Ultimate Guide to HIPAA Compliant Texting

As a healthcare practice, you know that SMS and HIPAA-compliant messaging go hand in hand as you handle sensitive patient health information (PHI) on a daily basis. By staying compliant, you can use your HIPAA-compliant SMS solution to stay connected with your patients and create a best-in-class experience.

With this guide, our aim is to break down the nitty-gritty of HIPAA compliance and how your practice can safely share patient data without violating any HIPAA SMS guidelines.

What is HIPAA compliant texting?
Is SMS texting HIPAA compliant?
7 benefits of using HIPAA compliant SMS text messaging
How healthcare providers use SMS messaging
Best practices for sending safe and secure HIPAA SMS and text messages
11 types of HIPAA compliant text messages: examples to use
10 best HIPAA compliant texting solutions

Let us first get a deeper understanding of HIPAA SMS messaging before learning about how healthcare practices use them.

What is HIPAA compliant text messaging?

HIPAA compliant texting is how covered entities that have access to PHI, such as healthcare providers, insurance companies, clearinghouses, and business associates (like vendors and subcontractors) can securely exchange sensitive data without violating any HIPAA regulations.

HIPAA-compliant messages are encrypted from a secure server that holds this data locally to prevent mobile phone networks from keeping a copy. To make sure your organization adheres to HIPAA SMS guidelines, there are multiple apps and solutions that your practice can integrate with to comply with the healthcare industry standards, ensuring the integrity of PHI is maintained.

Is SMS texting HIPAA compliant?

No, SMS texting is not automatically HIPAA-compliant, but by placing the right administrative, physical, and technical safeguards in place you can ensure that PHI can be securely stored and accessed by authorized personnel while maintaining the confidentiality and integrity of the data.

For any messaging provider to be HIPAA compliant, the text messages that are related to PHI need to be encrypted while sending, receiving, and when in transit. If any party fails to establish HIPAA compliance and sensitive PHI is compromised, it could lead to criminal charges or a civil legal action initiated by a patient.

HIPAA rules and regulations for SMS text messaging

The threat of data being compromised or misused by individuals who shouldn’t have access to it constantly looms over healthcare organizations. To address this and ensure patient safety, practices must have security controls in place when ePHI is created, modified, accessed, shared, or deleted.

It is the duty of all covered entities and business associates to educate their employees about the HIPAA regulations and the consequences of data breaches. Below are some of the main regulations for handling PHI under HIPAA:

Organizations should develop processes and procedures about who is allowed to access health information and how it can be used.
Periodic risk assessments must be conducted to identify and mitigate any threats that can compromise data integrity.
For individuals who use their personal mobile devices, encryption and data protection must be in place to access PHI.
When mobile devices are lost, stolen, or need to be disposed of, PHI must be deleted remotely to avoid any data breach.
PHI cannot be saved and stored on mobile devices used by employees and subcontractors.
Sending PHI to patients is admissible by HIPAA if the organization has warned the patient about the risk of unauthorized disclosure and has obtained the patients’ consent to communicate via text.

What is the penalty for breaking HIPAA SMS regulations?

Violating HIPAA regulations can range from $100 to $50,000 per day depending on the severity of the infraction. Healthcare organizations and their employees find themselves in these sticky situations due to their inability to fully understand the significance of the risk, the potential impact of the violation, and the parties who are affected by it.

In a situation where your staff member breaks a HIPAA Rule, there could be the following outcomes:

The matter can be handled by the practice internally
The staff member can be terminated
The practice could face sanctions from professional boards
The practice could face criminal charges that include fines and imprisonment

Civil penalties start at $100 per violation and can rise up to $25,000 if there were multiple violations of the same kind. Penalties apply to individuals who are aware that HIPAA regulations were being violated or should have been aware. In case there was no willful neglect of HIPAA rules, and the violation is corrected within 30 days from the date known, civil penalties will not be applied.

