HIPAA-Compliant Texting: A Complete Guide 

Introduction 

Communication in healthcare has witnessed quite an evolution over the years, with texting becoming the most preferred mode of communication for patients and providers alike. Texting is convenient, affordable, has better reach, and is immediate; which is why it is the first choice for 95% of Americans. 

While texting does have its share of benefits, it also brings along some regulations pertaining to sharing, disclosing, and protecting information. While dealing with sensitive patient information, healthcare providers need to adhere to HIPAA guidelines while sharing PHI via text, to avoid any legal action or penalties. Due to the digitally inclined systems and processes, HIPAA-compliant texting has become the need of the hour for all healthcare professionals and organizations. With data breaches becoming more common with each passing day, it is important for healthcare providers to have the required physical, technical, and administrative guidelines in place. 

If you are a healthcare provider looking for some answers pertaining to HIPAA-compliance, the associated rules, penalties, best practices, enforcement guidelines and more; this one-stop guide is all you need! Sit tight and keep scrolling! 

What Is HIPAA-Compliant Texting? 

HIPAA-compliant texting is the secure exchange of text messages sent in accordance to HIPAA rules. These are set in place to safeguard patient health information (PHI) transmitted via text.

The term HIPAA stands for Health Insurance Portability and Accountability Act of 1996. This act outlines the federal rules and regulations pertaining to the way organisations must use and disclose Protected Health Information.

These HIPAA standards are regulated by the Department of Health and Human Services and enforced by the Office for Civil Rights (OCR).

To be HIPAA compliant means that both Covered Entities and Business Associates must adhere to the HIPAA guidelines; particularly the administrative, technical, and physical safeguards. 

Texting by its nature is not HIPAA compliant which is why secure texting in accordance with HIPAA rules is needed to make it compliant. A major facet of HIPAA-compliant SMS is end-to-end encryption. HIPAA-compliant text messaging apps utilize secure texting links to ensure end-to-end encryption. 

To understand HIPAA comprehensively, you need to understand the associated rules and the penalties that follow when you don’t follow those rules. 

HIPAA Rules: A Brief Overview

HIPAA outlines three rules related to PHI: 

#1: The HIPAA Privacy Rule: This rule establishes standards for protecting the patient’s sensitive health information. It requires the implementation of appropriate safeguards and conditions for the use and disclosure of PHI (For example: Getting explicit patient consent). It also outlines the patients’ rights to review their health records and suggest corrections, if any. 

#2: The HIPAA Security Rule: This rule outlines the national standards for protecting the patient’s ePHI that is obtained and used by a Covered Entity. It sets comprehensive and scalable standards for safeguarding ePHI which are as follows: 

• Administrative safeguards: Developing policies and procedures for security standards, training, access management, and contingency plans. 
• Technical safeguards: Automated processes such as audit controls, access control, authentication controls, and encryption/decryption to protect ePHI. 
• Physical safeguards: Having mechanisms in place to protect electronic systems, equipment, and buildings, from any threats.  

#3: The Breach Notification Rule: This rule requires that both Covered Entities and Business Associates send notifications as a result of a breach of PHI. It could be any unauthorized acquisition, use, or disclosure of PHI.

HIPAA-Compliant Texting: Penalties 

If you fail to comply with the HIPAA guidelines and end up sharing or disclosing sensitive PHI, then you can land yourself in a lot of trouble. This trouble could come in the form of a civil lawsuit or even criminal charges! The degree of the penalties imposed depends on the category of non-compliance. The categories are explained as follows: 

Did you know?

In the year 2019, the American Medical Collection Agency (AMCA) failed to comply with HIPAA regulations and couldn’t protect the sensitive healthcare information of its patients. The deficiencies in information security led to a data breach, which exposed the personal health information of about 20 million individuals. The breach invited an extensive investigation and made the organization liable for $21 million as a penalty. 

Benefits of HIPAA-Compliant Texting

Secure communication

HIPAA-Compliant text messaging allows you to communicate securely with your patients. If you adhere to HIPAA guidelines for the sharing and disclosure of PHI, you can always make sure that any information you share or obtain is compliant with the set regulations. 

Limit information sharing 

With a comprehensive understanding of HIPAA guidelines, you will be able to differentiate between the information you can and cannot share. This will limit information sharing to a great extent and will protect your data from any unauthorized access. 

Improve patient engagement 

When you make sure to implement all safeguards in place to comply with HIPAA, your patients develop trust in you as their provider. They know that you are taking steps to protect your personal information, and this will further strengthen your relationship with them. As a result of stronger relationships, you will see a surge in patient engagement, thereby improving health outcomes. 

Avoid penalties 

Any non-compliance of HIPAA guidelines can lead you to pay hefty penalties. HIPAA-compliant texting with patients makes sure that you do not violate any HIPAA rules and maintain compliance. This will prevent you from breaking any rules and save you thousands of dollars. 

