Following some confusion, a Survey & Certification Letter sent last week has reaffirmed CMS’s stance on texting patient information, specifying that messages sent among clinicians are permissible so long as healthcare teams use a secure platform. Texting patient orders, however, is still prohibited across all platforms.

CMS’s clarification comes shortly after a Dec. 18 report from the Health Care Compliance Association (HCCA) that raised concerns about the center’s policy. The policy outlined in Thursday’s letter now mirrors the current position of the Joint Commission, which underwent its own series of flip-flops on the subject in 2016.

“In order to be compliant with the [Conditions of Participation (CoPs)] or [Conditions for Coverage (CfCs)], all providers must utilize and maintain systems/platforms that are secure, encrypted, and minimize the risks to patient privacy and confidentiality as per HIPAA regulations and the CoPs or CfCs,” CMS Survey and Certification Group Director David R. Wright wrote to state survey agency directors. “It is expected that providers/organizations will implement procedures/processes that routinely assess the security and integrity of the texting systems/platforms that are being utilized, in order to avoid negative outcomes that could compromise the care of patients.”

In the HCCA’s report, the association wrote that at least two hospitals had received emails from CMS saying that “texting is not permitted” regardless of whether the texting application was secure. These email correspondences cited meetings with secure texting app vendors and the Medicare Condition of Participation’s section about the retention of medical records and their confidentiality as factors in the center’s no-texting decision.

“If texting solutions are good for highly classified military applications, they’re probably appropriate for hospitals,” Robert Hudock, member at Epstein Becker & Green, said in the HCCA report. “This is almost like going back to the dark ages.”

While Wright’s letter did not mention the HCCA report, his indirect response to these concerns stressed the agency’s recognition of texting platforms as an increasingly important healthcare communication resource. Outside of the texting-specific policy clarifications, the CMS letter also noted that computerized provider order entry (CPOE) as the preferred method for provider order entry.

According to the letter, these policies are effective immediately and should be communicated to all survey certification staff, their managers, and the appropriate training coordinators within the next few weeks.

“CMS recognizes that the use of texting as a means of communication with other members of the healthcare team has become an essential and valuable means of communication among the team members,” Wright wrote.