Text messaging in healthcare: the debate goes on
A growing number of medical professionals are turning to mobile devices to coordinate care and manage patient health outcomes. Yet the use of text messaging specifically remains a contentious topic in the healthcare industry.
Back in 2011, The Joint Commission published a document stating that it is not acceptable for physicians or licensed independent practitioners (LIPs) to request orders for patient care, treatment, or services to hospitals or other healthcare settings via text message. The reason for this ban was the lack of safety and security offered by most text messaging platforms.
This ban was briefly lifted last Spring (with some caveats), and then temporarily reinstated the following Summer, to allow the Commission to establish guidelines, in collaboration with the Centers for Medicare & Medicaid Services (CMS).
However, following these conversations, The Joint Commission determined that although some prior data privacy and security concerns had been addressed, enough concerns remained for the ban on text messaging to remain, according to an announcement issued in December 2016.
Within this announcement, the following recommendations were issued:
- All healthcare organizations should have policies prohibiting the use of unsecured text messaging for communicating protected health information.
- The Joint Commission 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.
In concluding that the use of secure text orders should not be permitted until further notice, The Joint Commission and CMS provided the following reasons:
- Using text messaging apps to transmit orders may lead to an increased burden on nurses other clinical staff who would be responsible for inputting such data into electronic health records, adversely affecting their ability to carry out other critical patient care duties.
- The process for texting an order is an asynchronous interaction that requires additional steps to contact the ordering practitioner for any necessary discussion prior to order entry. Verbal orders on the other hand allow for real-time, synchronous clarification and confirmation of the order as it is given by the ordering practitioner.
- In the event that a CDS recommendation or alert is triggered during the order entry process, the individual manually entering the order into the EHR may need to contact the ordering practitioner for additional information. If this occurs during transmission of a verbal order, the conversation is immediate. If this occurs with a text order, the additional step(s) required to contact the ordering practitioner may result in a delay in treatment
The announcement concludes that The Joint Commission and CMS will continue to monitor advancements in text messaging technology and work with key stakeholders to determine whether future guidance on the use of secure text messaging systems to place orders is necessary.
We have written before about the benefits of secure mobile messaging in healthcare, which include improved communication amongst care teams, shorter length of stay for patients, and cost savings, to list just three. However, without proper planning and staff education, and without the right tools in place, mobile messaging presents a risky means of communication.
For further advice check out our guide, Mobile health & HIPAA: Playing it safe in 2017, which outlines five key steps that are intended to guide organizations through the process of appropriately managing mobile devices within the healthcare setting.