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January 5, 2018

After widespread confusion, CMS clarifies its stance on texting patient orders

Daily Briefing

    CMS in a memo sent Thursday to state survey agencies clarified its policies on whether health care providers can use text messages to communicate patient orders.

    According to MedCity News, CMS issued the memo a little more than one week after the Health Care Compliance Association released a report stating that two hospitals had gotten emails from CMS warning the hospitals that health care providers are not permitted to text patient orders, even when using secure text messaging applications. The report stated, "compliance officers, lawyers, and HIPAA experts were stunned" by the warnings because CMS rules permit providers to use secure text messaging platforms to communicate patient information.

    Memo details

    CMS in the memo wrote that although health care providers are permitted to text certain patient information via secure text messaging platforms, they are not permitted to text patient orders. The agency wrote, "The practice of texting orders from a provider to a member of the care team is not in compliance with [CMS'] Conditions of Participation … or Conditions for Coverage."

    CMS stated that providers should use Computerized Provider Order Entry (CPOE) to submit patient orders. The agency wrote, "CMS has held to the long standing practice that a physician or Licensed Independent Practitioner should enter orders into the medical record via a hand written order or via CPOE. An order if entered via CPOE, with an immediate download into the provider's electronic

    health records, is permitted as the order would be dated, timed, authenticated, and promptly placed in the medical record."

    According to FierceHealthcare, the policy matches guidance CMS released in 2016 in conjunction with the Joint Commission (Sweeney, FierceHealthcare, 12/29/17; Baum, MedCity News, 12/29/17; Health Care Compliance Association report, 12/18/17; CMS memo, 12/28/17).

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