How Secure Texting Best Practices Enable Health System Compliance, Better Workflows


Select a solution that brings convenience and stronger collaboration between team members

As we continue to await the combined, updated guidance on secure texting from The Joint Commission and the Centers for Medicare & Medicaid Services (CMS) that was due out in September, it’s important to ensure that your health system has best practices in place for secure collaborative communication, including the texting of medical orders.

While texting patient care-related orders introduces unrivaled convenience and speed, secure texting on its own doesn’t prevent the communication misunderstandings that drive the majority of medical errors. Simply encrypting a texted order or including a date and time stamp — both requirements included in The Joint Commission’s previous set of guidelines — doesn’t assure an order will go to the right person at the right time, or even that it will be properly carried out by the person receiving it.

Fortunately, forward-thinking health system leaders can achieve these goals by adopting a holistic enterprise communication platform that includes the convenience of smartphones and texting, while also strengthening communication between care team members and improving workflows.

Four Questions to Ask

In addition to the final guidance to be released by The Joint Commission and CMS, here are four questions your health system teams should be asking about your secure texting and communications practices:

  1. Security—Is patient data protected? Are communications, including orders, being sent and processed according to an enterprise-wide privacy and security policy?
  2. Accuracy—Are providers able to text a medical order within a structured template that assures the order was received by the right person, contains all the required information, and is correctly interpreted?
  3. Traceability—Can the communication status be tracked in real time? Can the sender confirm that the right person received the order and correctly interpreted it? This insight can mean the difference between a texted order for pain medications that is carried out within minutes and one that drags out for half an hour or longer, affecting patient experience and satisfaction.
  4. Accessibility—Can the order be archived in the patient’s hospital records and other systems? Can information needed to process the order be pulled from the same system that is texting the order? Interoperability with clinical systems such as EHRs and physiological monitors provides key contextual data about the patient while creating a record of the order so that care team members stay on the same page about the patient’s condition.

As these considerations demonstrate, there’s a much bigger picture to secure texting than merely typing in an order and hitting “send.

Enterprise Communication Platform Vs. a Texting App

Healthcare is inherently collaborative, a dynamic that isn’t fostered by using a texting app downloaded from an app store. There’s no way to assure that a texted medication order goes to the right place without certain built-in mechanisms for interaction, which disqualifies these types of texting apps for use in the health system environment.

In marked contrast, an enterprise collaboration platform can facilitate the more robust workflows required to achieve clinical collaboration, including issuing medication orders. In tandem, it also enables an unbroken flow of communication about a patient from one care setting to the next. With such a platform, caregivers can communicate across different devices, including smartphones, tablets, PCs or the voice-activated, hands-free communication badges that are popular in many hospitals.

Next, an enterprise communication platform supports the fundamental planks for texting a medical order that were earlier described—security, accuracy, traceability and accessibility—to assure that the right information about the right patient is received by the right person. Look for features such as a continuously updated master directory that identifies who is authorized and available; a structured template to text the order; and connections to other systems.

Avoid a “Check the Compliance Box” Approach

Note that none of these capabilities were included in The Joint Commission’s prior guidelines for secure texting (which the agency has since retracted as it works on devising new ones), and they may not be highlighted in the next. This gap illustrates why taking a narrow, compliance-centric approach to secure texting is unadvisable. Instead, hospitals should expand their secure texting solution criteria to include how well the technology does or doesn’t facilitate a smart workflow for communication.

That said, safeguarding patient data is paramount, so let’s talk a bit about how to transmit a medical order that does just that. Many texting vendors will claim to meet stringent security guidelines, but hospitals and health systems need to seek concrete evidence that these vendors really understand and are addressing today’s security threats. Have vendors show proof of government and commercial security-related certifications and passed third-party audits. They should also employ an enterprise communication platform, which unlike a single texting app, can support adoption of security best practices across the hospital, regardless of device.

One last piece of advice: Don’t wait for The Joint Commission’s guidance to start seeking texting solutions that can authentically deliver the right message to the right person about the right patient. Yes, that guidance will be needed to assure a compliant switch to what is undeniably an impressively convenient way to communicate. But the above considerations will help you select a solution that brings convenience and stronger collaboration between team members — truly the best of both worlds.


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About Author

Arun Mirchandani

Arun Mirchandani is senior vice president of products at Vocera Communications, Inc. He is also an investor of patented communication technology, a field he has held numerous positions in since 1987.

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