Tom Sullivan, M.D.

Hold up! Don’t start secure texting orders just yet, Joint Commission says

By now you’ve heard that the Joint Commission this year issued an about-face on its ban against using secure text to send orders, stating that yes, you can use secure, encrypted text messaging platforms to communicate orders for treatment, patient care or services to the hospital or other health care settings.
This was welcome news to providers, pharmacists and vendors like DrFirst. Our secure communications platform, Backline, meets all of the requirements the Joint Commission spelled out in its announcement and enables physicians and nurses to communicate critical patient information clearly, immediately and seamlessly.
But don’t reach for your smartphone just yet. Almost as soon as the Joint Commission gave its blessing to using secure text for orders, it took this measure away. This month, the accreditor announced that its ban on texting orders will remain in place until September 2016.
“Additional guidance is required,” the JC explained, adding that it needs to huddle with CMS to make sure its final guidance on texting orders is in lock-step with the Medicare Conditions of Participation.
In an email to DrFirst, a Joint Commission spokesperson added that “the delay in implementation will allow us to work closely with the CMS over the next several months to develop implementation guidance.”
The result will be a comprehensive series of Frequently Asked Questions (FAQ) published later this year.

Texting orders: 10 ways to prepare for Joint Commission guidance

Assuming the Joint Commission does issue guidelines this fall for texting orders, organizations can prepare now by ensuring that they meet the following requirements outlined by the Joint Commission in May:

• Comply with Medication Management Standard MM.04.01.01, which states that medication orders must be “clear and accurate”
• Have written policies and procedures that specify how orders transmitted via text messaging will be dated, timed, confirmed and authenticated by the ordering practitioner
• Require documentation of texted orders in the patient’s medical record, either via full integration of the text messaging platform with the EHR system or through manual entry
• Comply with Joint Commission standards that address verbal orders (PC.02.01.03, RC.02.03.07)
• Maintain a documented attestation of the capabilities of your secure text messaging platform
• Develop written policies that specify when text orders are and are not appropriate
• Create a system for monitoring how frequently texting is used for orders
• Assess your organization’s compliance with its written texting policies and procedures
• Create a written risk-management strategy and an executed risk assessment
• Train staff, licensed independent practitioners, and other practitioners on your organization’s applicable policies and procedures.

The DrFirst team is looking forward to this extension of the physician’s workflow and the Joint Commission’s acceptance of modern secure communications. But it looks like we may have to wait a few more months.
Additional Resources

• 5 rollout strategies for secure text messaging
• 4 Ways Secure Text Messaging Improves Healthcare
• 5 signs your hospital is ready for electronic medication reconciliation
• A case for electronic prior authorization
• Key benefits of e-prescribing controlled substances