Reduce phone calls 

Not just providers, but patients also have resorted to texting as the better medium of communication, due to convenience and accessibility. Texting your patients about general things such as appointments, promotions, and education can reduce phone calls by 80%; thereby saving you from long phone bills and 3-4 hours of daily time. 

Use Cases of HIPAA-Compliant texting  

Now that you have acquired a comprehensive understanding of HIPAA-Compliant messaging, it is time to see how different healthcare providers can use it to their advantage. 

HIPAA-Compliant texting for therapists 

• Send appointment reminders and rescheduling options 
• Engage in secure communication on medications and other therapy-related plans 
• Offer unwavering support between sessions to ensure better therapeutic outcomes
• Address and resolve issues in the case of emergencies 
• Share confidential resources and assignments 
• Track the progress of client and make changes as required
• Get billing and insurance-related information
• Collect patient feedback for continuous improvement in services 
• Collaborate with other teams for delivering exceptional care 

HIPAA-Compliant texting for dentists/doctors 

• Send appointment reminders and confirmations 
• Share HIPAA-compliant forms via text message
• Discuss treatment plans and recommendations with the patients 
• Send detailed preoperative and postoperative instructions to the patients 
• Share radiology tests and prescription refill reminders to patients 
• Offer virtual consultation (telehealth) in the case of emergencies 
• Track progress and provide follow-up care to the patients 
• Gather information related to billing and insurance 

HIPAA-compliant texting for veterinarians

• Send appointment reminder, confirmation, and scheduling messages 
• Share laboratory text results and other important diagnostic information 
• Share medication prescription information and related information
• Provide instructions for pre and post-surgical care 
• Offer remote consultations in case a physical visit isn’t possible 
• Extend behavioural support to the pet parents 
• Share medical records and vaccination history 
• Provide end-of-life care to the pet parents 
• Request feedback 
• Offer support during emergencies 

HIPAA-Compliant texting for Nurses 

• Share documents before appointment 
• Offer support to patients 
• Send important text message alerts and notifications
• Send medication reminders 
• Check into scheduled appointments with patients 
• Verify patient information 
• Collect patient feedback 
• Send payment reminders 

HIPAA-Compliant Texting – Free Templates 

Appointment confirmations SMS

Hey <First name>, you have an appointment scheduled for <day, date> with <Provider Name> at <Time>. Please type C to confirm and R to schedule the appointment. – Team XYZ 

Reminders SMS

Hey <First name>, this is a gentle reminder for your appointment with <Provider Name> which is scheduled for <Date, day, time>. Please reach 15 minutes prior to your appointment. Please reply C to cancel your appointment. – Team ABC

Follow up SMS

Dear <First name>, we wanted to check on you post-appointment. Please let us know if you have any questions. Regards, Team ABC 

Recall text SMS

Hey <first name>, you are due for an annual health checkup in two weeks. Please reply to this message if you wish to schedule an appointment. – Team ABC 

Payment SMS

Hey <first name>, this is a reminder that your payment is due. Please contact the office for the same. – Team XYZ 

Online forms SMS

Hey <first name>, before we proceed with the diagnosis and treatment, we’d like you to fill out an online patient intake form to understand your health condition and provide the best possible care. Please click on this link to access the form: <link>. – Team XYZ 

Review/feedback  SMS

Hey, we hope you had a good experience with us. We’d love to hear about it. Please leave us a review by clicking on this link: <link> – Team ABC 

Staff Communication SMS

Hey team, the meeting scheduled for tomorrow at 4 pm has been postponed to 6 pm. Please acknowledge the message. 

Best Practices of HIPAA-Compliant Texting

Use a HIPAA-compliant texting app 

This is the first thing you need to do to ensure HIPAA compliance. Use a HIPAA-compliant text messaging app that offers advanced texting capabilities, and user and access control, is HIPAA, HITECH, and TCPA compliant, and offers real-time alerts, great support, message lifespan, and interoperability as some key features.

Get the explicit consent of patients 

Before engaging in text messaging with your patients, make sure to familiarize them with the risks associated with sharing information via text, such as interception during transit, lost or stolen devices, or unauthorized access. Before you start engaging with your patients through text messages, you must have the patient’s written consent. For instance, if you wish to gather feedback from your patients or send out a survey to them, let them have the option to opt in or opt out of such communications.  

Limit information sharing 

By limiting information sharing on texts, you can reduce the risk of PHI falling into the wrong hands. Texting messages for the following purposes poses no risks –  

• Appointment booking 
• Appointment reminders
• Registration Guidelines
• Test result notification
• Routine healthcare guidelines
• Pre and post-operation directives

Actively monitor activity 

HIPAA audit requires the systems to provide timely evidence and records of PHI-sharing activities. HIPAA-compliant text platforms automatically document user management along with authentications and messaging information. Make use of a secure texting platform that can keep a record of all the messages for future audits. 

Set access control 

While sending HIPAA-compliant text messages, you must warn your patients about the risks of unauthorized disclosure of Protected Health Information (PHI).  

