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Secure Texting Ban Reinstated, Commission Calls for Guidance

The Joint Commission has delayed the removal of the secure texting ban for physician orders, saying that more guidance is needed.

By Elizabeth Snell

The previously announced secure texting ban removal by the Joint Commission on Accreditation of Healthcare (JCAHO) has since been delayed, according to the Commission’s online June newsletter.

Secure texting ban reinstated by Joint Commission

More guidance is needed “to ensure a safe implementation involving the secure texting of orders for those organizations desiring to employ technology supporting this practice,” federal officials explained in the newsletter.

The Commission will collaborate with the Centers for Medicare and Medicaid Services (CMS) to create more guidance on using secure texting for physician orders and ensure that they align with  the Medicare Conditions of Participation.

“The Joint Commission and CMS will develop a comprehensive series of Frequently Asked Questions (FAQ) documents to assist health care organizations with the incorporation of text orders into their policies and procedures,” read the newsletter. “This guidance information is designed to supplement the recommendations in the May 2016 Perspectives article permitting the use of secure text messaging platforms to transmit orders.”

The additional guidance is expected to be released by September 2016.

Previously, the Commission announced at the end of April 2016 that the secure texting ban for physician orders was to be lifted, and that the increase in secure texting options helped in making the decision.

The ban had been put in place because “texting applications were unable to verify the identity of the person sending the text or to retain the original message as validation of the information entered into the medical record,” the Commission stated. Moreover, the available technology at the time could not provide the necessary safety and security that’s needed for texting physician orders.

The Commission explained in its update that if an organization implemented a secure texting platform that adhered to certain guidelines, then it could use the process for sending physician orders:

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.

However, the original announcement said the following guidelines would help create an acceptable and secure environment for secure texting:  

  • A secure sign-on process
  • Encrypted messaging
  • Delivery and read receipts
  • Date and time stamp
  • Customized message retention time frames
  • A specified contact list for individuals authorized to receive and record orders

Additionally, JCAHO said that providers need to develop an attestation documenting the capabilities of their secure text messaging platform. Organizations also need to clearly define when texting is not appropriate for orders.

A comprehensive risk management strategy must also be implemented, and regular risk assessments need to be taken.

Staff training will also be essential, according to the previous JCAHO guidance. The frequency of the secure texting should also be carefully monitored.

TigerText CEO Brad Brooks had praised the lift on the secure texting ban, and told in May that the secure texting option was something that providers were organically gravitating towards.

“Ultimately, what this does now is really open up the floodgates to all kinds of incredible improvements to be realized around healthcare workflow,” Brooks said.

He added that there is great opportunity in the long-term for healthcare organizations to more fully integrate the secure texting into the digital information systems that have been put in place, such as EMRs and HIEs.

“Having the ability to connect those systems to the messenger in a comprehensive end to end workflow capability, the result of that is going to be incredible amount of time savings,” he explained.

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