01/03/2018

CMS Clarifies Position on Texting Patient Information Among Healthcare Providers

Guest Article by Elizabeth E. Hogue, Esq.

On December 28, 2017, David Wright, Director of the Survey and Certification Group at the Centers for Medicare & Medicaid Services (CMS), sent a Memorandum to all State Survey Agency Directors to clarify CMS' position regarding texting patient information among healthcare providers. This Memorandum is effective immediately. Here is a summary of the Memorandum:

• "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."

CMS goes on to say that it does not permit the texting of orders by physicians or other health care providers. In fact, according to CMS, the practice of texting orders from providers to members of the care team is not in compliance with Conditions of Participation (CoPs) or Conditions for Coverage (CfCs).

CMS also says that CPOE is the preferred method of order entry by providers. Handwritten orders are also permitted. When orders are entered via CPOE with an immediate download into providers' electronic health records (EHR), orders are dated, timed, authenticated and promptly placed in medical records.

CMS then acknowledges that texting as a means of communication with other members of healthcare teams has become an essential and valuable means of communication among team members. In order to be compliant with CoPs or CfCs, however, all providers must utilize and maintain systems/platforms that are secure and encrypted and that minimize risks to patient privacy and confidentiality, consistent with HIPAA regulations and applicable CoPs and CfCs. Providers are also expected to implement procedures/processes that routinely assess the security and integrity of texting systems/platforms being utilized in order to avoid negative outcomes that could compromise patient care.

These requirements likely apply to all providers who receive reimbursement from the Medicare and Medicaid Programs, including Medicaid waiver programs. Providers should immediately modify their practices, if necessary, to comply with direction from CMS.

©2018 Elizabeth E. Hogue, Esq.  All rights reserved.