This month The Joint Commission announced that it was ending its ban on sending patient care orders via text message effective immediately, provided certain requirements are met (as noted in the implementation section below).

Announcement.

The announcement ends the ban set forth in The Joint Commission’s 2011 FAQ, which stated that it was not acceptable for physicians or licensed independent practitioners to text orders for patient care, treatment, or services to hospitals or other health care settings. The Joint Commission put in place the 2011 prohibition because it was concerned that mobile devices did not have the technological capability to provide necessary safety and security, i.e., (i) sending unsecure messages using personal mobile devices and (ii) the inability to verify the identity of the person sending the text or retain the original message as validation of the information entered into the medical record. However, The Joint Commission’s recent research on secure text messaging platforms has led to the conclusion that available platforms now offer functionality to address concerns outlined in the 2011 FAQ.

Implementation.

The end of the ban does not allow open texting of patient orders. Instead, organizations must use a secure text messaging platform with the following capabilities:

1. Secure sign-on process;

2. Encrypted messaging;

3. Delivery and read receipts;

4. Date and time stamp;

5. Customized message retention time frames; and

6. Specified contact list for individuals authorized to receive and record orders.

In addition, policies and procedures for text orders should specify how orders transmitted via text messaging will be dated, timed, confirmed, and authenticated by the ordering physician; and organizations need to consider how text orders will be documented in the medical record.

Organizations should expect that The Joint Commission noted may further delineate expectations for secure text messaging platforms within its accreditation standards. In the meantime, The Joint Commission offers the following suggestions:

1. Develop an attestation documenting the capabilities of secure text messaging platform;

2. Define when text orders are or are not appropriate;

3. Monitor how frequently texting is used for orders;

4. Assess compliance with texting policies and procedures;

5. Develop a risk-management strategy and perform a risk assessment; and

6. Conduct training for staff, licensed independent practitioners, and other practitioners on applicable policies and procedures.