word: email and text communication with patients: staff...

Word: Email And Text Communication With Patients: Staff Guideline

Appendix D

PROFESSIONAL STANDARDS AND OBLIGATIONS

Purpose

This guideline is designed to assist Staff and healthcare providers with “least risk, best practices” use of email and text messaging to communicate directly with patients and/or patient representative. Using a principle-based approach, the guideline serves to support healthcare providers to balance clinical care mandates with current privacy policy and legislative requirements.

Background

Email and text messaging have many advantages to both patients and healthcare providers, including appointment reminders, increased accessibility, education and health promotion and improved coordination of work. However, the use of email and text messaging to support patient care comes with inherent risks.

Email and text messaging are not secure, private or confidential modes of information transmission. Emailing patient information over unprotected networks (i.e. open internet) is equivalent to mailing a post card through regular mail. Once sent, the information can be forwarded, changed, stored, deleted, not received by the intended recipient and/or intercepted by others. Text messages may be stored in backup servers by telecommunications service providers, even if manually deleted from a phone. These risks must be understood and acknowledged by both the patient, and Staff or healthcare provider.

Additional privacy risks include possible re-routing or storing of electronic communications outside of Canada, the disclosure of personal health information to unknown entities and retention of email on multiple servers between senders and receivers. The BC Freedom of Information and Protection of Privacy Act requires consent for Personal Information that may be stored outside of Canada.2

Ensuring optimal patient care and protecting Personal Information of patients served by C&W are both matters of patient safety. Where use of email and text messaging is warranted from an improved service delivery perspective, Staff and healthcare providers have a duty to use such communication thoughtfully and ethically within their professional scope of practice.

Site applicability

This guideline applies to all staff and healthcare providers, including physicians, and is applicable to all personal information and confidential information transmitted through email, including through Outlook Web Access and mobile devices such as tablets and smart phones.

Scope of use of email and text messages

I. C&W Permitted Use of Email and Text Messages for Direct Patient Communication

1. Responding to general inquires for information about C&W or its services

2. Health Education or Promotion Purposes

a. Health promotion messages

b. Routine information

c. Invitations to health promotion events

Items 1 and 2 do not typically require the transmission of personal information and provide general information only (e.g. information about C&W clinics, distribution of public health awareness messaging).

3. Administrative Purposes

a. Scheduling appointments

b. Appointment Reminders

c. Providing general information which may include sensitive information

Item 3 may include personal and sensitive Information about a patient (e.g. reminder of an upcoming appointment). Communication and messaging must limit information on a “need to know” basis and comply with program specific procedures (Standard Operating Procedures, SOP).

4. Communication with a patient that requires the transmission of personal information to that patient.

Item 4 involves the transmission of personal information (e.g. a request for a test result) and must adhere to the principles outlined in this guideline such as consent and identity verification, and program specific procedures.

For examples see Appendix A: Email and Text Message Tip Sheet

II. Requirements for Transmitting Personal Information to a Patient (Items 3 and 4 above)

If a situation requires sending personally identifiable or patient-specific information by email or text message at the request of a patient, staff and healthcare provider must ensure:

· Consent form is obtained and recorded (Appendix B)

· The patient’s identity has been verified

· Only the minimum amount of information necessary to support the purpose of the contact is provided

· All patient personal Information or clinical information is removed from previous communications

· Encryption of personal information is considered in relation to the type of information requested3

Principles

Overarching Principles for Direct Patient Communication via Email and/or Text Messaging

The following principles provide a framework for acceptable use of email and text messaging for direct patient communication.

PRINCIPLE 1: Respect patient privacy and confidentiality

Staff and healthcare provider must take reasonable steps to protect the privacy and health information of a patient at all times.

Implications for Program Specific Standard Operating Procedures (SOP)

Email and text messaging are not secure methods of communication. Staff and healthcare providers must assume that electronic communications are at a risk of unauthorized access unless the information they contain is encrypted.

Patients may not be fully aware of the potential risks of electronic communication, where their information might be stored or how it may be accessed. It is the responsibility of staff to inform patient/client/family of potential risks. We are also required by law4 to obtain a patient’s consent to transmit personal information through email or text message.

