notes, etc. are included in the record.

Secure the record to prevent snooping or modification to the record. Also ensure that the record is available for continuing care and treatment of the patient, if needed.

In an electronic record, prepare an audit log of all the transactions on that patients’ chart.

Ensure there is no duplicate or second chart for the patient that may have been created in error. Search by alternate names, spellings, date of birth, etc.

Ensure that each custodian included in the patients’ care and your healthcare practice’s privacy officer is informed of the court order to produce the record. The custodian should be provided an opportunity to review their clinic notes. Remind the custodian that they cannot further disclose the patient’s record.

Prepare the Patient Record

Review the court order and identify exactly what information is requested. It might be for specific dates or a condition or treatment.

Keep complete and detailed notes about how you prepared your response to the court order. You will bring your notes with you to court to assist you in your testimony about how your clinic creates and maintains patient records and what you did to respond to the court order. After your court appearance, you will maintain your notes as part of the business records for the clinic.

Collect the information and record each of your steps and your results, including the records that you searched for as well as those that you did not find any results for.

If you maintain your patient records in an electronic medical record (EMR) or digital practice management software, print out a hard copy of all the information that responds to the information that is requested.

Sever (also known as redact or black-line) any information that is not appropriate to include in the disclosure. Cross-reference each redacted entry to the legal authority not to include the information in the disclosure.

illustration of text that has black lines through sections sever or redact part of How to Prepare Patient Records for a Court Order
If you are using an EMR, organize the paper print-out in a format that makes sense. This might be in chronological date order, or by grouping like records (clinic notes, lab results, etc.) together.

Create a ‘Table of Contents’ of the information in the patient record. This will help you in your testimony to quickly find requested information, and to help the court to locate information in the records that you have prepared.

At the same time, handwrite in ink at the bottom of each page the sequential page number in the package. Update the table of contents with the page numbers.

Stamp ‘COPY’ on each page.

When the package is complete, make a photocopy (or two) of the entire package. The ‘original’ paper copy will be maintained at the clinic. Bring the original and the copy to court and ask the court to accept your copy. Return the original package to the clinic and securely maintain this as part of the business records of the clinic until the court file is complete.

When You Attend At Court

As the clinic manager, your role at the court is to tell the court how patient information is collected and maintained in your healthcare practice. Your job is not to interpret the content of the clinic notes.

A few days prior to the court date indicated on the court order, phone the clerk’s office or witness support office to confirm the date, time, and location of the proceedings and if you are still required to attend.

image of 3d figure in a witness box in court raising hand to affirm testimony How to Prepare Patient Records for a Court Order
On the day of the proceedings, report to the clerk of the court.

Bring with you the court order, your photo ID, the patient record, and your notes. Bring a good book to read in case you have a long wait.

You will be advised (again) if you are required that day. If you are not required, the clerk will make a notation on your court order to appear that you attended and that you have been dismissed. Keep this in your business records with the patient record.

If your testimony and the patient records are required, you will be called as a witness during the court proceeding.

You will be asked to swear or affirm an oath to speak honestly during your testimony.

Typical questions that you should be prepared to answer include:

  • Your name.
  • Your role at the clinic, how long you have been in that role, your routine tasks and responsibilities at the clinic.
  • Describe how patient records are maintained. Be prepared to explain your EMR or computer patient management system (if you have one).
  • Bring your notes about the steps that took to prepare for the court order. You may ask permission of the court to refer to your notes that you created when preparing to respond to the court order during your testimony, if necessary.
  • Explain that the patient records are kept electronically and that you have prepared a paper print-out of those notes.
  • Be prepared to explain how you know that the records are complete, not missing any details, etc.
  • If the court asks you to enter the records into evidence, explain that you have an ‘original’ and a ‘copy’ and ask the court to accept the ‘copy’ into evidence.

When You Return to the Clinic

Complete your notes by documenting your day at the court. Write a short summary of your day including:

  • Did you give a copy of the patient records to the court? To whom?
  • Remember to add this notation to the patients’ record that you disclosed this information according to the court order.
  • Any follow-up required for this disclosure?
  • Review your procedures. Anything that you would edit or provide additional instructions that will help you to be better prepared for next time you receive a court order?
  • Submit a copy of your out of pocket expenses (parking receipts, meals, etc.) for re-imbursement by your employer, if applicable.

What You Should Do Now

  1. Review your policies and procedures now to ensure that it includes how to respond to a court order.
  2. Train your reception staff on what to do if they receive a court order.
  3. Train your privacy officer and clinic manager on how to prepare a patient record for a court order.

Depending on where you work, you may receive a court order regularly or it might be a once-in-a-career experience. When you have policies and procedures and a little bit of training to assist you, you can respond to a court order calmly and confidently.

If you are a member of Practice Management Success, login and access the ’Procedure:  Preparing Patient Records for a Court Order’ template and the replay of the tutorial video.
Download Practice Management Success Tip – Preparing Patient Records for a Court Order Now!
 
