Texting patient orders a no-no

David Williams with an interesting post about the Joint Commission issuing a ruling that texting of patient orders is unacceptable:

No it is not acceptable for physicians or licensed independent practitioners to text orders for patients to the hospital or other healthcare setting. This method provides no ability to verify the identity of the person sending the text and there is no way to keep the original message as validation of what is entered into the medical record.

My initial gut is that this prohibition makes sense, but David makes an appeal for more information that also rings true:

I understand the downsides but I’d be interested to learn more about what’s driving the use of texting for orders — if there is in fact such a trend. My guess is that younger physicians in particular are used to texting in their personal lives, finding it convenient, immediate, reliable, concise and likely to be read, acknowledged and acted on quickly. Add to that the fact that texting can easily be done from personal mobile devices and the appeal becomes pretty clear.

As someone who has been texted from the rear of my minivan by one of my teenagers saying they wanted to stop and get a drink, I am acutely aware that the preferred patterns of communication are not stable across time.

 

About Don Taylor
Professor of Public Policy at Duke University (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute). I am one of the founding faculty of the Margolis Center for Health Policy, and currently serve as Chair of Duke's University Priorities Committee (UPC). My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

4 Responses to Texting patient orders a no-no

  1. steve says:

    I can give an order over a phone, but not text one. I suspect there would be fewer errors with a text, but there is no data to support that. My texts stay on my phone. I would bet that you could have texts go into the hospital system if the hospital had phones that accept texts. The current problem is that texts are going to some nurse’s personal phone.

    Steve

    • Don Taylor says:

      @steve
      I suspect that isn’t last word on the issue….my wife carries a charge phone at work (she is a peds hemeonc nurse) so that could receive the text messages. My teenagers can text at an astonishing pace, so I agree quite precise. Needs to be studied….

      • steve says:

        I have a standing offer from an IT company exec to provide input on apps. Wonder if I should ask him to work on a text app that would record and preserve texts, kind of like what happens with the back up for my phone numbers? The problem I would see at my hospital, and others, is that the phones nurses carry around for official business on the floors are pretty primitive and do not receive texts. I suppose that could be updated, but would guess it is a bit expensive.

        Steve

      • Don Taylor says:

        @steve
        would be interesting to devise a study to see it texting improved accuracy. Not sure of all the issues, but this issue will be around for a while

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