Joint Commission Reinstates Ban on Order Texting

[NRSKarenRN, BSN, RN]

Found at Medscape Medical News

Ken Terry

January 06, 2017

Use of Secure Text Messaging for Patient Care Orders Is Not Acceptable

Joint Commission Reinstates Ban on Order Texting

Citing patient safety and workflow issues, the Joint Commission last month restored its ban on the texting of orders in hospitals after consulting with the Centers for Medicare & Medicaid Services (CMS).

In the December issue of its Perspectives newsletter, the Joint Commission, which accredits hospitals and other healthcare organizations, said that computerized physician 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). CPOE helps ensure accuracy and allows the provider to view and respond to clinical decision support (CDS) recommendations and alerts."

If CPOE isn't available to the practitioner at the time of the order, a verbal order is acceptable, the Joint Commission said. Verbal orders should be infrequent and not used for the convenience of the practitioner, the body noted.

According to the Joint Commission, the impact of secure text orders on patient safety remains unclear, for the following reasons:

• Placing the burden of entering orders from texts on nurses may increase the burden on them and adversely affect their ability to provide care.
  
• Transmission of a texted order, unlike a verbal order, does not allow for real-time clarification and confirmation of the order.
  
• If a CDS recommendation or alert is triggered during the order entry process, the nurse would have to contact the ordering practitioner for additional information, which could result in a delay in treatment....
  

See JCAHO pdf Clarification: Use of Secure Text Messaging

[caliotter3]

I agree with this decision based upon the lack of reliability I have experienced with texting, of anything. What good is it to send a text if the receiving party never receives the text at all?

[CraigB-RN, MSN, RN]

When using secure messaging you get feedback on who the person at the other end is and that they got it. Secure messaging isn't the same thing as normal txt messaging.

[CraigB-RN, MSN, RN]

I wonder if facetime counts. I would think that would be equivalent as telemedicine. But I guess CPOE would still be needed.

[NRSKarenRN, BSN, RN]

Will be interesting if they allow facetime -- issue is SECURE connection, ability to clarify orders provided, able to verify clinician giving orders. What if wife or significant other involved in healthcare picks up cellphone and texts orders without provider being even aware...