· Confirm your contact. When initiating an email or text message, carefully validate the email address or phone number to confirm accuracy.

· Remove old correspondence before sending. Previous emails containing personal information must be removed before responding.

· Conceal distribution lists. When sending an email to a group, recipients should not see the names and addresses of others. One method of keeping the names and addresses confidential is to use the blind carbon copy (bcc) field.

· Limit transmission of data based on the “need to know” principle. Staff and healthcare providers must limit personal or sensitive information to the minimum amount possible to meet the needs of the patient.

Small amounts of personal information (e.g. clinic name and appointment time and date - do not include patient/family names) that are pre-approved under program specific procedures may be transmitted without encryption.

· Large amounts of Personal Information (e.g. documents) must be encrypted prior to transmission. 5 C&W does not recommend transmitting large amounts of personal information unencrypted. Patient consent must be obtained prior to transmission. Chart information must be released in accordance with the PHSA Guidelines For Staff on Requests for Information.

· Avoid lengthy clinical engagements. Email and text messaging are not appropriate tools for providing clinical advice or crisis-related support and communication. In such cases, patients should be directed to contact a healthcare provider directly by phone.

Disclaimers: Confidentiality disclaimers must be included with all emails (see Appendix C)

PRINCIPLE 2: Use only approved communication tools

Staff and healthcare providers may only use PHSA approved mobile devices and email accounts to communicate electronically with patients.

Implications for Program Specific Standard Operating Procedures

Staff and healthcare providers must only use PHSA approved tools for patient engagement. Program specific procedures must include the following:

· Program areas must designate a specific PHSA email account(s) and/or mobile device(s) for patient communication.

· Access to designated email accounts and mobile devices must be limited to those that “need to know”.

· Only PHSA-approved texting applications are permitted. No third party applications (apps) are allowed without PHSA approval.

· Use of personal email accounts to communicate with patients (e.g. Gmail, Yahoo, Hotmail) is not permitted.

· Use of personal mobile devices to communicate with patients is not permitted.

· All devices must be password protected.

· Devices with the capacity to have information deleted remotely are preferred to assist in dealing with lost or stolen phones.

· Routine audits must be established by the program area on regular intervals to ensure appropriate access and use of email accounts and mobile devices guidelines are being adhered to.

PRINCIPLE 3: Document patient consent

A patient must provide informed consent prior to receiving personal information via email or text message. Staff and healthcare providers must document consent.


A patient’s consent is required to communicate through email and text when sharing personal information (see Appendix B). Consent must be documented in the patient record.

Consent may be documented in the following ways:

· In-person: the paper consent form is signed and a copy stored in the patient record.

· Via Cerner Process Alert: to confirm consent for use of email and text. If consent has been provided as indicated via the Cerner process alert then the Health Care Provider is only required to reconfirm consent and email address or phone number for transfer of information via email or text.

· Via email: print email indicating a patient's consent (e.g. “I agree”) and place a copy in the patient record.

· Via text message: Forward the text message (“I agree”) to email (see Appendix C), print the email and place a copy in the patient record.

If it is not technically feasible to add a copy to an electronic patient record, record manually in the patient’s electronic record and include the date and how the consent was provided. Corresponding paper consent form should be retained by program area.

Documentation of consent in the patient record:

Documentation in the patient record needs to occur as per program specific procedures and must be consistent with other forms of communication documentation (i.e. phone calls). Documentation is recommended to contain:

· The patient’s email address and/or text number.

· The patient’s consent and/or refusal for email and/or text communication.

· Withdrawal of the agreement to email and/or text.

· The information obtained, care provided and any agreed upon plan of care as per the program documentation standards.

Other documentation considerations

· Emails and text messages must be deleted from email accounts and mobile phones once documentation of the contact/message has occurred in the patient record and/or within predetermined program timeframes.

· Mailing lists (e.g. electronic spreadsheets or databases) must include the date of consent/acknowledgement.

When consent is not required

· Responding to general information inquiries

· Administrative, health education, or health promotion exchanges that do not contain personal information require the patient to agree to contact for these purposes (see Appendix A). A similar information statement can also be sent by email/text - see Appendix C for examples.

PRINCIPLE 4: Verify patient identity

A patient’s identity must be confirmed prior to releasing personal information to that patient.