Criminal penalties, on the other hand, are more severe, with a minimum fine for a willful violation being $50,000 to a maximum of $250,000. In addition to this financial penalty, the board could also call for a jail term. Violation due to negligence can result in a prison term of up to 1 year while obtaining PHI under false pretenses could lead to a 5-year sentence. If HIPAA Rules were violated with malicious intent for personal gain, there is a prison term of up to 10 years, whereas those caught in an identity theft fraud can be put behind bars for at least 2 years.

7 benefits of using HIPAA compliant SMS text messaging

Apart from being mandatory, HIPAA compliant texting offers the convenience and opportunity to create a modern patient experience as they can communicate with your practice in real-time. Getting patients into your office faster and booking more appointments will help you build a stable and profitable healthcare practice.

Data is secure: By having a HIPAA compliant texting solution in place to communicate with your patients and business associates, you can rest assured that the data that you share meets protocols and is transmitted and stored securely.‍
Avoid penalties and violation fees: By getting on board with a HIPAA-compliant text messaging solution, your practice no longer has to worry about violating regulations that lead to hefty fines.‍
Integrates with your practice management system: With a seamless and secure flow of information to and from your practice management system, your practice has access to all patient data available in one platform.‍
Increased operational efficiency: By automating appointment reminders, confirmation, and payment messages through a HIPAA-compliant texting service, your staff has more time to focus on making your patients feel cared for and welcome.‍
Patient engagement: Two-way messaging guarantees your practice will receive a timely response from your patients since patients prefer text messages over phone calls.‍
Staying connected: Secure messaging allows your practice to maximize your patient access by sending practice updates, pre and post-op instructions, and other types of communication that help reduce call volumes.‍
Better health outcomes: HIPAA compliant messaging enables your practice to keep patients informed about their well-being and how your practice or their treatment can help them achieve their health goals.

How healthcare providers use SMS messaging

By integrating a HIPAA-compliant messaging service into your suite of tools, you have the potential to up your patient engagement efforts. Since text messages have a very high open rate, this is clearly the best way to get your patient’s attention.

When drawing out your marketing and promotion plan for your healthcare practice, you can rely on SMS messaging heavily to see conversions. Unlike social media posts that may or may not reach the right audience and where viewership depends on how your audience has engaged with your content in the past, SMSs are delivered right into your patient’s inbox.

1. Include a call to action (CTA) for your patients

The success of a text message campaign can be measured by the open rate and how your audience interacts with it. The text message must be a medium to take your audience to your website or point them at a valuable resource that doesn’t limit their engagement to just opening and deleting the message without giving it any further thought. You could remind them to book an appointment, share a payment link, leave a review, or take them to your online store to purchase products that contribute to your practice revenue.

2. Staff communication

Along with using text messages to communicate with your patients, your practice can send out notifications and announcements that pertain to staff members. Whether you operate from a single location or have multiple offices, text messages help you maintain consistent messaging across the organization to close any gaps.

3. Send practice updates

Text messages can also be used to share practice-wide announcements such as changes in office hours, new services, seasonal activities, and other such updates that you want to keep your patients and staff abreast of. If your contact list is updated, all you have to do is compose a clear and concise message and hit ‘Send All’. This is a more efficient and more effective way of communicating with your internal and external stakeholders.

4. Send public health warnings

As a healthcare expert, your patients value your opinion above any hearsay. Apart from sending out communication that directly relates to the growth of your practice, it is your responsibility to share news alerts, mandates, and warnings that affect public health that echoes government guidelines.

5. Cross-sell products and services

Using text messaging to promote new or existing services that your practice offers, can help you generate additional revenue without any additional spending on new patient acquisition. By informing your patients about all the services that you offer, they could refer their friends and family to your practice who are on the lookout for a reliable and great quality healthcare provider.

6. Share social media content

If your practice is actively creating content on social media to help with your SEO and online visibility, text messages can be used as a medium to share your content with your patients. Your patients will have a higher interest in watching your content compared to audiences who may just stumble upon your page and are unaware of your acumen as a healthcare provider.

