The Joint Commission recently lifted its previous ban on physicians using traditional SMS for any communication that contains ePHI data or includes an order for a patient to a hospital or other healthcare provider. Effective immediately, “licensed independent practitioners or other practitioners in accordance with professional standards of practice, law and regulation and policies and procedures may text orders as long as a secure text messaging platform is used and the required components of an order are included,” the commission announced in its May 2016 Perspectives newsletter.
The commission noted that several secure text-messaging platforms have been introduced since the initial ban in 2011, giving clinicians a safe and secure means of texting with their colleagues to coordinate care. Some of the more popular SMS communications platforms – such as TigerText and Voalte – have seen a big uptick in usage in recent months.
JCAHO does set forth guidelines for allowable text messaging platforms: A secure service must include a secure sign-on process; encrypted messaging; delivery and read receipts; date and time stamp; customized message retention time frames; and a specified contact list for individuals authorized to receive and record orders.
In addition, the commission said any healthcare provider allowing text messaging should comply with Medication Management Standard MM.04.01.01, which establishes a protocol for medication orders and steps to take when an order is unclear or incomplete.
The commission also urged providers to determine if texted orders are automatically entered into the patient’s electronic health record or entered manually. For guidance, it refers providers to the Provision of Care, Treatment and Services Standard PC.02.01.03 and Record of Care, Treatment and Services Standard RC.02.03.07. For guidelines on the use of mobile devices, it advises contacting the Office of the National Coordinator for Health IT (ONC).
Going forward, the commission said it’s “assessing the need to further delineate the expectations for secure text messaging platforms and policies and procedures for texted orders within the accreditation standards.” For now, it advises providers to:
Develop an attestation documenting the capabilities of their secure text messaging platform;
Define when text orders are or are not appropriate;
Monitor how frequently texting is used for orders;
Assess compliance with texting policies and procedures;
Develop a risk-management strategy and perform a risk assessment; and
Conduct training for staff, licensed independent practitioners and other practitioners on applicable policies and procedures.
It is clear that electronic communication in all forms can increase efficiency and reduce costs – but if SMS messaging is a technology that you want to incorporate into your practice, make sure you have adequate, compliant policies, and procedures in place and that all staff is trained on those policies and procedures.