The Joint Commission Issues Clarification on Texting of Patient Care Orders

“The use of secure text orders is not permitted at this time.”

In 2011, the technology to provide for the safety and security of text messaging was not available and, at that time, The Joint Commission (“TJC”) said it was not acceptable for practitioners to text orders for patient care and treatment. Then, in May 2016, TJC revised its position in recognition of technological advances and said physicians could text message when done in accordance with standards of practice, laws, regulations, policies and practices “as long as the system met specific requirements.”

Since then, however, TJC got together with the Centers for Medicare & Medicaid Services (CMS) and issued updated recommendations that include the following:

• Providers should have policies prohibiting the use of unsecured text messaging of protected health information (PHI).
• CPOE (computerized provider order entry) should be the preferred method for submitting orders, which are directly entered into the electronic health record.
• The use of secure text orders is not permitted at this time.

This turnaround came after TJC and CMS discussed the issues with numerous stakeholders, including text messaging platform vendors and experts in electronic health records (EHRs). The identified concerns for maintaining the existing status quo were:

• Increased burden on nurses to manually transcribe text orders into the EHR.
• Verbal orders are preferred when CPOE not used, because they allow for real-time clarification and confirmation of the order as it is given by the practitioner.
• Text messaging could cause delay in treatment where a clinical decision support (“CDS”) recommendation or alert is triggered during data entry, requiring the nurse to contact the practitioner for additional information.

To view the full text article on the TJC website click here.