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Vorys Health Care Advisors

Texting Comes to Health Care

Posted in CMS

M. Reneé Bostick joined Vorys Health Care Advisors (VHCA) as a full time Senior Advisor in 2018 to expand VHCA’s work with Health Information Technology (Health IT) – an essential and innovative capability for modern health care. VHCA assists health care providers, associations and stakeholders with compliance and management of electronic health record (EHR) systems and health information exchange in their rapidly changing health care business. VHCA also enables providers to strategically use opportunities of change to improve care quality, coordination and experience, enhance revenue cycle management, and build analytical capabilities to improve performance and outcomes.

Several recently announced changes in federal policy, which will be featured in this Blog, signal that Health Information Technology (Health IT) remains integral to the modernization of health care.

Late in November 2017, the CMS Survey & Certification Group (SCG) sent e-mails to two hospitals stating, “texting is not permitted,” even for secure text applications. “After meeting with vendors regarding these products, it was determined they cannot always ensure the privacy and confidentiality of PHI [protected health information] of the information being transmitted,” according to the e-mail reported by Report on Medicare Compliance. The ban surprised many in the health care accreditation and compliance community, particularly after JCAHO solicited public comment and developed a position statement supporting the use of secure texting. As a result, JCAHO reversed this position on December 22, 2017 issuing the “Clarification: Use of Secure Text Messaging for Patient Care Orders Is Not Acceptable.” Many hospital compliance officers indicated that secure texting and paging was an integral part of their secure communication platform, and that this decision would negatively disrupt their critical patient communication pathway.

Then on December 28, 2018, the Director of CMS Survey & Certification Group released S&C 18-10-ALL reversing the e-mail position by concluding:

  • Texting patient information among members of the health care team is permissible if accomplished through a secure platform.
  • Texting of patient orders is prohibited regardless of the platform utilized.
  • Computerized Provider Order Entry (CPOE) is the preferred method of order entry by a provider.

While CMS S&C now supports secure texting, it does not support the use of texting of patient orders.   Stay tuned as JCAHO posted an FAQ response on the same day as CMS memo stating “The practice of texting orders is currently under review.”