 

 

 
image Jean L. Eaton

When we know better, we can do better…

Jean Eaton is constructively obsessive about privacy, confidentiality, and security especially when it comes to the handling of personal health information. If you would like to discuss how I can help your practice, just send me an email. I am here to help you.

Jean L. Eaton
Your Practical Privacy Coach
INFORMATION MANAGERS

Do You Use Employee Privacy and Security Policy and Procedure Checklist Templates?

Do You Use Employee Privacy and Security Policy and Procedure Checklist Templates?

Why Do You Need Policy and Procedure Checklists for Onboarding and Exiting Employees?

There is much excitement when we welcome a new hire to our team and there are many administrative tasks that need to take place to get this individual up and running. An employee policy and procedure checklist will help!

Policies and procedures must be in writing, available to employees, and monitored to ensure that they are followed to protect patient privacy as required by our professional colleges and privacy legislation. Otherwise, you face all sorts of risks, including privacy breaches and other legal problems.

To ensure that onboarding a new employee is a smooth transition, it is imperative to follow a practical checklist procedure to make sure no important steps are missed. There are also many other managerial benefits to adopting this high-quality process:

  • Better job performance and satisfaction
  • Greater commitment to protecting privacy in the organization
  • Reduced stress and better staff retention

Employee Privacy and Security Policy and Procedure Checklist

Policies and procedures are reasonable safeguards to protect the personal and health information entrusted to us. But polices and good intentions alone are not enough; we also need to take action to ensure our policies are understood and are being followed by all our employees.

Training new and existing staff on privacy and security best practices is instrumental in making your healthcare practice a success and maintaining its fine reputation. Following a systematic approach to welcoming a new employee, transitioning an existing employee into a new position, or offboarding an employee who is exiting will guarantee that valuable privacy and security training and accesses are completed.

Read this Privacy Breach Nugget that explains what can happen if you don’t have these good practices in place. Do You Know Where Your Policies And Procedures Are? 

New Employee Orientation / Onboarding

New employees are a welcome addition to any team and there is a vast amount of training that needs to take place from general procedures on how to handle phone calls to signing confidentiality oaths to becoming familiar with all policies and procedures, in addition to learning the everyday job duties for their own position.

Since privacy is good for business, we do not want to miss any important opportunities to train our new staff on privacy and security best practices. Using the Employee Privacy and Security Checklist will help facilitate training discussions and document the authorized accesses of each employee.

Existing Employees / Annual Review

The checklist will also act as a tool for each employee at their performance review. Provide positive feedback and observations of an employee’s successes in protecting personal information. Discuss opportunities for improvement, too. This is also a good time to review an employee’s current authorized role-based accesses and determine if any changes are needed to match the employee’s current job duties.

Ensure that the employee still has ‘tokens’ that they were given at the time of their hire, like identity badge, keys to the clinic or Alberta Netcare RSA fob.

Privacy and security best practices dictate that confidentiality oaths should be signed on an annual basis and annual privacy awareness and security refresher training should also be provided to all employees. In the event of a privacy incident or breach, it is imperative that a healthcare practice can prove by their documentation that regular privacy and security training is provided to their staff.

Transferring / Exiting Employees

When an employee transitions into a new role or is terminated, review and update the privacy and security checklist to ensure that access and permissions are appropriately modified or terminated.

Custodian Responsibility

Custodians have an obligation to ensure reasonable safeguards to protect the privacy and security of health information. This includes having appropriate policies and procedures in place, as well as demonstrating and documenting that you have implemented your plans. This is a requirement of professional college standards of practice and privacy legislation like the Health Information Act (HIA).

See the article Do You Know Where Your Policies And Procedures Are? to learn what can happen to you if you don’t have your employee training process well documented

The Employee Privacy and Security Checklist will make it easy for you to ensure your new hires, existing employees, and transferring or exiting employees are privacy and security compliant.

 

Download the FREE Report – Employee Privacy and Security Policy and Procedure Checklist Template
 

Your practice also needs to have policies and procedures that set out how you ensure the privacy, confidentiality, and security of the health information you collect, use, and disclose. Don’t know which policies and procedures you need? Download the Privacy and Security Policies and Procedures Checklist below!

Show Me the Policy and Procedure Checklist!
 

Practice Management Success

If you are a member of Practice Management Success, login and access the webinar replay, and the policy, procedure, and checklist template.

Not a member? Join today!

 

Did you enjoy this article? If you’d like to look at similar posts, visit these links:

Do You Know Where Your Policies And Procedures Are?

Why Do You Need Health Information Policies and Procedures?

Healthcare Policies And Procedures: Essential in EVERY Practice

New! Health Information Policy and Procedure Manuals

 

When we know better, we can do better…

Jean L. Eaton is constructively obsessive about privacy, confidentiality, and security expecially when it comes to the handling of personal health information. If you would like to discuss how I can help your practice, just send me an email. I am here to help you.

Jean L. Eaton
Your Practical Privacy Coach
INFORMATION MANAGERS