On February 8, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a new memorandum, QSO-24-05-Hospital/CAH, officially updating the policy on texting patient information and orders within hospitals and Critical Access Hospitals (CAHs).
What happened
This directive, communicated to State Survey Agency Directors by the Director of the Quality, Safety & Oversight Group (QSOG), signifies a policy shift from the stance CMS took in a previous memorandum, QSO-18-10-Hospital/CAHs, released on January 5, 2018.
The 2018 memorandum acknowledged the role of texting in communication among healthcare teams. Still, it had deemed texting patient orders non-compliant with the Conditions of Participation (CoPs) due to concerns over record retention, privacy, confidentiality, security, and system integrity.
Recognizing advancements in secure texting technology and the integration capabilities with electronic health records (EHRs), the CMS has now authorized the use of HIPAA compliant secure texting platforms (STP) for both patient information and orders, provided they comply with the CoPs. This move is contingent on the continued preference for Computerized Provider Order Entry (CPOE) as the primary method of entering orders by providers.
See also: What does the Centers for Medicare and Medicaid Services (CMS) do?
In the know
The CoPs are health and safety standards that hospitals and CAHs must meet to participate in the Medicare and Medicaid programs. While the detailed CoPs are extensive and cover various aspects of hospital operations and patient care, here’s a simplified list of some key areas they address:
- Hospitals must ensure that patient rights are protected.
- Patients must receive care in a safe setting.
- Hospitals must have a governing body that is legally responsible for the conduct of the hospital.
- The hospital must have an effective quality assessment and performance improvement program.
- Medical staff must be accountable for the quality of medical care provided to patients.
- Nursing services must have adequate staff to provide nursing care to all patients as needed.
- Hospitals must have a medical record service that has administrative responsibility for medical records.
- Hospitals must provide pharmaceutical services that meet the needs of the patients.
- Hospitals must have infection control policies and procedures in place.
- The hospital must ensure that its physical environment is safe and suitable for patient care and staff.
See also: CMS releases final rule addressing behavioral health
Why it matters
This memorandum matters because it officially sanctions the use of secure texting platforms for transmitting patient information and orders among healthcare providers within hospitals and CAHs. In practical terms, this policy change acknowledges the evolution and integration of secure messaging technology in healthcare settings. This comes in the backdrop of a staggering increase in texting; in the last decade, the number of monthly texts sent has surged by over 7,700%, with more than 560 billion texts sent each month.
This offers a more flexible and instantaneous method of communication that aligns with contemporary communication habits and technological advancements. For healthcare organizations, this means the ability to leverage texting—a quick and efficient communication tool—while ensuring that patient data remains secure and private. This adaptability is necessary for improving response times, coordination of care, and ultimately, patient outcomes.
See also: The guide to HIPAA compliant text messaging
FAQs
What are the limitations of secure texting in healthcare settings?
Secure texting in healthcare has some challenges, such as making sure everyone knows how to use the technology safely, keeping the system up to date, and following all privacy laws.
How does this memorandum affect communication with patients directly, if at all?
The new rules are mainly about how doctors and nurses talk to each other about patients through text. It doesn't change how you might text with your doctor.
Kirsten Peremore