A patient’s identity must be confirmed prior to the release of personal information or patient-specific clinical information to that individual.

· A patient must provide, at minimum, two patient specific identifiers (e.g. name, date of last clinic visit, reference number, date of birth) to confirm their identity in order to receive personal information.

· Program areas are expected to document appropriate verification procedures specific to their areas

PRINCIPLE 5: Adhere to Program Specific Standard Operation Procedures (SOP)

Programs must develop, and staff and healthcare provider must adhere to, SOP processes based on this guideline that are specific to their service area.


Programs are expected to develop operational processes for staff and healthcare providers based on this guideline that are specific to their service area. These processes must, at minimum, specify:

· Dedicated email inboxes and/or mobile phones approved for direct patient communication and what role is responsible for managing that account.

· Defined circumstances where Personal Information may be shared unencrypted with a patient.

· Processes for obtaining and recording patient consent

· Process for verifying a patient’s identity

· Approved communication scripts and confidentiality disclaimers

· Process for auditing Staff and healthcare providers access to dedicated email inboxes and mobile phones

PRINCIPLE 6: Be Aware of your Professional Responsibilities

Staff and healthcare providers must be aware of their relevant professional and ethical obligations regarding electronic communications with patients.


Staff and healthcare provider must review and be aware of their professional and ethical obligations regarding electronic communications with patients (See Appendix D).

PRINCIPLE 7: Report Potential or Actual Privacy Breach

Staff and healthcare providers must immediately report to their Supervisor or Manager any event whereby a communication has been misdirected, or if an account or device has been compromised, misplaced, lost or stolen (i.e. privacy breach).


· Staff and healthcare providers are required to immediately notify their supervisor or manager if an email or text has been misdirected and the PHSA Privacy Office ([email protected]).

· If staff and healthcare provider suspect that an email account has been compromised, they must immediately contact the PHSA Service Desk (604-675-4299 / [email protected]) and notify their supervisor, manager and IMITS Security ([email protected]) and the PHSA Privacy Office ([email protected]).

· If a PHSA computer, laptop or mobile device is misplaced, lost or stolen the incident must be reported immediately to your manager or supervisor, the PHSA Privacy Officer ([email protected]) and the PHSA Service Desk (604-675-4299 / [email protected]).

Definitions

Cerner Process Alert: Process alerts are placed at the person level in Cerner and will remain on the patient’s profile until manually removed. When this process alert is active the patient has consented to being contacted via email or text.

Confidentiality: Confidentiality is the responsibility and obligation of an employee or agent of PHSA to ensure that Personal Information or other confidential information is kept secure and is collected, accessed, used, disclosed, stored and disposed of only for purposes necessary and authorized by PHSA to conduct its business. Examples of the following types of information considered to be confidential:

1. Personal information and personal health information regarding patients, residents and their families;

2. Personal information, personal health information, employment information, and compensation information regarding staff/physicians; and,

3. Information regarding the organization’s operations that is not publicly disclosed by the organization (e.g., unpublished financial statements, legal matters).

Consent: for the purpose of this guideline, consent is a signed acknowledgment from a patient to permit a specified action in relation to that patient's personal or Sensitive Information. Consent must be retained in either physical form (Signature; paper based record) or electronic form (“I agree”; “yes”; ticked check-box) as part of an electronic health record.

Encryption: encryption is the process of encoding messages or information in such a way that only authorized parties can read it. Encryption does not of itself prevent interception, but denies the message content to the interceptor.

Health Care Provider: C&W staff who are providing direct health-related care to a patient.

Patient: any person receiving services from C&W.

Personal Identifier: for the purpose of this guideline, a personal identifier is information that identifies the individual by name, address or identifying number, e.g. Personal Health Number.

Personal Information: means any information about an identifiable individual, but it does not include business contact information (business contact information is information such as a person’s title, business telephone number, business address, email or facsimile number). Personal information examples are name, personal address, date of birth, PHN, financial, legal or clinical information of the patient. Personal information can also include information that when combined with other information may reveal an individual.

Sensitive Information: Sensitive information may include personal or health information that would be most appropriately delivered in person because the impact of disclosing the information may cause an emotional effect on the individual, or may give someone an advantage if revealed to persons not entitled to know it.

