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7 Rules to HIPAA Compliant Text Messages

Dec 30, 2021


In the realm of healthcare, patient privacy is sacrosanct. Upholding confidentiality not only fosters trust between healthcare providers and patients but also ensures the ethical and legal obligations of medical professionals. 

Using SMS texting to communicate with patients and other healthcare providers is fast, easy and convenient. But first, you must ensure that you’re in compliance with HIPAA (Health Insurance Portability and Accountability Act) laws. 

In this blog, we will dive into the nuances of HIPAA-compliant text messaging, exploring its significance in modern healthcare communication, its role in upholding patient privacy, and seven important rules to follow when using SMS for healthcare communications.

Table of Contents 

  • What is HIPAA?
  • Confidential Information vs. Public Information
  • Examples of Confidential Information 
  • Is Text Messaging HIPAA-compliant
  • 7 Rules for Sending HIPAA-Compliant Text Messages 


What is HIPAA?

HIPAA, the Health Insurance Portability and Accountability Act, enacted in 1996, is a landmark legislation designed to safeguard patient privacy and security in the healthcare industry. At its core, HIPAA aims to ensure the confidentiality, integrity, and availability of individuals' protected health information (PHI), while also facilitating the efficient flow of healthcare information.

In the context of text messaging, HIPAA plays a crucial role in regulating the transmission and storage of electronic protected health information (ePHI). Text messaging has become an integral part of healthcare communication, allowing for quick exchanges of information between healthcare professionals, patients, and other stakeholders. However, providers must follow additional guidelines—beyond traditional mass texting rules and regulations—to ensure compliance.  


Confidential Information vs. Public Information 

Confidential information is any data that is protected by law or regulation, such as HIPAA, and is intended to be kept private and secure. This includes patient medical records, diagnostic information, treatment plans, and any other information that could potentially identify an individual's health status or medical history. Even seemingly innocuous details, such as a patient's name or date of birth, fall under the category of confidential information when linked to health-related data.

On the other hand, public information refers to data that is readily accessible to the general public and does not pose a risk to an individual's privacy or security. This may include information found in public records, such as birth or marriage certificates, or data that an individual has chosen to share publicly, such as social media posts or public statements.

The distinction between confidential and public information is not always clear-cut, and healthcare professionals must exercise caution when handling patient data to prevent inadvertent disclosure or breaches of privacy. Even seemingly benign pieces of information, when combined with other data points, can paint a detailed picture of an individual's health profile and identity.


Examples of Confidential Information 

In the complex landscape of healthcare, a myriad of data points constitute confidential information, each requiring meticulous protection to uphold patient privacy and comply with regulatory standards. From personal identifiers to sensitive medical records, confidential information encompasses a broad spectrum of data that must be safeguarded against unauthorized access or disclosure. Let's explore some examples:

  • Personal identification information like full names, date of birth, home addresses, social security numbers, and personal phone numbers.
  • Financial information, like bank account numbers, credit card information, income details, and tax information.
  • Health information like medical records, health insurance details, medication histories, and diagnostic test results.
  • Employment information, such as salary details, job titles, performance reviews, employment contracts, and disciplinary records.
  • Legal information, including divorce papers, wills, court orders, and ongoing lawsuits.
  • Business-related information, such as trade secrets, business plans, client lists, vendor contracts, proprietary software, or technology.
  • Education records like transcripts, admission applications, disciplinary records, and academic performance evaluations.

Each of these examples represents a facet of confidential information that is integral to an individual's privacy and security. 

By understanding the breadth and depth of confidential information in healthcare, healthcare professionals can proactively identify areas of vulnerability and implement strategies to safeguard patient privacy effectively. From encryption and access controls to comprehensive employee training programs, a multi-faceted approach is essential to ensuring the integrity and confidentiality of confidential information in today's digital age.


Is Text Messaging HIPAA Compliant? 

As healthcare communication evolves, many professionals turn to text messaging as a convenient and efficient means of exchanging information. However, the question arises: Is text messaging HIPAA compliant? The answer is nuanced, as traditional texting methods often fall short of  HIPAA’s stringent requirements. 

Generally speaking, unless your texts are encrypted, they are not considered HIPAA compliant. However, there are acceptable healthcare updates you can send via SMS without sharing protected data, and you can always use SMS to share links to secure patient portals. These, and other security-focused text options, are detailed more thoroughly below. 


