Joint Commission lifts ban on clinical texting of orders

Physicians have long recognized the benefits of a mobile workflow, having the ability to carry out tasks with minimal disruption is an effective means of delivering care to their patients. In fact, around 87 percent of doctors are currently using smartphones and tablets to complement their workload. Secure text messaging is becoming an increasingly popular communication tool for healthcare providers looking to streamline the exchange of sensitive clinical conversations while remaining mobile.

In 2011, The Joint Commission national hospital accreditation program implemented an outright ban on the clinical texting of orders in a bid to protect patient privacy stating that “It is not acceptable for physicians or licensed independent practitioners to text orders for patients to the hospital or other healthcare setting”. Responding to this, many hospitals have completely restricted or outright prohibited the use of clinical texting amongst staff.

However, things are set to change. In an immediately effective update to its 2011 FAQ, The Joint Commission stated that “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 guideline revisions have come into effect following the Commission’s recent research to better understand the security capabilities and functionality of modern texting platforms. Discussing the parameters for clinical texting, they confirm that the messaging platform must include the following:

  • Secure sign-on process
  • Encrypted messaging
  • Delivery and read receipts
  • Date and time stamps
  • Customized message retention time frames
  • Specified contact list for authorized individuals to receive and record orders

For healthcare organizations wishing to implement a strategy for HIPAA secure text messaging, The Joint Commission advises the following:

  • Develop an attestation documenting the capabilities of the 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
  • Conduct training for staff, licensed independent practitioners, and other practitioners on applicable policies and procedures

Rolling out secure text messaging in a hospital setting can present many challenges; among these challenges is a need for creating an acceptable use policy for which staff are required to adhere.  Government guidelines often call for detailed interpretation before consistent policies can be put into place. Implementing a secure text messaging platform that fully integrates with EHR platforms can take a great deal of time, planning and resources, and this should be taken into consideration by any healthcare organization wanting to introduce texting as a method of communication.

The following useful resources from the Office of the National Coordinator for Health Information Technology (ONC) will assist healthcare organizations with the use of mobile devices.

Information on mobile devices and health data privacy and security:

Management of mobile devices in a healthcare setting:
For more information on HIPAA compliant messaging, speak to DocbookMD today.