Electronic Communications Policy
Updated July 17, 2019
TLDR: As long as you understand the privacy risks of text and email, and if you would agree to consider the therapeutic dimensions of it, I am glad to communicate with you via text or email.
Electronic communications such as email and text are incredibly convenient, and I absolutely support convenient communication. Exchanges with healthcare providers, however, are different than those with friends or family. This document is written to help you understand those differences and set clear guidelines for our communications in between sessions. I describe the two dimensions of Privacy Protections and Therapeutic Process before summarizing.
Privacy Protections
One difference I would want you to understand is that I am subject to important laws written to protect your privacy. The concerns that brought you to seek my help and our meetings that follow are a private matter. Others should know about them only as you allow. These privacy laws, then, set a standard in how I maintain your health record and how I communicate with you outside of sessions.
What do these laws imply for our communications?
For speaking by telephone, phone conversations and voicemail are known as an adequately secure method for our communications. Please feel free to contact me by telephone at any time.
For secure messaging, the online practice management system I use, Simple Practice, has a HIPAA-compliant messaging feature. It is accessible via the client portal (the same place where you would submit your initial intake). Please feel free to use this method freely.
For communicating via other methods, such as by email or text, I am enabled to defer to your preference provided that you are informed of the privacy risks of these other methods.
Email, text and other electronic communication methods carry a greater risk of being hacked than formal HIPAA-compliant solutions. If a hack should occur, others could feasibly read what we’ve discussed via text or email. That said, I don’t want you to feel alarmed. The risk of being hacked can be vastly minimized by using simple security measures on our phones and computers. For my part, I am very careful to keep both my laptop and phone locked with passwords and never leave them unattended. If you aren’t already, I would advise you to protect your phone and computer by requiring a password for access.
Concerning texting: my business line is on an iPhone, and text messages with other iPhone users (using iMessage) are encrypted end-to-end. SMS texts (e.g. with Android users) are not encrypted.
Concerning email: My email is hosted by Google, which stores information in a HIPAA-compliant manner. I have opted against using encrypted email, which I have found too cumbersome. If I have documents to share, including statements, invoices and superbills, Simple Practice (mentioned above) will email you a link to the client portal where such documents are securely stored in a password-protected, HIPAA-compliant manner.
If you understand the risks of SMS and email, I am glad to defer to your preference for communications. You can elect your preference either through the consent form I ask you to sign in the client portal or by initiating contact by text or email.
Therapeutic Process
A second difference I’d want you to understand concerns therapeutic process.
Questions or thoughts may occur in between our sessions, and you may have an impulse to discuss these with me outside of session. Some of these may be easily handled over email (e.g. What was the name of that book you recommended?). As I outline below, I welcome simple inquiries about impersonal things like resources.
Still, other inquiries may not be easily handled over email (e.g. My boss did that thing again that annoys me. What do you think I should do?”). In some instances, efforts to have questions answered over email could actually be counterproductive. Consider the case of someone who is working on defining boundaries and becoming independent. Efforts to make contact outside of sessions could lead to blurred boundaries or foster increased dependency, the exact things they would be trying to control.
There are a number of such invisible dynamics that could interfere with your progress. I wouldn’t expect you to understand them all. However, I do want you to be aware that there are these underlying dynamics that I am responsible for managing. If I should find that a question is better addressed in person, I may simply ask you to hold it to our next session.
In Summary
To facilitate easy communications while meeting my responsibilities to protect your privacy and deliver quality care, I am offering the following guidelines:
I assume you understand the risks to privacy of various communication methods and defer to your preference.
If you reach out to me via text or email, I will assume this is a suitable method for communicating with you.
You are also able to state your preference in the electronic communications consent form you are asked to complete during enrollment.
I will use the Simple Practice HIPPA-compliant secure messaging service for highly sensitive documents or communications.
Questions related to scheduling, insurance and billing are always welcome.
I also welcome simple questions related to resources (e.g. What was the name of that book you recommended?).
For questions that seem more personal or are related to the concerns bringing you to treatment, I recommend holding this question until our next meeting. If you have questions about what is appropriate to contact me about, let’s discuss that in person at our next session.
Thank you for keeping these guidelines in mind. Please don’t hesitate to let me know of any questions or concerns.