Joint Commission permits texting of medical orders, with caveats
In 2011, The Joint Commission ruled that physicians and practitioners were forbidden from using text messaging to send patient care orders. Now the accreditor has reversed its ruling, and effective immediately hospital staff are allowed to send orders for care, treatment, and services via text. The change applies to all Joint Commission-accredited and certified organizations.
The Joint Commission had originally ruled against using text messaging in medicine because:
1. Worries about private medical information being sent through unencrypted texting services
2. A lack of a way to verify who was actually sending the text
However, technology has finally reached a point where the twin issues of verification and encryption for texts are no longer a problem. That said, organizations are still expected to comply with Medication Management standard MM.04.01.01 and there are restrictions on the type of texting program that can be used. The Joint Commission says that for a messaging service to be used, it must have:
• A secure sign-on process
• Encrypted messaging
• Delivery and read receipts
• Date and time stamp
• Customized message retention time frames
• Specified contact list for individuals authorized to receive and record orders
Healthcare organizations are also expected to develop clear policies and procedures on how text orders will be dated, timed, confirmed, authenticated, and documented in either the paper or electronic health record. Facilities should study PC.02.01.03 and RC.02.03.07 when developing texting policies. Some of the steps that facilities are recommended to take are:
• Figure out when it’s appropriate to use text orders
• Document the capabilities of their text messaging platform
• Determine how often texting is used for orders
• Assess compliance with texting policies and procedures
• Perform a risk assessment and develop a corresponding risk-management strategy
• Conduct training for staff, licensed independent practitioners, and other practitioners on policies and procedures
Resources are available from the Office of the National Coordinator for Health Information Technology, with information on mobile devices and health information privacy and security and how to manage mobile devices in healthcare. Those seeking more information should contact Christina Cordero, PhD, MPH at ccordero@jointcommission.org.