The Centers for Medicare and Medicaid Services issued a memo December 28, 2017 confirming its stance on text message orders. Effective immediately, texting patient orders among physicians or healthcare providers is prohibited. CMS’ stance prohibiting text message orders aligns with The Joint Commission’s position to prohibit secure text orders, which was re-examined in mid-2016 and confirmed in 2017.
CMS does not permit the texting of orders by physicians or other health care providers because the practice of texting orders from a provider to a member of the care team is not in compliance with the Conditions of Participation (CoPs) or Conditions for Coverage (CfCs).
Order Entry Method
Computerized Provider Order Entry (CPOE) is the preferred method of order entry by a provider. CMS has held to the long-standing practice that a physician or Licensed Independent Practitioner (LIP) should enter orders into the medical record via a handwritten order or via CPOE. The order must be dated, timed, authenticated, and placed into the medical record immediately.
Healthcare Team Member Communication
While texting patient orders among healthcare providers is prohibited, texting patient information among members of the healthcare team is permissible if accomplished through a secure platform. CMS does recognize that the use of texting between members of the healthcare team has become a valuable means for members to communicate with each other. To maintain compliance, all providers must utilize and maintain systems/platforms that are secure, encrypted, and minimize the risks to patient privacy and confidentiality as per HIPAA regulations and the CoPs or CfCs. Procedures must be implemented to routinely assess the integrity of the texting systems that are being used to effectively avoid negative outcomes with the potential to compromise quality, safe patient care.
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