While text messaging has become an essential tool for healthcare communication, it also presents unique challenges when it comes to HIPAA compliance. Improper messaging practices can put patient data and healthcare providers at risk.
In this article, we’ll explore what exactly HIPAA compliant text messaging is and provide guidance on how healthcare organizations can ensure that their SMS practices are secure, compliant, and effective.
Jump right to:
- What is HIPAA?
- Who must adhere to HIPAA?
- Is texting HIPAA compliant?
- Why HIPAA compliance matters in texting
- Benefits of texting for HIPAA-covered entities
- Requirements for HIPAA-compliant texting
- General topics okay and off-limit to text
- 24 HIPAA-compliant SMS examples
- 5 top HIPAA-compliant texting services
<h2 id="What">What is HIPAA?</h2>
The Health Insurance Portability and Accountability Act, known as HIPAA, protects the privacy and confidentiality of patient’s health data. The HIPAA regulations establish national standards for electronic healthcare transactions, privacy, and security, with three key subsets to note:
- Privacy Rule. This rule defines how a patient’s protected health information (PHI) can be used and disclosed, who can access it, and how it should be protected.
- Security Rule. The security rule protects how electronic PHI (ePHI) is created, received, used, or maintained by entities bound by HIPAA. It requires companies to have physical and technical safeguards to secure this health data.
- Breach Notification Rule. This rule outlines the requirements healthcare organizations and covered entities must follow when notifying patients in case of a breach of their PHI.
HIPAA compliance means following these HIPAA rules if you’re a covered entity dealing with PHI.
<h2 id="Who">Who must adhere to HIPAA?</h2>
Any company that handles PHI must comply with HIPAA. The Department of Health and Human Services says the following groups must follow it:
- Healthcare professionals (doctors, dentists, pharmacists, psychologists, etc.)
- Health plans (health insurers, Medicare, Medicaid, HMOs, etc.)
- Healthcare clearinghouses (billing or claim service provider)
- Business associates (contractors, vendors, subcontractors, any business working with covered entities)
<h2 id="Is">Is texting HIPAA compliant?</h2>
Texting can be HIPAA compliant when done with the proper controls. To ensure HIPAA-compliant texting, businesses must use a secure SMS platform and ensure necessary administrative, physical, and technical safeguards are in place.
If texting is used to transmit ePHI, it must be secured using encryption or other appropriate security measures to prevent unauthorized access. Healthcare organizations should also have policies and procedures in place to govern the use of text messaging for patient-related communications, including guidelines for when it is appropriate to use text messaging and what information can be shared.
To ensure HIPAA compliance when using text messaging, healthcare organizations need to use HIPAA-compliant messaging platforms that encrypt data at rest, safely store patient consent, and offer access controls.
<h2 id="Why">Why HIPAA compliance matters in texting</h2>
Healthcare providers, insurers, or any organization handling PHI must ensure their texting practices protect patient privacy to avoid severe legal and finance repercussions and maintain patient trust. Ignoring compliance regulations can lead to significant consequences, including:
- Legal damage. Organizations found guilty of non-compliant texting practices may face lawsuits from affected patients, regulatory scrutiny, and even criminal charges and prison time.
- Reputational damage. HIPAA violations can severely impact an organization’s reputation. Patients trust healthcare providers with sensitive information and any breaches in trust can result in a loss of confidence, leading patients to seek care elsewhere, discourage potential partnerships, and even affect employee morale.
- Financial penalties. HIPAA violation fines are determined based on the severity of a violation, ranging from $100 to $50,000 per violation. Annual penalties for repeated violations can reach up to $1.5 million.
<h2 id="Benefits">Benefits of texting for HIPAA-covered entities</h2>
HIPAA-compliant texting enables healthcare providers to offer patients a modern communication channel and real-time access to providers.
Texting makes it easy for HIPAA-covered entities to book and manage more appointments, streamlining their patient experience and overall satisfaction rates. A few key benefits of healthcare texting include:
- Improved communication. Texting allows healthcare providers to send appointment reminders, follow-up messages, and prescription updates in a time-sensitive manner, leading to fewer no-shows and better patient retention.
- Secure patient data. With HIPAA-compliant texting, providers can feel confident that their sensitive patient and associate data is stored, protected, and transmitted securely.
- Enhanced efficiency. Automated appointment, scheduling, and payment reminder texts allow staff to focus on providing better patient care and reduce manual workload.
- Easy integration. Platforms like Textline have advanced native integrations that seamlessly connect your SMS platform to your patient management system, enabling your team to access data and conversations within one unified platform.
<h2 id="Reqs">Requirements for HIPAA-compliant texting </h2>
For a provider's texting service to be considered HIPAA compliant, the following rules and regulations have to be met in order to avoid negative financial, legal, and reputation repercussions.
