From the January 2017 issue of HealthCare Business News magazine

Wayward text messages can easily lead to confusion that leads to medical errors, just as communication misunderstandings in person can result in those errors. Security considerations should also include chain of custody for mobile devices, which are more vulnerable to loss and theft than bulky desktop computers. All communications, including mobile communications, should be sent and processed in alignment with an enterprise-wide privacy and security policy.

Accuracy and traceability. The communication status of any patient clinical information, along any channel, should be able to be tracked in real time. Upon receipt, the sender should be able to easily confirm that the right person received clinically relevant information, correctly interpreted it and acted upon that information, if necessary.


Accessibility. Information sent via secure text needs to be archived in the patient’s EHR and other systems to ensure continuity of care for patients across all channels, clinicians and health care facilities within a system. Information needed to make clinical decisions should be accessible from the same system that is used to create secure texts. Interoperability with clinical systems, such as EHRs and physiological monitors, provides key contextual data about the patient while creating a record, so that care team members stay on the same page about the patient’s condition.

In addition, workflow integration is critical. The promise of secure texting is that it will ease burdens on providers and speed communication to improve the patient experience. But adding a new communication channel threatens to disrupt workflows if it is not incorporated into existing systems and protocols. The ability to create, maintain and optimize the robust clinical, communication and business workflows that underlie the process of patient care is critical to ensuring the adoption and continued use of the communication system.

Go beyond "compliance." In December 2016, the Joint Commission issued updated guidelines on secure texting that included input from the Centers for Medicare & Medicaid Services (CMS). The new guidelines once again lift the ban on secure texting. However, the commission continues to recommend CPOE as the preferred method for submitting patient orders, reportedly in an effort to minimize errors and ensure patient safety. The updated Joint Commission/CMS guidance now prohibits the sending of physician orders over secure text, which came as a surprise to many in the industry, since secure, EHR-compatible technology and templates exist today that would have made this a viable option for busy care teams.

January 2017 Magazine

Read more stories from the January 2017 issue

Health IT Homepage