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The Joint Commission and CMS Again Prohibit Text Orders

Posted in Electronic Health Records, HIPAA and the HITECH Act, Hospitals and Institutions, Legislation and Public Policy, Privacy and Data Protection

In a clarification issued in the December 2016 issues of its official newsletter, Perspectives, The Joint Commission, in collaboration with the Centers for Medicare & Medicaid Services (CMS), announced that it has reinstated its ban on using text message communications – even through secure text messaging – for patient care orders.

During 2016 The Joint Commission flip-flopped on this issue, briefly lifting the ban last spring, but then temporarily reinstating it over the summer. The Joint Commission and CMS noted that while their privacy and security concerns have been addressed with secure text messaging, there remain reservations associated with text messaged orders, including: 

  • The increased burden on nurses and other clinical staff who are responsible for inputting such electronic data into electronic health records (EHRs);
  • In-person communication allows for easier clarifications if there are questions about an order, and allows for better confirmation of directives; and
  • If the order generates any clinical decision support alerts, the ordering clinician needs to personally address these in a timely fashion to avoid delay in care.

The announcement stated that The Joint Commission and CMS will continue to monitor advancements in text messaging to further evaluate the ban and other guidelines in the future.

The announcement also included the following guidance:

  • All healthcare organizations should have policies prohibiting the use of unsecured text messaging for communicating protected health information; and
  • Computerized provider order entry should be the preferred method for submitting orders into the EHR, but a verbal order is acceptable.

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