Last month, the Joint Commission rescinded its previous position prohibiting physicians or licensed independent practitioners from texting orders for patient care, treatment or services to hospital or other health care settings. The Joint Commission cited the evolution of technology and more secure measures to transmit orders as the reason for changing its stance. Now, the Joint Commission permits orders to be sent through secure text messaging systems, provided such platforms include the following:

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

Additionally, health care organizations allowing the texting of orders are expected to comply with the Joint Commission’s Medication Management Standard MM.04.01.01, which addresses the required elements of a medication order and actions to take when orders are incomplete. Furthermore, policies and procedures should specify how text orders are dated, timed, confirmed and authenticated by the ordering practitioners. The Joint Commission also recommends that health care organizations consider how text orders will be documented in the patient’s medical record (e.g., direct integration with the electronic medical record).

While the Joint Commission continues to assess the long term viability of texted orders, healthcare organizations that permit text orders are advised to do the following:

• Develop an attestation documenting the capabilities of their secure text messaging platform.
• Define when text orders 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.