7 Rules to HIPAA-Compliant Text Messages 

Here are seven rules to follow to help healthcare staff send compliant healthcare updates by text message.

Rule #1: Get Permission

Before sending text messages to your patients, you have to get their permission first. Express written consent requires that you need some form of documentation, like a text message reply or an online form submission, to show that the recipient agreed to receive text messages.

Rule #2: Control Access

When it comes to sending HIPAA-compliant text messages, healthcare organizations must also warn their patients about the risks of unauthorized disclosure of Protected Health Information (PHI). This is when someone other than the patient or their healthcare provider accesses sensitive patient information. To comply with HIPAA, you must warn your patients in writing about this risk.

Healthcare providers must also implement controls to limit access to PHI and what authorized users can do with PHI when they access it.

The HIPAA Security Rule requires these access control precautions:

  • Unique user IDs: Authorized users must each have a unique identification, such as an ID number or username while accessing a system with PHI. This includes SMS text messaging platforms which require a unique ID to access, send and receive HIPAA-compliant text messages.
  • Emergency access procedures: Healthcare providers should consider what kind of emergencies might require urgent access to PHI and who should have access in these situations.
  • Automatic logoff: Any platform that works with PHI must automatically log off users after a specified time of inactivity. This ensures no unauthorized individuals can access PHI on someone else’s device if it’s left unattended.
  • Encrypted messages: Secure text messaging must be encrypted to prevent unauthorized access to PHI, particularly if a device has been lost or stolen.

Rule #3: Only Send Secure Messages

As mentioned above, you must ensure that HIPAA-compliant text messages are encrypted on all devices for both senders and recipients. Text messages are typically not secure while in transit because cellular carriers or other third parties can access them.

To protect PHI, you should encrypt all messages, especially if you use personal devices to communicate or access sensitive patient data. We recommend using TLS/SSL encryption across all server nodes or a similar encryption method.

Rule #4: Use Multi-Factor Authentication (MFA)

To send text messages that contain PHI, you should implement multi-factor authentication (MFA). MFA requires that users prove their identity by logging in with something unique to them. This typically involves a traditional username and password combined with another layer of security. These include one-time passcodes sent to your mobile device or a biometric identifier such as your fingerprint, face or voice.

Rule #5: Limit Information Sent Via Text

Although text messaging is a quick and convenient way to get in touch with patients, you must take the proper precautions to protect patient privacy. By limiting what kind of information you send in your text messages, you can reduce the risk of PHI falling into unauthorized hands.

We recommend using SMS texting to send information about:

  • Appointments and appointment reminders
  • Registration instructions
  • Pre- and post-operative instructions
  • Test result notifications
  • Prescription notifications
  • Home healthcare information and instructions

Texting patients a link to log into an online patient portal is preferable to sharing private information directly.

Rule #6: Keep Accurate Records of All Messages

You are only compliant when you successfully pass a HIPAA audit. Therefore, you should always be ready to provide evidence of the systems that record all PHI-sharing activities in case of an audit.

To prove compliance, HIPAA-compliant text message platforms will automatically document how administrators manage authorized users and security policies, along with authentication events and message read receipts. In addition, using a secure SMS marketing platform allows you to rest easy knowing that your text messages are appropriately recorded for future audits.

Rule #7: Erase Data in Case of Theft

Mobile devices offer a convenient way to access all kinds of information, including PHI. However, smartphones and other mobile devices can also be easily lost or stolen, which can put your HIPAA compliance at risk. To eliminate the possibility of unauthorized access, you should ensure that you can remotely delete PHI from a stolen or lost device.


Start Sending HIPAA-Compliant Text Messages With Textedly Today

Many hospitals, medical professionals and healthcare organizations have started using SMS text messaging solutions to improve care and patient communications. If you’re ready to try using SMS for healthcare, Textedly can help. 

Textedly’s user-friendly platform offers powerful features from scheduled text messages to emergency alerts, ensuring that your patients have the healthcare information they need. 

In addition, our secure platform protects sensitive patient information so you can rest easy knowing you’re only sending HIPAA-compliant text messages.

Get started with a free 14-day trial of Textedly today.