Staff: all officers, directors, employees, contractors, physicians, health care professionals, students and volunteers employed or contracted by C&W.

References

BC Centre for Disease Control, Privacy and Access Committee Statement: Communicating Personal Information Electronically, (October 2014) http://pod/BCCDC/privacy/BCCDC%20Privacy%20and%20Access%20Policies/BCCDC%20Communicating%20Personal%20Information%20Electronically%20with%20Health%20Professionals%20FINAL.pdf

BC Centre for Disease Control, Staff Guidelines – Email and Text Communication with Clients, (March 2016). http://pod/BCCDC/privacy/BCCDC%20Privacy%20and%20Access%20Policies/BCCDC%20Email%20and%20Text%20Guidelines%20for%20Communicating%20with%20Clients%20FINAL.pdf

Interior Health – Email & Text Messaging – Policy and Staff Information Sheet (May 2016)

Vancouver Coastal – Emailing Policy, Emailing Guidelines, Emailing FAQ (July 2017)

BC Physicians Toolkit: Use of Email by Physicians, BC Office of the Information and Privacy Commissioner, BC Medical Association, BC College of Physicians & Surgeons (June 2009). https://www.doctorsofbc.ca/sites/default/files/use_of_email_by_physicians.pdf

BC Physicians Privacy Toolkit: A Guide for Physicians in Private Practice, Doctors of BC (BCMA), the College of Physicians and Surgeons of BC (College) and the Office of the Information and Privacy Commissioner for BC (OIPC) (August 2017). https://www.oipc.bc.ca/guidance-documents/1470

Canadian Medical Protective Association (CMPA). Using Email Communication with your patient: Legal Risks. Safety of Care. (Revised May 2015). https://www.cmpa-acpm.ca/-/using-email-communication-with-your-patients-legal-ris-1

Canadian Medical Protective Association (CMPA). Using Electronic Communications, Protecting Privacy. Duties and Responsibilities. (Revised January 2016). https://www.cmpa-acpm.ca/-/using-electronic-communications-protecting-privacy

College of Physicians and Surgeons of BC, Professional Standards and Guidelines, Emailing Patient Information (February 2013). https://www.cpsbc.ca/files/pdf/PSG-Emailing-Patient-Information.pdf

College of Registered Nurses of BC (CRNBC). Practice Standards. (July 2012). https://www.crnbc.ca/Standards/PracticeStandards/Pages/Default.aspx

Doctors of BC. Email Communication with Patients. (November 2012). https://www.doctorsofbc.ca/sites/default/files/email_communication_with_patients_-_nov_2012.pdf

Interior Health Authority. Policy AR0500 – Email and Text Messaging. (May 2016)

PHSA policy – IMIT 140 - Internet and Electronic Mail Messaging Policy. http://2pod.phsa.ca/workplace-resources/policies-procedures/_layouts/15/WopiFrame2.aspx?sourcedoc=/workplace-resources/policies-procedures/acrossPhsa/Internet%20and%20Electronic%20Mail%20Messaging.pdf&action=default&DefaultItemOpen=1

PHSA policy - IA_020 - Information Access and Privacy - Privacy and Confidentiality Policy http://2pod.phsa.ca/workplace-resources/policies-procedures/_layouts/15/WopiFrame2.aspx?sourcedoc=/workplace-resources/policies-procedures/acrossPhsa/Privacy%20and%20Confidentiality%20Policy.pdf&action=default&DefaultItemOpen=1

PHSA policy IMITS guide -File Encryption for Emails/FFTP/Lync Distribution. http://pod/COMPUTERS-PHONES-TECHNOLOGY/ITSecurity/protectnetwork/Documents/IMITS%20File%20Encryption%20Guide_Oct2014.pdf

University of British Columbia (UBC). Policy 104. Acceptable Use and Security of UBC Electronic Information and Systems. (June 2013). http://universitycounsel.ubc.ca/files/2013/06/policy104.pdf

University of British Columbia (UBC). Privacy Fact Sheet. Privacy of Email Systems. (Revised May 2015). http://universitycounsel.ubc.ca/files/2015/05/Fact-Sheet-Privacy-of-Email-Systems.pdf

