A ban on the use of secure text messaging for patient care orders will remain in effect. The Joint Commission, a national group that accredits and certifies health care organizations and programs in the U.S., confirmed the decision in a December 2016 update.
Previously, in Spring 2016, the ban had been temporarily lifted. However, the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission have elected to keep the ban in place.
CMS and the Joint Commission are working together to monitor advancements in the field, as well as gather input from stakeholders, in order to determine whether future guidance for using secure texts for orders will be developed. They identified three reasons for keeping the prohibition in place at this time:
- A new order transmission method could lead to an increased burden on nurses to manually transcribe text orders into the Electronic Health Record (EHR), potentially adversely affecting nurses' ability to complete other critical patient care duties.
- The process of texting an order may require the extra step of contacting the ordering practitioner for any necessary discussion prior to order entry. By contrast, verbal orders allow for real-time clarification of the order.
- If a clinical decision support (CDS) recommendation/alert is triggered by a text order, the individual entering the order into the EHR may need to take the additional step of contacting the ordering practitioner for more information. A verbal order allows for this conversation to occur in real time.
According to the Joint Commission and CMS, the current barriers to using secure texts for ordering treatment could impact patient care or cause delays in treatment.
CMS and the Joint Commission also developed these recommendations:
- All health care organizations should have policies prohibiting the use of unsecured text messaging (i.e., short message service (SMS) text messaging from a personal mobile device) for communicating protected health information.
- Computerized provider order entry (CPOE) should be the preferred method for submitting orders as it allows providers to directly enter orders into the EHR.
- In the event that a CPOE or written order cannot be submitted, a verbal order is acceptable.
Questions can be directed to the Joint Commission at firstname.lastname@example.org. Pennsylvania Medical Society (PAMED) members with questions can also contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.