Just before Christmas, The Joint Commission (TJC) published an update clarifying its previous guidance regarding practitioners’ use of text messaging. TJC now says that practitioners may communicate with each other via secure text messaging systems. Practitioners are still banned, however, from issuing orders via text message, even though TJC’s previous concerns regarding data privacy and security were addressed. TJC has been grappling with this issue for several years, having originally issued the ban in 2011, which was lifted in April and then reinstated in July of this year.

After collaborating on this issue with the Centers for Medicare & Medicaid Services (CMS), TJC remains concerned that using secure text messaging to transmit orders may impact patient safety. In particular, among other issues, TJC is concerned that text orders may increase the burden on nurses to manually transcribe orders into the EHR and texting does not allow real-time communication, clarification and confirmation of orders in the same way as a verbal conversation. Therefore, TJC-accredited providers should ensure their policies and procedures prohibit text orders and implement these additional recommendations from TJC:

  • All healthcare organizations should have policies prohibiting the use of unsecured text messaging - that is, short message service (SMS) text messaging from a personal mobile device - for communicating protected health information.
  • TJC and CMS agree that computerized provider order entry (CPOE) should be the preferred method for submitting orders as it allows providers to directly enter orders into the electronic health record (EHR).
  • In the event that a CPOE or written order cannot be submitted, a verbal order is acceptable.

TJC says that it will continue to monitor advancements in the field and engage with key stakeholders to see if future guidance is necessary with respect to the use of secure text messaging for placement of orders. Arent Fox’s Health Care Group and Cybersecurity & Data Protection Group will follow developments in health care technology and their potential impact on TJC’s guidance. If you have any questions or need assistance on the topic covered here, please contact Sarah Bruno or Jade Kelly in our San Francisco office, Tom Jeffry in our Los Angeles office, Linda Baumann, Douglas Grimm or Samuel Cohen in our Washington, D.C. office, or the Arent Fox professional who normally handles your matters.