​Significant limitations exist for text paging as a real-time communication method in acute care settings, according to an August 2017 research letter in JAMA Internal Medicine. The authors used a mixed-methods approach to analyze the content of text messages sent between providers at a large teaching hospital. In all, they observed 575 texts related to 217 patients. Most (78%) of the messages were sent by nonphysicians, such as nurses or medical students, to physicians. The analysis revealed three main themes: a lack of standardization; a varying range of urgency; and a wide communication gap. The text messages frequently included incomplete vital signs, such as a heart rate without blood pressure, the authors said. Additionally, few messages followed any standard format. The majority (93%) of the messages were either not urgent or lacked consistent language to indicate their urgency. Future guidelines should focus on improving communication among team members and should be similar to those that have improved communication during handoffs, the authors said.

HRC Recommends: For communication to be effective, it must be complete, clear, concise, and timely. When used properly, technologies that transmit information across settings and between care providers bring consistency and coordination to care practices and promote communication among providers. However, organizations must oversee the use of these technologies and ensure that they are implemented in a manner designed to facilitate communication using organization-approved practices.