The December 2016 issue of Perspectives clarified the position on text messaging orders saying, “although its prior data privacy and security concerns had been addressed, concerns remained about transmitting text orders even when a secure text messaging system is used”, and therefore texting orders is not permitted. Specifically, TJC, with CMS’s input, found that:
Joint Commission requires organizations to have a written policy addressing the privacy of health information, and this requirement applies to the privacy of health information transmitted through text messaging.’
Part of the document.
l The use of secure text orders is not permitted at this
time. The implementation of secure text orders was discussed
with numerous text messaging platform vendors,
experts in EHRs, and other key stakeholders. After extensive
discussion weighing the pros and cons of using secure
text messaging systems to place orders, The Joint Commission
and CMS have concluded that the impact of secure
text orders on patient safety remains unclear. A variety of
issues were identified that influenced this decision, including
❍ The implementation of an additional mechanism to transmit
orders may lead to an increased burden on nurses to
manually transcribe text orders into the EHR. This could
adversely affect nurses’ ability to do their other critical
patient care duties.
❍ The transmission of a verbal order allows for a real-time,
synchronous clarification and confirmation of the order
as it is given by the ordering practitioner. As the process
for texting an order is an asynchronous interaction, an
additional step(s) is required to contact the ordering
practitioner for any necessary discussion prior to order
❍ In the event that a CDS recommendation or alert is
triggered during the order entry process, the individual manually
entering the order into the EHR may need to contact
the ordering practitioner for additional information. If this
occurs during transmission of a verbal order, the conversation
is immediate. If this occurs with a text order,
the additional step(s) required to contact the ordering
practitioner may result in a delay in treatment.
The Joint Commission and CMS will continue to
monitor advancements in the field and engage with key
stakeholders to determine whether future guidance on the use
of secure text messaging systems to place orders is necessary.
Full release here.