The Joint Commission clarifies use of text messaging for patient orders

In May 2016, the Joint Commission announced that based on its research of secure texting technology it now approved of the use of this technology by practitioners provided that such use is in accordance with professional standards of practice and applicable laws and regulations. At such time, the Joint Commission further indicated that any secure texting service or platform used by health care providers should have encryption and message retention capabilities as well as the ability to restrict who can receive texted orders.

In the December issue of the Joint Commission Perspectives, the Joint Commission has clarified its position stating that the use of secure text messaging for patient care orders is currently not acceptable. In issuing the clarification, the Joint Commission cited to the uncertainty regarding the impact of secure text orders on patient safety. In addition, the Joint Commission cited several additional concerns including 1) the burden on nurses who would need to transcribe text orders into the EHR taking them away from other critical duties and 2) the fact that unlike a verbal order, which can be clarified and confirmed as it is given, a texted order may necessitate contacting the ordering practitioner for additional discussion prior to order entry, which could lead to delay in treatment.

In addition, the Joint Commission and CMS have developed the following recommendations:

  •  “All health care organizations should have policies prohibiting the use of unsecured text messaging . . . for communicating protected health information.”
  •  “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.”  
  • “In the event that a CPOE or written order cannot be submitted, a verbal order is acceptable,” although verbal orders should be used infrequently.

Questions regarding this clarification can be directed to