On another note, being a responsible healthcare provider, you must also implement access control to limit access exclusively to authorized users. HIPAA security rule requires the following access control provisions –

• Exclusive user ID: The professionals accessing a system with PHI should have unique user IDs with their individual names or numbers. All the platforms including text messaging platforms should be accessed through these unique user IDs to avoid information misuse and data breaches.  
• Encrypted messaging: The text messaging must have end-to-end encryption to protect PHI and prevent unauthorized access, especially in case of loss of the device. 
• Auto log-off: Platforms working with PHI must have an auto log-off option after the user has been inactive for a particular time duration. This ensures the security of the information and avoids unauthorized data tampering.
• Have an SOP for emergencies: Platforms working with PHI must have an auto log-off option after the user has been inactive for a particular time duration. This ensures the security of the information and avoids unauthorized data tampering.
• Multi-factor authentication: Make sure that the platform allows users to confirm their identities before accessing the platform. This means that the users would have to enter more than just a password to access the platform. Such a level of authentication will ensure added security. 

Sign a BAA 

The third-party vendors working with your healthcare organization may get access to PHI. These third-party vendors are also known as business associates. Make sure to sign a BAA with your HIPAA-compliant text messaging service. 

Keep the conversation history  

Let’s say one of your patients was due for an annual checkup for a chronic condition and you sent them a reminder for the same. For some reason, your patient didn’t pay attention to the reminder and decided not to visit you. After some time, their health deteriorated as a result of negligence and they filed a case against you claiming that you didn’t send them the notification for the due checkup. That is when you can pull out the conversation history of this patient and save yourself. Make sure to document such conversations in case an audit takes place. 

Train your employees

Just as important as it is to familiarize your patients for secure PHI sharing, it is also crucial to train your employees accordingly to avoid any HIPAA violation. Tell your employees about the HIPAA rules in detail and help them understand how messaging can be made HIPAA-compliant. This way you’ll be able to ensure end-to-end compliance and avoid any penalties or legal action. 

How To Enforce HIPAA Compliance

As a healthcare provider, it is crucial that you take HIPAA compliance seriously and implement the required safeguards whenever you send text messages to your patients. To be able to enforce HIPAA compliance while texting your patients, you must sign up with a HIPAA-compliant texting app. 

A HIPAA-Compliant messaging app like Emitrr offers you everything you need to maintain compliance, right from managing access controls to undertaking frequent risk assessments. You must stay HIPAA compliant in order to keep communicating with your patients, while also avoiding hefty fines or legal action. 

Here’s how Emitrr ensures HIPAA-Compliance for all healthcare providers: 

End-to-end encryption 

With a safeguard like end-to-end encryption, you can be assured that no third party can access any messages you share with your patients. This is because all the data hosted on the servers is encrypted, and only the intended recipient can view those messages. No third party, including Google, can access your messages. 

Secure PHI sharing 

Emitrr offers an interesting feature called ‘secure text messaging’, through which you can easily exchange confidential messages with your patients. All the data will be exchanged in a controlled environment. This means that no third party will be able to access your messages that travel between your device and the recipient’s device. It’s that safe. 

Multi-tenant architecture  

Emitrr’s multi-tenant architecture ensures that all the data hosted is protected at all costs. It means that all the patient data is not hosted on one single architecture but on different servers. Since the data is hosted on different servers, not all patient data will be at risk in case of a potential breach. 

SOC2 Compliance 

SOC2 Compliance is a voluntary compliance standard developed by the American Institute of CPAs (AICPA) that enlists how service organizations should manage all customer data. It is categorized into 4 Trust Services Criteria; namely Security, Confidentiality, Availability, and Processing Integrity. Emitrr is not just HIPAA-compliant but also SOC2-compliant. Make sure to check for SOC2 Compliance while choosing a HIPAA-compliant platform. 

In addition to the above use cases, patients can also request their data for storage purposes. For the same, a link will be generated by Emitrr that will collect all conversation and voicemail data for the particular patient. Also, if the patients want their data to be deleted, they can reach out to the Emitrr support team for the same. 

How To Send HIPAA-Compliant Messages Through Emitrr? 

If you want to exchange PHI while also maintaining compliance, not only do you need to follow the aforementioned best practices but also implement measures to ensure patient engagement. To make the most of HIPAA-compliant texting via Emitrr, you need to use the secure texting feature. 

Check out this video to see how you can communicate securely with your patients: 

Frequently Asked Questions 

Conclusion 

Protecting the rights of the patients and safeguarding their personal information is as important as delivering exceptional care. Any negligence on that front not only attracts legal troubles but also breaks the trust between you and your patients. HIPAA-compliant texting with patients is the way forward if you want to offer the best possible care to them, while also ensuring that their PHI doesn’t get into the hands of unauthorized individuals. Invest in a HIPAA-compliant messaging app like Emitrr to enhance patient engagement and experience. Book a demo here to see what Emitrr has in store for you.