Developed By

CW Professional Practice – Associate Director

Version History

DATE

DOCUMENT NUMBER and TITLE

ACTION TAKEN

01-Oct-2020

C-0506-07-60850 Email And Text Communication With Patients: Staff Guideline

Approved at: CW Best Practice Committee

DISCLAIMER

This document is intended for use within BC Children’s and BC Women’s Hospitals only. Any other use or reliance is at your sole risk. The content does not constitute and is not in substitution of professional medical advice. Provincial Health Services Authority (PHSA) assumes no liability arising from use or reliance on this document. This document is protected by copyright and may only be reprinted in whole or in part with the prior written approval of PHSA.

EMAIL AND TEXT COMMUNICATION WITH PATIENTS:

STAFF GUIDELINE

DOCUMENT TYPE: GUIDELINE

C-0506-07-60850 Effective Date: 26-Oct-2023

Page 8 of 17 Review Date: 26-Oct-2023

This is a controlled document for BCCH& BCW internal use. Refer to online version. Print copy may not be current. See Disclaimer at the end of the document.

Action

Personal Information disclosure by C&W

Requirements

Notes

RESPONDING TO GENERAL INQUIRIES

· To provide general information to individuals who contact C&W.

e.g. Need general information, statistics, typo on website, department, authority, physician

NO

No consent necessary

No client verification necessary

· Responses are to be general in nature.

· If the client sends unsolicited personal information, it is recommended to remove the original email from the response email.

HEALTH EDUCATION / PROMOTION PURPOSES

NO

No consent necessary

· General Information with no patient information

AUTOMATED APPOINTMENT REMINDERS

· To establish automated appointment reminders between C&W and a patient

NO

Yes, consent necessary

· When a patient is informed* of the inherent risks to using email and text messaging, expressed verbal consent is accepted by the client providing his/her email and/or cell number.

*as described in Appendix B

ADMINISTRATIVE

· To establish exchanges between C&W and a patient

YES

(if Includes name,PHN,etc.)

consent necessary

Enrollment for email/text is generally onsite with in-person verification of client identity

· Client must review and sign the risk summary outlined in Appendix B.

Action


Requirements

Notes

TRANSMISSION OF PERSONAL INFORMATION

· Small amounts of personal information (e.g. a test result)

YES

Get Consent. Client must review and agree to the Consent Form (Appendix B) for the purposes of sending personal information.

Verify the client’s identity.

Document client consent and information released.

· Small amounts of personal information (e.g. a test result) that are pre-approved under program specific procedures do not need to be encrypted if the client has provided consent.

· Client must review the risk summary in Appendix B/Appendix C and provide written consent.

· Staff must abide by client verification requirements in accordance with their program specific procedures.

· Document information released in the client record, including email address/phone number.

Action


Requirements

Notes

TRANSMISSION OF PERSONAL INFORMATION

· Large amounts of Personal Information (e.g. chart information, documents containing Personal Information)

YES

Get Consent. Client must review and agree to the Consent Form (Appendix B) for the purposes of sending personal information.

Verify the client’s identity.

Encrypt using an approved encryption process.

Document client consent and information released.

· Refer to program specific procedures. If an exceptional request consult with your manager/supervisor.

· Staff must abide by client verification requirements in program specific procedures.

· Client must review the risk summary in Appendix B/Appendix C and provide written consent.

· Large amounts of personal information (e.g. documents, patient chart, lists of patient information pertaining to more than 10 individuals) must be encrypted prior to transmission.

· Chart information must abide by C&W Release of Information procedures. Consult with your Manager or Supervisor.

· See document encryption options available on the PHSA POD.

http://2pod.phsa.ca/quality-safety/privacy/data-protection/Pages/default.aspx

· Document information released in the client record, including email address/phone number.

Appendix A

GUIDELINE SUMMARY ON EMAIL AND TEXT COMMUNICATION WITH PATIENTS

C-0506-07-60850 Effective Date: 26-May-2020

Page 11 of 17 Review Date: 26-May-2023


Your privacy is very important to us. Children’s & Women’s Health Centre of BC (C&W) wants to make sure your personal health information remains safe and protected.

