News & Insights

New Guidance on Secure Text Messaging

January 10, 2018

New Guidance on Secure Text Messaging

Texting has largely replaced telephone calls in modern communication due to its convenience and speed. For that reason, healthcare practitioners may view it as an alternative to playing telephone tag. Many may be surprised to learn, however, that there are significant regulatory privacy limitations when texting patient information.

The Center for Medicare and Medicaid Services (CMS) recently clarified its position on texting in a memo to state surveyors. In short, the memo distinguishes texting patient information from texting patient orders:

  • Texting patient information among members of the healthcare team is permissible if accomplished through a secure platform.
  • Texting of patient orders is prohibited regardless of the platform utilized.
  • Computerized Provider Order Entry is the preferred method of order entry by a provider.

The rationale for the limitation was recently published by The Joint Commission (TJC). According to TJC’s rationale, texting patient orders, even through a secure platform, presents a number of concerns:

  1. Texting adds an additional burden on nurses to manually transcribe text orders into the EHR. The Joint Commission notes that the additional burden could adversely affect nurses’ ability to do their other critical patient care duties.
  2. Verbal orders allow for a real-time, synchronous clarification and confirmation of the order as it is given by the ordering practitioner. Texting is asynchronous, so additional steps are required to contact the ordering practitioner for any necessary discussion prior to order entry.
  3. A CDS recommendation or alert may be triggered during the EHR order entry by the nurse. In that event, the nurse manually entering the order into the EHR may need to contact the ordering practitioner for additional information. In verbal ordering, the conversation is immediate. If it is a text order, the additional steps required to contact the ordering practitioner may result in a delay in treatment.

To view TJC’s rationale in its entirety, click here.

Contact your local LAMMICO Risk Management and Patient Safety representative or dial 504.841.5211 for consultation or additional information.


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