CMS Lifts Ban on Texting Patient Care Orders
By Emma Freer

Clinicians in hospitals and critical access hospitals may now securely text patient information and orders to other members of the health care team if using a compliant platform, thanks to advocacy by the Texas Medical Association. 

“Our ability to provide efficient and comprehensive care to our patients is very important, and in the inpatient setting there’s opportunity for improvement in terms of being able to provide accurate orders to nurses that relies less on our ability to understand each other on the phone,” said Majid Basit, MD, a cardiologist in Sugar Land who serves on TMA’s Patient-Physician Advocacy Committee. With this policy change, “They can see it in plain text, exactly what you want.”  

The Centers for Medicare & Medicaid Services (CMS) announced the policy change in a Feb. 8 memo sent to state health departments, reversing a previous prohibition on clinician use of secure text messaging to communicate patient orders. The federal agency attributed the change to widespread adoption of texting among care team members, the availability of more secure platforms, and feedback from TMA and others.  

“[Computerized Provider Order Entry] continues to be the preferred method of order entry by a provider, but we recognize that alternatives also exist now, as well as significant improvements in the encryption and application interface capabilities of texting platforms to transfer data into electronic health records (EHRs),” the memo states.  

To comply with the updated guidance, clinicians must use and maintain text messaging platforms that are secure, encrypted, allow for author identification, and minimize risk to patient privacy and confidentiality, per HIPAA and Medicare/Medicaid Conditions of Participation. CMS also recommends clinicians routinely assess the security and integrity of any platforms they use, according to the memo. 

TMA urged CMS to consider such an update in a May 2022 letter to The Joint Commission, a nonprofit that accredits health care organizations and programs, and to CMS.  

“This type of technology allows patients to receive accurate interventions more quickly when the physician is not on the premises or in close proximity and cannot access the hospital’s [EHR] to place the order,” wrote Dr. Basit, then chair of the Patient-Physician Advocacy Committee; Ogechika Alozie, MD, then chair of TMA’s Committee on Health Information Technology; and Gary Floyd, MD, then TMA president. 

Dr. Basit urges physicians who hold positions of authority at hospitals and health systems to build on this win by encouraging their employers to follow CMS’ lead. 

“Just because CMS made a [policy] change doesn’t mean the hospital[s] ... will change their policy immediately,” he said.  

For more technology information, check out TMA’s online Health Information Technology Resource Center.  

Last Updated On

February 28, 2024

Originally Published On

February 23, 2024

Emma Freer

Associate Editor

(512) 370-1383

Emma Freer is a reporter for Texas Medicine. She previously worked in local news, covering city politics, economic development, and public health. A native Clevelander, she graduated from Columbia Journalism School and the University of St. Andrews.

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