This is a consent form for release of personal information. It is important that you understand:

1) Getting your personal health information by email or text message may not always be secure. Your email/phone could be broken into and your personal health information could be seen or shared with others or changed without your permission. We recommend deleting personal health information from your email or phone to reduce the risk to you.

2) Depending on what company your cell phone plan or email is with (such as Gmail or Yahoo), information we send to you may be stored outside of Canada.

3) If you delete email or text messages from C&W, backup copies could still be on your computer or in cyberspace.

4) C&W Staff do not check email and texts every day. If you need to talk to staff in an urgent situation please call your child’s physician and/or family physician or seek care at your closest walk in clinic or emergency department.

5) Do not email or text the C&W if you have an emergency. If you have an emergency, call 911 or go to the closest emergency department.

6) C&W Staff will not give your health advice by email or text; you have to call or come into the clinic if you have questions about your health.

7) It is your responsibility to let us know if your email address or phone number changes.

8) It is your responsibility to tell the C&W if you change your mind and no longer want to get messages by email or text.

Please select one or both options below:

· I agree to provide my email and/or text (cell phone) message number for administrative purposes/general inquiries (including requests to contact C&W)/health education or promotion purposes. No personal health information will be shared.

· I agree to provide my email and/or text (cell phone) message number for administrative purposes (i.e. scheduling appointments, test reminders) where small amount of personal information may be shared.

· By signing below, I agree to provide my email and/or text (cell phone) message number for the purpose of sharing my/my child’s (less than 12 years of age) personal health information.

Signatures:

Patient (or substitute decision maker*) signature

Patient Name or Substitute Decision Maker*(Print)

Reason for Substitute

Witness Signature

Witness Name (Print)

_______/__________________/______

Day Month Year

* For the purpose of this consent a substitute decision maker may only be a family member or other legally appointed decision maker (e.g.: Representative, Committee, guardian)

TO BE COMPLETED BY THE INTERPRETER (if applicable):

I confirm that I have explained the nature of the above consent to the above-named patient (and/or legal substitute) in

the presence of ______________________ and to the best of my knowledge the context of this consent. Witness Name (Print)

__________________________________ __________/_______________/__________

Signature of Interpreter Day Month Year

__________________________________

Interpreter Name (Print)

All information collection is done in accordance with section 26(c) the Freedom of Information and Protection of Privacy Act. If you have any questions about how your personal information is used or stored, please contact the Corporate Director, Information Access & Privacy at (604) 707-5834.

Appendix B

CONSENT FORM

FOR RELEASE OF

PERSONAL INFORMATION

Placement of PATIENT ID LABEL




The following scripts are suggested examples for developing program specific procedures

Email Acknowledgement:

At times this clinic uses email to share information with clients. We will only share information with you by email if you give us permission to do so. Your health information is private and personal and there are some risks to sending this information by email. Some of these risks are:

· Once an email message is sent we can’t guarantee who will be able to see it.

· We will double-check that the email address you give us is right but sometimes we may make a mistake and the message could be sent to the wrong person.

· We recommended that you delete emails you get from this clinic. Sometimes, even if you delete emails, backup copies may exist on your computer or in cyberspace.

· Someone could hack your email account and look at your private information.

· We don’t check our email account everyday so if you need help right away, you must call the clinic.

· We have no way of knowing if you have read the email we sent to you.

· It is your responsibility to let us know if your email address changes.

· It is your responsibility to let us know if you no longer want to receive your information from us by email.

If you have read and understand these risks, please reply to this email with “I Agree”. You will be asked to verify your identity in an email before we send you any information. If you have questions about this email, please call the Clinic ‘at ‘phone number’ between 9:00 AM and 4:00 PM Monday to Friday.

Subsequent Email Acknowledgements (abbreviated version sent to clients to acknowledge risks):

Your health information is private and personal and there are some risks to sending this information by email. We recommended that you don’t forward emails you receive from this clinic to other people and that you delete emails from us.

It is your responsibility to let us know if your emailaddress changes or if you don’t want to receive your information from us by email anymore.

We don’t check this email account everyday so if you need help right away, you must call the clinic at ‘phone number’.