Get and store explicit consent to text
Before sending your first text, get explicit written consent from patients. Under HIPAA, providers can text patients if the healthcare entity explicitly states the risks of texting and gains patient permission. Covered entities must also store this written consent. Textline has a patented contact consent process, which ensures consent is collected, documented, and securely stored.
Alert patients to the risk of texting
There’s always a risk that someone else may see personal information texted to a patient’s phone. As a result, to stay compliant, you must warn patients in writing about these risks. A good practice is including this verbiage in your opt-in text message.
For example, here’s the texting consent verbiage required by Textline.
Choose a HIPAA-compliant SMS software
For healthcare organizations to have HIPAA-secure texting, data must be encrypted within the platform, patient consent must be obtained, and access safeguards must be in place. HIPAA-compliant texting software helps businesses meet or exceed the privacy and security standards demanded by HIPAA.
Sign a BAA
Covered entities are required to have a signed business associate agreement (BAA) with their HIPAA SMS provider. A BAA is a contract that outlines how a business associate — in this case the business texting platform — will handle and protect patient information. Textline’s BAA is automatically included in the onboarding process for HIPAA plan users.
Ensure technical safeguards
To stay compliant, healthcare organizations must implement safeguards to prevent unauthorized access to PHI and share what authorized users can do with PHI.
Some specific technical controls to set up include:
- Admin Controls. Restrict user access to sensitive PHI, billing, and performance information with administrative controls.
- Unique log-ins. Like you would with an electronic health record, ensure authorized users have a unique username or ID to log into your texting platform.
- Multi-factor authentication. Make authorized users confirm their identities before accessing the texting platform.
- Automatic sign-offs. Ensure the platform automatically logs users out after a period of time has elapsed to prevent unauthorized access to PHI.
- Sensitive data redaction. Only allow certain members of your organization to view sensitive data.
Keep text conversation history
In the event of a HIPAA audit, you’ll want to have a record of your text exchanges with patients. This includes having consent documented and stored.
Limit PHI in texts
Only include necessary information in texts. This helps covered entities meet the minimum necessary standard, which requires those to disclose the smallest amount of PHI as possible to accomplish the task at hand.
Train employees
Employee training is vital to ensuring HIPAA compliance. Make sure your employees know the policies and procedures you have in place surrounding securely texting patients.
Ensure the ability to redact data or delete remotely
Make sure you can delete protected information from any company-owned device remotely in case of theft or lost device.
Conduct risk assessments
Regular HIPAA risk assessments help to identify potential threats to ePHI, protect against any identified hazards, and ensure compliance with regulations. Many of HIPAA’s largest fines are attributed to organizations failing to try and identify risks.
<h2 id="General">General topics okay and off-limits to text </h2>
It can be difficult to parse out what is and isn’t okay to text customers under HIPAA regulations. Let’s look at an overview of patient health topics and determine which ones are HIPAA compliant.
*Rather than sharing sensitive PHI via text, share a link to the patient’s secure health portal.
<h2 id="Examples">24 HIPAA-compliant SMS examples</h2>
To minimize risk, healthcare providers should always try to keep their texts general in nature and, when possible, share links to secure portals rather than explicitly sharing confidential information via text.
When executed compliantly, healthcare providers can use texting to improve communication and enhance patient care. Providers can share appointment, billing, and medication reminders, share emergency alerts, notify patients when lab results are ready, and so much more. The following compliant SMS examples can be useful templates for any provider looking to text patients.
This is a reminder that your appointment with [organization name] is on [date] at [time]. Reply to cancel or reschedule.
Hello [name], this is [organization name]. Your annual appointment is upcoming on [date] at [time]. We look forward to seeing you soon.
- Appointment confirmations
Please reply YES to confirm your dental appointment with Dr. Knutson on [date] at [time].
[Patient’s name]: Your appointment has been scheduled for [date] at [time] at our [address] location. Reply Y to confirm.
- Rescheduling notifications
Hello [patient's name], we need to adjust your upcoming appointment. Please call or text us at [office number] to reschedule at your convenience. Thank you!
Your appointment with [provider’s name] has been rescheduled from [date] to [date] at [time]. Reply Y to accept.
[Organization]: This is a reminder that your payment of [amount] is due on [due date]. Please visit [payment link] or contact us at [phone number] for assistance. Thank you!
This is a reminder to pay your bill from [organization name]. Visit your patient portal to pay.
- Request additional information
Hi [name]. The prior insurance you had on file with Dr. Patel has expired. Please call our office at [phone number] to update your information when you have a chance.
Hi [name], we noticed that your address is missing from our records. Please reply with your updated address. Thank you!
