Secure Chat

Secure chat can be great... or awful. Some ways to get the benefits (ease of communication, HIPAA compliant) and minimize the downsides (zillions of messages from anyone in the entire world) include:

  1. Get into the habit of making yourself "offline" when you leave work and aren't on call. No one can message you in that setting.
  2. You can direct utilization to what works for you by creating a profile message. For example mine says that I use it only for APPs and residents and everyone else should page or send a staff message. A caveat though, is that when you mark yourself "offline" you then have to retype your message every time you come back online.
  3. Labelling yourself “busy” or “do not disturb” will help filter out some unnecessary messages when in meetings, clinic, etc. You can still get messages, however.

Hospital guidance on secure chat (developed with input from WVUH physicians, residents, APPs, and nurses)

Must-Know Ground Rules

  • Do NOT use Secure Chat for emergent/urgent/critical needs. Use direct communication (phone, pager, etc.) instead.
  • Use ONLY for non-urgent, patient-centered messages.
  • Unsure about urgency? Always use direct communication (phone, pager).
  • Secure Chat is NOT closed-loop communication. If there's no response, follow up with a phone call.
  • Messages are temporarily visible and are not maintained as part of the medical record.
  • Clinically relevant information must be documented in the medical record.
  • Do NOT copy/paste Secure Chat messages into charts.
  • Do NOT place “verbal” orders via Secure Chat—enter orders directly in Epic or via Haiku/Canto.
  • Do NOT use Secure Chat in lieu of placing consult orders.
  • Usage may vary by provider and department.

Best Practices for Patient-Centered Communication

  • Manage your chat “status” appropriately. “Offline” prevents messages from being sent to you while off work. Your status should be “Available” when providing clinical care.
  • Check recipient’s call status and availability before messaging.
  • Do NOT mass message large groups hoping someone will receive/respond.
  • Always link messages to the appropriate patient chart and provide relevant info up front.
  • Once you have received a confirmation/response, limit ongoing empty replies (e.g., “Thanks”, “Got it”, emojis) to reduce work interruptions.
  • Use Secure Chat to effectively coordinate care among teams/units.
  • Consider using other means of communication, such as staff messages, for complex clinical decision making between teams (e.g. tumor board discussions) so that communication is documented.

Secure Chat Etiquette

  • Keep messages concise and professional.
  • Avoid ALL non-patient related communication.
  • Be mindful of time of day—delay non-urgent messages until daytime.

Remember: If it’s urgent, pick up the phone or page. Secure Chat is a tool for enhancing NON-URGENT communication and care coordination—NOT for replacing critical, closedloop communication channels.