Questions to ask when creating a text messaging policy in healthcare

Technology has transformed how well the health industry communicates and presents unique challenges to healthcare providers and organizations. Americans check their phones 205 times daily, so text messaging is undoubtedly a convenient way to communicate when done properly under HIPAA. By understanding HIPAA regulations and implementing clear text messaging policies, healthcare organizations can navigate text communication while maintaining patient privacy and HIPAA compliance.

A comprehensive text messaging policy should require organizations to obtain patient authorization, use secure communication methods, and guarantee third-party security with signed business associate agreements (BAAs).

Extra info: HIPAA compliant email: The definitive guide

What is HIPAA compliant communication?

The Health Insurance Portability and Accountability Act (HIPAA) sets national standards that safeguard the privacy and security of protected health information (PHI). HIPAA compliance is a legal requirement that protects patients’ privacy and ultimately lets organizations focus on patient care. With HIPAA regulations in place to protect patient privacy, healthcare providers must choose secure, compliant communication methods, including when and how to send or receive text messages.

HIPAA compliance in communication refers to the measures and protocols that healthcare organizations must follow to ensure the confidentiality, integrity, and security of PHI when transmitted or shared. The act’s Privacy and Security Rules mandate sensitive data be safeguarded from unauthorized access, ensuring that healthcare organizations take adequate precautions when handling PHI. Specific cybersecurity strategies include:

• Adherence to the minimum necessary standard
• Encrypting emails and text messages
• Securing phone and video conservations
• Using only HIPAA compliant messaging platforms
• Restricting what is released on social media
• Enabling strong access controls (e.g., passwords)
• Utilizing regular audits

Ensuring HIPAA compliant healthcare communication requires a multifaceted approach to security that involves implementing strong cyber technologies, robust policies and procedures, and ongoing staff training.

See also: How the HIPAA Omnibus Rule impacts communication practices

HIPAA, healthcare, and text messaging

HIPAA compliant text messaging has gained popularity among medical personnel who may need to send patients or other providers medical information. Although texting is convenient, it can present potential vulnerabilities that should be considered and eliminated carefully. HIPAA regulations uphold patients’ rights and ensure the protection of sensitive data, reinforcing the integrity of a healthcare organization.

While the Privacy and Security Rules do not explicitly mention text messaging, they do establish guidelines for the digital transmission of PHI. Interestingly, the U.S. Health and Human Services (HHS) recently stated that texting patient information is HIPAA permissible if accomplished through a secure platform. In general, healthcare organizations are permitted to send PHI via text message when:

• Patients initiate communication
• Adhering to the minimum necessary standard
• Technical safeguards are appropriately implemented

Furthermore, organizations should obtain patient consent through a text messaging consent form to text them. Healthcare providers must be careful about how they use text messaging to avoid violating HIPAA by exposing a patient's PHI. 

What is a healthcare text messaging policy?

By instilling texting boundaries with policies, healthcare practices can educate staff on the importance of maintaining confidentiality and respecting patient privacy. They can also keep everyone involved, including patients, on the same track. Central ideas to strengthen through a healthcare text messaging policy include:

1. Confidentiality and privacy
2. Consent and notification
3. Professional boundaries
4. Documentation and recordkeeping
5. Competence and training
6. Misinterpretation and clarity
7. Duty of care
8. Patient empowerment
9. Security and data protection
10. Transparency and patient awareness

Organizations (along with their employees) should understand what they can—and cannot—say in a text through a text messaging policy. A good policy will limit the amount of PHI shared via text messages to reduce exposure while also finding a way to encourage patients to communicate back. Established boundaries and clearly defined texting policies manage patient expectations and maintain professional relationships.

Think about: Is posting on social media a HIPAA violation?

Risks of not using a text messaging policy in healthcare

The absence of clear guidelines can lead to confusion and uncertainty about what constitutes appropriate communication. It can also result in inconsistent practices among healthcare providers, leading to misunderstandings or breaches of confidentiality. Without clear policies, staff may inadvertently send the wrong information to the wrong patient, violating both patients’ rights.

Common mistakes in communication include using unencrypted channels, failure to obtain patient consent, not training staff adequately, and neglecting to update tools and procedures. Poor, unprotected communication can result in misdiagnoses and other medical errors that can lead to avoidable health complications and adverse incidents for patients. HIPAA violations can also lead to reputational damage, legal consequences, and financial penalties.

Healthcare organizations can reduce such issues and risks and maintain HIPAA compliance by implementing secure communication practices. HIPAA compliance demonstrates an organization's dedication to safeguarding patient privacy and adhering to healthcare regulations.

Questions to ask when creating a text messaging policy in healthcare

An organization’s text messaging policy depends on its needs and will change from organization to organization and situation to situation. Healthcare organizations should ask themselves the following questions, among others, about the elements and strategies to include in a text messaging policy.

Why do you want to text your patients?

How should patient consent be gathered, given, and shared?

What is the minimum amount of information to be revealed in a text?

What costs are involved with communicating over text messages?

What security measures should be used by your text messaging platform?

How do you plan to monitor, evaluate, and audit your strategy?

How and when do you plan to update your strategy?

What happens in the event of a breach?

How do you plan to train employees on texting best practices?

Healthcare professionals and organizations can use text messages when a proper policy is in place. With it, healthcare organizations can protect patient privacy, comply with HIPAA regulations, and promote better health outcomes through clear and secure communication.

Paubox’s solution

Paubox Texting is a HIPAA compliant API designed for patient engagement, allowing seamless delivery of personalized text messages directly to recipients' mobile devices without the need for third-party apps or passcode-protected portals. Using Paubox's established email encryption standards, this innovative solution ensures the security of PHI while enabling modern patient communication. With support for both iPhone and Android, personalized reminders, test results, and follow-ups can be sent effortlessly, backed by top-rated U.S. support and clear documentation.

Learn more about the following:

• Introducing HIPAA compliant texting API by Paubox
• Can you share PHI over the phone or text?
• The guide to HIPAA compliant text messaging
• A guide to HITRUST and HIPAA compliant texting

FAQs

Does HIPAA apply to the use of text messaging?

Yes, HIPAA applies to the use of text messaging in the context of healthcare. Text messages containing PHI are subject to HIPAA regulations to ensure patient privacy and data security.

Do I need consent to communicate PHI via text messaging?

Yes, healthcare providers and organizations must obtain patient consent to communicate PHI via text messaging. Consent should be obtained in compliance with HIPAA regulations and should include acknowledgment of the potential risks associated with electronic communication.

What types of messages require written consent?

Messages that are not considered healthcare-related, such as billing notifications, marketing messages, or solicitations, require express written consent.

Can automated text messages be used for healthcare communications?

Yes, automated messages can be used for appointment reminders, follow-ups, and other healthcare communications.

See also: Top HIPAA compliant email services