Healthcare Alert: Texting of Patient Care Orders Banned by Joint Commission

The Joint Commission, which establishes standards for healthcare organizations related to the provision of safe, high quality care and accredits those organizations who meet the standards, has recently announced that the use of secure text messaging platforms to transmit patient care orders is prohibited. The Joint Commission worked with CMS to develop guidelines for text-message based orders to ensure consistency with Medicare’s Conditions of Participation.  The guidelines set forth the following recommendations:

• All healthcare organizations should have policies prohibiting the use of unsecured text messaging from personal mobile devices for communicating protected health information;
• Computerized provider order entry is the preferred method for submitting orders;
• If a computerized provider order entry or other written order cannot be submitted, then a verbal order is acceptable; and
• The use of secure text orders is not permitted at this time.

The newly released recommendation prohibiting the use of secure text orders reverses the Joint Commission’s position in May 2016.  In the May 2016 issue of Perspectives, the Joint Commission acknowledged that technology had advanced and that secure text messaging platforms offered functionality to address all data privacy and security concerns previously cited by the Joint Commission and outlined in its 2011 publication of Frequently Asked Questions. Following publication of the May issue of Perspectives, the Joint Commission determined that privacy and security concerns about the transmission of text orders remained, even when a secure text messaging system is used, due to the unknown impact on patient safety.

In particular, the Joint Commission noted that secure text messaging of an order is an asynchronous form of communication, whereas a verbal order allows for a real-time, synchronous clarification and confirmation of the order.  The Joint Communication also noted that secure text messaging of orders may cause delays in treatment when an alert is triggered during the order entry process and the individual entering the order needs to contact the ordering provider for additional information. When this type of alert is triggered during the entry of a verbal order, the individual entering the order can immediately discuss the issue with the ordering provider.

The Joint Commission will continue to monitor advancements in technology, and will determine whether future guidance on the use of secure text messaging is warranted.  In the meantime, healthcare organizations should update their policies and procedures to ensure that text messaging in any form (secured or unsecured) is not permitted within the organization.