The Joint Commission has banned doctors from texting orders, but the rule makes little sense to clinicians who want faster ways to communicate in a fast-paced environment.
Melissa Walton-Shirley, M.D., a Kentucky-based cardiologist and blogger, writes in a Medscape Medical News column that it makes little sense for agencies to be stricter about texting than they are with verbal communication. For example, one of the main criticisms of text orders is that they may not make it into health records, but verbal directions can also be missed, she says.
As for privacy concerns, many clinicians forget that verbal commands are often issued in crowded hallways or in busy rooms with thin curtains separating beds. Those orders are likely to be overheard, she adds.
The Joint Commission lifted its ban on texting orders in April and then put it back in place in July while it worked to develop clearer safety guidance on texting orders. The commission confirmed the decision to leave the ban in place last month after it and the Centers for Medicare & Medicaid Services noted several concerns about doctors using it for orders, including the possibility for delays and the increased burden on clinical staff designated to input that data into electronic health records.
Critics of texting orders have noted that slow networks can hinder communication, which needs to be quick particularly for critically ill patients. However, some hospitals have found that texting care protocols improves communication and reduces patient length of stay.
Walton-Shirley warns that doctors that are comfortable with and used to texting orders are likely to skirt the Joint Commission’s rules. “The reality is that squashing an efficient and safe form of communication won't ever happen,” she writes.