TJC Issues Clarification on Text Messaging for Patient Care Orders

PUBLISHED: Dec 27, 2016
Sources: Centers for Medicare and Medicaid Services, The Joint Commission

The Joint Commission has published a clarification about their stance on the use of text messaging for the transmission of patient care orders.

Background:

TJC first addressed this topic in a frequently asked question published in 2011. In that FAQ TJC stated that, “…it is not acceptable for physicians or licensed independent practitioners (LIPs) to text orders for patient care, treatment, or services to hospitals or other health care settings.”

In May 2016 reversed their position. Citing advancements in technology and secure text messaging platforms, TJC said that, “…LIPs or other practitioners, in accordance with professional standards of practice, law and regulation, and policies and procedures, [may] use a secure text messaging platform to send orders as long as the system met specific requirements and all the typical required components of an order are included.”

Recently, however, TJC has determined that there are still enough concerns about transmitting text orders (even when a secure text messaging system is used) that text messaging of orders is not allowable.

According to TJC, and consultation and agreement with the Centers for Medicare and Medicaid Services (CMS), the impact of secure text orders on patient safety remains unclear. There is thought that the implementation of an additional mechanism to transmit orders may increase burden on nurses to manually transcribe text orders into the EHR which could adversely affect nurses’ ability to do their other critical patient care duties. Additional concern is that texting an order may create situations where additional step(s) are needed to clarify orders prior to order entry resulting in delay in treatment.

To that end, and in collaboration with the Centers for Medicare & Medicaid Services (CMS) TJC has published a correction that includes the following:

  • All health care organizations should have policies prohibiting the use of unsecured text messaging—that is, short message service (SMS) text messaging from a personal mobile device—for communicating protected health information.
  • Notes: In compliance with TJC Standard IM.02.01.01, EP 1 organization’s written policies should address restrictions on the use of unsecured text messaging. Additionally these policies should be reviewed with staff on a routine basis.
  • TJC and CMS agree that computerized provider order entry (CPOE) is the preferred method for submitting orders.
  • Use of verbal orders remains acceptable in limited situations so long as they are used in accordance with requirements outlined by TJC and CMS Conditions of Participation.
  • The use of secure text orders is not permitted at this time.

StayAlert! is continuing to monitor this topic and will publish additional information as it becomes available

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