If you choose to contact your provider by texting, the below is a statement from Apple about its inability to comply with government request for data due to iMessage traffic being encrypted:

“...conversations which take place over iMessage and FaceTime are protected by end-to-end encryption so no one but the sender and receiver can see or read them. Apple cannot decrypt that data.”  

Wikipedia’s article about iMessage states:

“Every connection has its own unique code, which acts as an identifier for the route that should be used to send a message to a specific device. The connection is encrypted with TLS using a client side certificate, which is requested by the device on the activation of iMessage.”

IMessage traffic is encrypted, only readable for the two end users and is therefore HIPAA compliant. You can tell when a message is being sent using iMessage because it will show in blue and not green.

Blue = iMessage = encrypted, is HIPAA compliant and is Ok to use for healthcare information

Green = SMS = is not encrypted, is not HIPAA compliant and is not OK for healthcare information.

Group Texting

If you send a group message to 10 people and 9 of them have iPhones setup with iMessage and one has SMS. The texting will send it to all of them as SMS. Don’t do this.  Encryption only works  from iPhone to iPhone, and your iPhone needs to be setup to use iMessage.

1. Go to Settings > Messages > and
2. Make sure iMessage is turned on.

It is up to you but you can also turn “Send as SMS” off. This would act as a safety net in case you sent a text to someone that did not have iMessage it would not send it as text. There are instances when due to poor signal your phone could choose to send something as SMS as opposed to iMessage. Messages are only HIPAA compliant if it is sent using iMessage.

Remember:

1. This only works from iPhone to iPhone. If one person does not have a iPhone it will not be encrypted.
2. You will not have a saved copy of this texting - so for orders from a physician or NP to an RN or LVN, it should always be e-mail so that we have a permanent copy.  It texting is used, the text should be copied and with a time and date stamp placed in the patient’s chart.
3. If you must text and if it is important that you keep a copy - you can copy the text put it into an e-mail and send it to yourself. Just make sure you put a Subject line which will allow you to search for the e-mail.
4. Text will not have a subject or a source unless you type your name, no one will know who sent the text.

Your Satisfaction with care in SETMA’s medical home

In order to make our service better, we want to know when you have a problem. When you contact SETMA for any reason and by any means -- appointment, refill, referral request, question or another issue -- always get the name of the person with whom you spoke. In the event that you have a problem, this will help us identify any issues on our end and improve our service. If you do have a problem of discourteous, rude or improper behavior with or from someone, you can ask to speak to their supervisor. Once again, you should have your contacts name so you can reference this with their supervisor.

SETMA works hard to response in a timely and appropriate way to all telephone calls. Many days SETMA receives more than 3,000 phone calls from our patients. Please be patient with us, as we try to keep wait times to at a minimum while still giving care to each person. If you get a voice mail, you will be instructed to leave your number and information. You will also be given a number to call if you do not receive a return call within two hours. This number will connect you with one of SETMA's management staff who will make sure your needs are met.

Patient Satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS)

SETMA measures patient satisfaction in three ways:

1. SETMA’s internal patient satisfaction survey
2. The Patient-Centered CAHPS survey which is done by an independent vendor
3. The HCAHPS Survey which is done through the hospital by an independent vendor

For over ten years, SETMA has ask you to complete “patient satisfaction surveys .   We have taken your responses seriously.  SETMA’s Executive Management reviews these surveys and distributes them to providers.  We compare results over time to see if we are learning from what you are telling us.

In April, 2014, SETMA will formally receive the NCQA Distinction in Patient Experience Reporting. The National Committee for Quality Assurance (NCQA developed the optional Distinction in Patient Experience Reporting to help practices capture patient and family feedback through the newly developed Consumer Assessment of Healthcare Providers and Systems (CAHPS) Patient-Centered Medical Home (PCMH) Survey. Because consumer experience is a critical component of quality of care, giving more prominence to patient engagement is a crucial change to the PCMH program.

The CAHPS PCMH Survey assesses several domains of care:

• Access
• Information
• Communication
• Coordination of care
• Comprehensiveness
• Self-management support and shared decision making.

Sine 2010, SETMA has been an NCQA PCMH-Recognized practice and in September, 2013 began using the CAHPS PCMH survey tool to obtain the new NCQA Distinction in Patient Experience Reporting. The survey is completed by an NCQA recognized vendor who sends out letters to a statistically significant sample of SETMA patients. The letters are then followed up with telephone calls. The completion of this survey involves more than 100 questions. This represents a significant commitment of time by SETMA’s patients and we are grateful to those who take the time to participate in this process. It gives SETMA providers critically important information on how they can improve the care patients receive.

At the next reporting period, April, 2014, SETMA will receive the NCQA’s Distinction in Patient Experience Reporting. This will help the healthcare community as submitted data will be used to develop a benchmarking database that will allow comparison across practices. As SETMA and other healthcare providers work to improve the quality of care everyone receives, these benchmarks are critical.

HCAHPS - Hospital Consumer Assessment of Healthcare Providers and Systems

In July, 2013, SETMA devised a plan for improving our results on the patient satisfaction of the care they receive in the hospital.  Hospitals are required to employ an independent contractor to complete the HCAPHS survey oh patient satisfaction of that care.  Historically, physicians did not know what the standards were for the HCAHPS survey.  Starting in 2014, hospitals reimbursement is dependent a number of factors, one of them is providers HCAHPS scores.

There has been on the part of providers a sense of futility as the standard required on the HCAPHS survey is extraordinarily high and the judgment of whether or not a provider meets that standard is totally subjective on the part of the patient and/or patient’s family.

SETMA’s determined to improve our patient’s hospital experience and to do that in a systemic and sustainable fashion.  SETMA is determined to solve this problem in a manner which will contribute to the quality of care all of our patients receive.  As a result, SETMA learned the elements of the HCAHPS survey and added those to the Care Coaching Call SETMA’s Care Coordination Department makes to the patient the day following discharge from the hospital.

This is SETMA’s medical home; this is your medical home.  Use your medical home; learn from it.  Get involved in your own care; you and your heath will benefit.