- General health tips
[Office name]: It’s flu season! Protect yourself & others by washing your hands frequently, staying home when sick, and getting your annual flu shot.
It’s blazing outside! Make sure you’re staying hydrated this summer. Drinking enough water helps with digestion, circulation, and energy levels. Aim for at least 8 glasses a day. - [office name]
- Care alerts
Hello [patient name], your test results are now available. Please log in to your patient portal here [link] or contact our office for more information. – [healthcare provider]
[Provider’s name] has an important message for you. Please reach out to our office at [phone number] at your earliest convenience. Thank you!
- Follow up text
Sending a text to a patient after a procedure or appointment is a quick and reliable way to check-in, share additional instructions, and provide post-treatment care tips.
Hi [patient’s name], we hope you're doing well. If you have any concerns or need further assistance after your recent visit, feel free to reach out. We're here to help!
Hi there. This is [name] from [provider’s] office. How are you feeling today?
- Feedback collection
Requesting feedback from patients via text is a convenient way to encourage responses, make customers feel valued, and ensure your organization keeps a pulse on your customer experience.
We’re thrilled you had a good experience at our office today. Would you mind leaving a review? [Link]
Hi [patient's name], we’d love to hear about your recent visit. Please reply with a number between 1-5 to let us know how we did, with 1 being poor and 5 being excellent. Your feedback helps us improve!
- Organizational updates
[Healthcare provider]: Please note that our office hours will be changing to [new hours] starting [date]. If you need to reschedule or have questions, call us at [phone number] or reply to this message. Thank you!
To ensure your safety and the safety of others, [provider name] is updating our health & safety protocols. For your upcoming visit, please note that all patients will be required to wear a mask upon entering. Thank you for helping us protect our community.
- Team scheduling
Hi [name], shift reminder: your shift starts at [time] on [date]. Please be ten minutes early for the handoff with [name]. Let us know if you need anything.
Hi team. Due to flu-related staffing shortages, we need someone to volunteer to work overtime this weekend. Is anyone available to help?
- Emergency notifications
ALERT: Due to severe weather conditions, [provider name’s] office will be closed tomorrow, [date]. We hope to reopen on [date] for normal business hours. If you have a medical emergency, please dial 9-1-1.
A [outbreak] has been reported in our area. If you're experiencing symptoms, please contact [healthcare facility name] immediately at [phone number].
Get more healthcare texting examples here.
<h2 id="Services">5 top HIPAA-compliant texting services>
To protect PHI and your organization from legal risk, it’s crucial to choose an SMS provider that takes security and compliance seriously. Let’s look at five of the top HIPAA-compliant texting services that healthcare providers can rely on for safe communication with patients.
Textline was the first-ever HIPAA-compliant SMS platform on the market, built to keep health data safe and providers compliant in their texting practices. To further invest in its commitment to privacy and security in the SMS space, Textline patented its HIPAA Contact Consent feature, creating strict controls that guarantee healthcare providers remain compliant and consent is stored securely.
With Textline, healthcare organizations can be assured their texting practices will be secure and compliant, with advanced features like secure data storage, automatic sign out, data encryption, multi-factor authentication, and unlimited data retention.
Plus, Textline’s platform was built with teams in mind, making it easy for providers to utilize SMS for internal coordination, advanced workflow automation, and external communication with patients.
OhMD is a patient communication software made exclusively for providers to text with patients. They offer two-way, broadcast, and scheduled text messaging, and the ability to automatically transcribe phone calls into patient records.
TigerConnect is a popular, secure messaging platform that offers a range of clinical communication products. TigerConnect’s product is less focused on SMS and more on improving clinical workflows overall, with features like rapid file sharing, physician scheduling, and voice or video calling.
Klara’s telemedicine and communication platform offers users webchat, messaging, call-to-text, scheduling, and workflow automation with the ultimate goal of reducing phone time and allowing staff to focus on patient care. Klara’s telemedicine features, like its virtual waiting room and video visits, are ideal for providers looking to streamline their telemedicine services.
Luma’s AI-driven patient success platform aims to boost staff efficiency, patient communication, and appointment management with features like an AI-enabled omnichannel concierge, staff efficiency insights, and automated referral outreach.
Text patients confidently with Textline
Textline is a leader in HIPAA-compliant texting, with a patented Contact Consent feature that automates and ensures compliance before a provider can text each contact. This feature simplifies patient onboarding while maintaining strict adherence to HIPAA guidelines.
Plus, Textline offers much more beyond HIPAA-compliant messaging. It’s packed with features to enhance your organizations overall communication, from sharing mass alerts and automating complex workflows to powering team collaboration and personalized two-way patient texting.
Experience the security of Textline with a demo, or sign up for a free trial today.
