Recent advances in the security of texting platforms prompted the Joint Commission to reconsider text messaging as an acceptable means of communicating patient care orders.

In June, TJC was set to approve texting orders; however, the organization decided to delay implementation until September 2016 so that additional guidance could be provided, helping to ensure safe implementation and assist healthcare institutions in developing policies and procedures around texting patient care orders.

TJC staff will assess the need for additional clarification of expectations regarding text messaging platforms as it further develops the medical management standards and releases additional support and guidance. For healthcare institutions that plan to use texting as a means of communicating patient care orders, TJC recommends considering a risk management strategy, defining scenarios for which text orders are inappropriate, and monitoring frequency of use and patient safety. It also urges considering how texted orders will be integrated into the permanent health record and suggests the adoption of the agency's recommendations surrounding verbal orders for text orders as well.

ONS expressed concerns to TJC regarding the safety of texting patient care orders, especially those that communicate chemotherapy- and biotherapy-related care. Orders involving chemotherapy and biotherapy should be considered high risk and have strong safeguards surrounding them. Per the ASCO/ONS Chemotherapy Safety Standards, verbal orders surrounding antineoplastic agents are unacceptable, and should only be used with regard to holding or stopping doses. As TJC makes further decisions about texting patient care orders, oncology nurses should be involved in the development of any policies or procedures regarding texted orders.