CMS: Providers may now text patient info, orders to care teams

Providers working in hospitals and critical access hospitals may now text patient information and patient orders among care team members without landing on the wrong side of Medicare’s Conditions of Participation, the Centers for Medicare & Medicaid Services (CMS) wrote in a recent memorandum to state survey agencies.

The catch, per the notice, is that the providers must be sending the texts through a secure texting platform that is compliant with the Health Insurance Portability and Accountability Act (HIPAA).

The agency said it still prefers that providers enter their orders into the medical record via a computerized provider order entry or a handwritten order. However, “we recognize that alternatives also exist now, as well as significant improvements in the encryption and application interface capabilities of texting platforms to transfer data into electronic health records [EHR],” it wrote in the memorandum.

The policy change was sent out to survey agencies Feb. 8 and is effective immediately.

CMS said that providers who choose to incorporate texting into their workflows and EHRs are expected to “implement a platform that meets the requirements of the HIPAA Security Rule and the HITECH Act Amendment 2021 as well as the [Conditions of Participation].” It also recommended that providers have processes in place to “routinely assess” their chosen secure texting platform “to avoid negative outcomes that could compromise the care of patients.”

CMS had put patient info texts between care team members on ice back in late 2017 or early 2018. That memorandum (PDF) had acknowledged the “essential means of communication” between team members that texting had become, but cited concerns around record retention, privacy, confidentiality, security and system integrity.

“When CMS developed the 2018 guidance, most hospitals and [critical access hospitals] did not have the ability to use secure texting platforms to incorporate these messages into the medical record,” the agency wrote in the more recent memorandum.

The policy change was applauded a day later by the American Hospital Association (AHA). The hospital lobbying group noted in a post that it had encouraged the agency to consider recent years’ platform updates as well as the upsides of speedier treatments and reduced burden on clinicians.

“We are grateful that CMS considered the issue and chose to make this change,” AHA Director for Health IT Policy Stephen Hughes said. “It will be good for patients and providers.”