Appointment reminder:

“patient name* (optional)”, this is to remind you about your appointment scheduled for “date” at “time” in the “clinic name” at “site.” If you have any questions or need to cancel the appointment, please call the clinic at “PhoneNumber”

*inclusion of personally identifiable information such as name requires written consent

Request to contact: Subject line: Important Health Matter

[add reference number]

Please call me as soon as possible to discuss an important health matter.

[add business contact information]

Email Disclaimer:

The contents of this Email, including attachments, are intended for exclusive use of the recipient and may contain confidential or privileged information. If you are not the intended recipient, you are strictly prohibited from reading, using, disclosing, copying or distributing this Email or any of its contents. If you have received this Email in error, please notify the sender by reply Email and permanently delete this Email and its attachments.

Text acknowledgment:

Text is not considered secure and your personal information may be at risk if the system is compromised. You need to let us know if you no longer want to text with us or if your phone number changes. Call the clinic for serious, urgent or time critical issues. Please text us if you accept this risk and would like to continue to communicate by text.

Appendix C

SAMPLE SCRIPT TO SUPPORT

STANDARD OPERATING PROCEDURE (SOP)

Staff and healthcare providers must review and be aware of their professional and ethical obligations regarding electronic communications with patients.

For all:

· PHSA Data Protection & encryption guide: Data Protection

For physicians:

· College of Physicians and Surgeons of BC: Emailing Patient Information.

· Doctors of BC: Email Communication with Patients.

· CMA Policy: Physician guidelines for online communication with patients.

· CMPA: Using Email Communication with your Patients: Legal Risks.

For nurses:

· CRNBC Practice Standards Privacy and Confidentiality

· CRNBC Practice Standards Telehealth

· CRNBC Practice Standards Consent

· CRNBC Practice Support Nursing Documentation Electronic Mail (page 17)

For dietitians::

· College of Dietitians of BC Electronic Dietetic Practice http://collegeofdietitiansofbc.org/home/documents/2014/Qac-10-EPractice-final-Apr-15-14.pdf

For psychologists:

· College of Psychologists of BC Code of Conduct: http://www.collegeofpsychologists.bc.ca/docs/sept1/Schedule%20F%20(Code%20of%20Conduct),%20Sept%201,%202014.pdf

For child life specialists:

· Standards of Clinical Practice for the Association of Child Life Professionals: http://www.childlife.org/docs/default-source/the-child-life-profession/standardsofclinicalpractice.pdf?sfvrsn=2

· Competencies https://www.childlife.org/docs/default-source/about-aclp/core-competencies.pdf

· Codes for Guidelines for Professional Conduct https://www.childlife.org/about-aclp/purpose-mission-values/official-documents/codes-and-guidelines-for-professional-conduct

· For occupational therapists:

· College of Occupational Therapists of BC (COTBC) Practice Standards

· https://cotbc.org/library/cotbc-standards/

· COTBC Managing Client Information (MCI) Practice Standards

· https://cotbc.org/library/cotbc-standards/practice-standards-and-guidelines/managing-client-information/

· Collecting and Recording Client Information

· https://cotbc.org/wp-content/uploads/COTBC_ManagingClientInfo_Standard1_2014-1.pdf

· Protecting Client Information (Privacy and Security)

· https://cotbc.org/wp-content/uploads/COTBC_ManagingClientInfo_Standard2_2014-1.pdf

· Code of Ethics https://cotbc.org/wp-content/uploads/Code_of_Ethics.pdf

For physical therapists:

· College of Physical Therapists of BC http://cptbc.org/resources/

For social workers:

· BC College of Social Workers Standards for Technology http://www.bccollegeofsocialworkers.ca/wp-content/uploads/2016/09/BCCSW-Technology-Standards.pdf

For speech and hearing professionals::

· College of Speech and Hearing Language Professionals of BC Standard of Practice Documentation and Record Management: http://www.cshhpbc.org/docs/documentation_and_record_management__sop_prac_01_(002).pdf

· Clinical Practice Guideline Documentation and Record Management: http://www.cshhpbc.org/docs/cpg-04_-_documentation_and_record_management.pdf

Should a conflict between these guidelines and your professional and ethical obligations be apparent, it is incumbent on staff and healthcare providers to notify their Supervisor or Manager.


