Secure messaging ban: Why The Joint Commission got it wrong
(Article originally published on Becker’s Hospital Review by Galina Datskovsky, January 23, 2017)
Secure messaging its latest update, The Joint Commission banned the use of secure text messaging for patient care orders due to concerns over privacy and security.
The decision was a curious one since it came just a few months after announcing an end to the very same ban. Though its concerns are certainly warranted, as healthcare is the most targeted sector for cyber-attacks, The Joint Commission’s latest assertions against secure text orders are, quick frankly, unsubstantiated. In fact, modern secure messaging platforms not only address the issues raised by The Joint Commission but can also serve to improve a hospital’s security, efficiency, and compliance.
The Joint Commission provided three main issues with secure messaging platforms, which are outlined and rebutted below:
1) The implementation of an additional mechanism to transmit orders may lead to an increased burden on nurses to manually transcribe text orders into the EHR.Modern secure messaging apps on the market today have the ability to seamlessly integrate directly into a healthcare organization’s EHR and securely archive text messages for complete and comprehensive documentation. This process eliminates any notion of increased burden or manual transcribing and, in fact, improves efficiency and decision making for superior patient care. Further, secure messaging platforms can provide protection of PHI, PII, and IP to ensure the privacy of patient records.
2) The transmission of a verbal order allows for a real-time, synchronous clarification and confirmation of the order as it is given by the ordering practitioner. As the process for texting an order is an asynchronous interaction, an additional step(s) is required to contact the ordering practitioner for any necessary discussion prior to order entry. In actuality, secure messaging can streamline business workflows and enable a new level of business agility through rapid response – without jeopardizing security or compliance.
For example, nurses spend a lot of time trying to find doctors in order to communicate verbally, but there is often a breakdown in communication as each professional is tremendously busy in his or her own right. Further, verbal communication can be misunderstood or forgotten – leading to potential malpractice lawsuits. In fact, in a recent report, the CRICO looked at over 23,000 medical malpractice lawsuits and claims where patients suffered harm. Out of these cases, over 7,000 were directly caused by miscommunication. With secure messaging, however, the conversation is delivered in writing to ensure accuracy and recorded in a secure format for both compliance purposes and future reference.
3) In the event that a CDS recommendation or alert is triggered during the order entry process, the individual manually entering the order into the EHR may need to contact the ordering practitioner for additional information. If this occurs during transmission of a verbal order, the conversation is immediate. If this occurs with a text order, the additional step(s) required to contact the ordering practitioner may result in a delay in treatment.
In any situation where an ordering practitioner must be contacted, the individual would first need to physically find that practitioner to verbally communicate, which is a challenge in itself. Patient care requires fast-paced, asynchronous collaboration for life-saving decisions and waiting for a return call can delay treatment and increase patient suffering. Because text is the most rapidly responded to communication channel utilized today, over both email and voice, a secure messaging platform improves patient outcomes while providing streamlined workflows for care teams.
Simply put, relying solely on verbal communication hinders workflow, patient care, and collaboration should the physician or practitioner be on call, in surgery or otherwise unavailable. Alternatively, a secure messaging platform uniquely increases business efficiency, protects sensitive information and improves decision-making among mobile work teams. In addition, it alleviates the cybersecurity risks commonly found with native SMS text messaging, of which 95 percent healthcare professionals, physicians, and nurses are already using to communicate – whether sanctioned or not. According to Kaspersky Labs, mobile attacks have almost quadrupled over the last two years and are expected to be even more popular in 2017. In other words, not requiring the use of secure messaging could potentially increase cyber threats facing the healthcare industry.
At the conclusion of its most recent update, The Joint Commission stated it will continue to monitor advancements in healthcare to determine “whether future guidance on the use of secure text messaging systems to place orders is necessary.” However, the opportunity to implement secure, ephemeral and compliant messaging is already available – so the question now becomes, when will The Joint Commission reverse its decision once again?
Galina Datskovsky, CEO of Vaporstream
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