IM (Instant Messaging) and EMR/EHR

I’ve been participating in a really interesting discussion going on over on EMRUpdate. The discussion revolves around the integration of IM into an EMR or EHR and the role of IM in a clinical environment.

One person suggested the use of a LAN only IM that he’s been using for a while. Looks like a pretty cool software and prevents your users from chatting it up with their best friend across town all day on work time.

My biggest problem with the LAN only IM software is that it’s just one more program that you have to manage. This is why in our clinic we’ve been using MSN Messenger. This comes installed by default on Windows and so it seemed like a logical choice. It also had some good upload features that allowed us to add our long list of users to a new person with little hassle. We have upgraded most of our computers to the latest MSN Messenger, but now it will just manage itself.

The other advantage of the commercial messengers is their advanced chatting and status features. You can add users to an existing discussion or start a discussion with a large group. The status of your messenger automatically updates as you’re away from your computer. I also loved messenger for when I was at home helping my wife who was sick. Just by going to their messenger, everyone in the clinic could see my status that I was at home taking care of my sick wife.

There are a whole host of other features that make the commercial version nice. One simple example is that it tells you when the person you’ve sent an IM to is typing or not. That way you can have at least some idea of whether you’re going to get a reply soon or not.

We only use IM in our individual offices, but I’ve heard of one person that has an IM user called “Room 1” that is signed into Room 1. That way when he’s in the room, he can IM from that room without a problem. Of course, if you’re carrying a laptop around this isn’t a problem. Also, I haven’t tested this yet, but the next version of MSN Messenger seems like it has the ability to be signed into 2 locations. Could be pretty cool.

Of course, I’m sure that everyone’s wondering about HIPAA. In our clinic we’ve decided to just not put information protected by HIPAA in IM. We might say, Dr. Smith Pt 12345’s labs are available now. This makes it so IM doesn’t have to follow the security guidelines required by HIPAA. Some might argue that this isn’t failsafe. I’d respond that of course it’s not, but neither is someone sending an email with the same information. Neither is someone doing any countless number of things electronically. Therefore I treat it similar to how we treat email.

Despite the benefits we’ve seen from using IM in our clinic. It is really interesting to imagine what an IM program integrated with your EMR would look like. What new possibilities would it open up to you? Tomorrow I’ll discuss some of the cool integrations that could be created by a forward looking EMR company that integrates IM into their EMR.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Alex, I haven’t tried that many. However, at $10 a client license for the one you linked to would have been ruled out from the beginning. Comparing $10 per user to absolutely free is a deal breaker for us.

    You’re right about security though. MSN Messenger is not up to HIPAA standards. However, we don’t use it for that right now. It would be nice, but it’s just not necessary.

  • Wow, from a security expert position as that is my job, I have to say that would not hold up for you in any sort of investigation. MSN or Public IM’s as such are NOT HIPAA or GLBA compliant. Actions should not be one of disregard because of cost necessarily. It would have been helpful for you to atleast offer up the controls you have in place.

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