‍With NexHealth’s HIPAA-compliant messaging you have a secure and powerful way to engage with your patients stress-free. Schedule a demo with NexHealth today to be available for your patients like never before!

Best practices for sending safe and secure HIPAA SMS and text messages

While legal language can be difficult to understand and you want to tread carefully when you are handling sensitive PHI, the following best practices can help you evaluate the best HIPAA SMS solution for your healthcare practice.

1. Choose a provider that will sign a BAA

HIPAA Privacy Rule states that a covered entity and a business associate must sign a business associate agreement (BAA) to ensure that the latter will fulfill their duty to protect sensitive PHI. This contract must be in writing to affirm the business associate’s willingness to act responsibly and have appropriate safeguards in place to comply with HIPAA requirements when they handle PHI on your behalf.

2. Messages must be encrypted both in transit and at rest

Secure HIPAA SMS platforms will not just encrypt your messages in transit, they will encrypt your messages, directory information, and other proprietary information on your phone. Unlike regular text messages that aren’t encrypted and go through various carriers and are stored on their servers, PHI needs an additional layer of security at every storage point. This encryption ensures no data leak occurs in the event of phone theft or loss.

3. Define authorization hierarchy

By defining who, when, and for how long patients typically access their information, you can determine patterns that can be attributed to authorized individuals. Having such audit controls in place helps in detecting unauthorized access to PHI, unlike traditional texting services where monitoring access is impossible.

4. Document consent from patients

Before you begin communicating with your patients via text, you must first get their formal written consent. This consent must inform them of the nature of data that will be shared and the patients’ duty to protect it so that it does not reach the hands of unauthorized individuals.

5. Ensure devices used are secure

As healthcare professionals, it is important to keep professional and personal messages separate. Your work messages that contain PHI must be secured with strong password authentication and must only be accessible via a HIPAA-compliant text messaging service to ensure that the data is only privy to them.

6. Two-factor authentication

Two-factor authentication allows you to validate a person’s identity and ensure that they are authorized to access your data. This additional layer of security is becoming increasingly preferred as passwords are vulnerable to security breaches. When onboarding a patient you can establish a two-factor authentication to confirm their phone and email address which also ensures your records are updated.

7. Don’t display PHI from screen notifications

Secure communication applications will ensure that every time a text with PHI is sent, it hides the text preview to eliminate potential data leaks. This allows the user to view the sender of the text, but to read the contents of the message, they’d have to unlock their phone, preferably through a pin, password, or face recognition software.

8. Only connect to a secure WiFi network

When sending out communication, you want to make sure that your device is connected to a secure network that is strong enough to protect your data and cant be exploited. Your WiFi networks must be password protected and must have restricted access to only your staff.

9. Archive all message history

Unlike native text message archiving, HIPAA compliant messaging solutions have an automatic, systematic, and encrypted approach for all communication sent within the organization’s network. Demonstrating the archiving process is essential to HIPAA compliance.

10. Integrate auditing capabilities

From time to time your healthcare practice will have to undergo HIPAA audits to provide evidence of systems and processes that record and examine how PHI is shared and stored. Deploying a HIPAA-compliant messaging solution for your practice communication automatically audits and logs all administrator activities related to users, policies, authentication, and reading receipts of messages.

11. Enable secure image sharing

Just like text messages, photos must also be encrypted while sharing to protect and maintain the privacy of the photographed patient. By using a HIPAA-compliant messaging service you can ensure that photos are taken within the system and not stored in the devices’ memory.

12. Immediately delete data if the device is lost or stolen

Mobile devices - which contain a wealth of personal information and login accesses - can easily get lost or stolen. If the device contains HIPAA compliant data, then it must be promptly deleted so that the information can’t be misused by unauthorized personnel.

11 types of HIPAA compliant text messages: examples to use

Having a HIPAA-compliant texting solution gives your practice the opportunity to safely use SMS as a targeted advertising medium. This feature gives you the ability to send a variety of different types of messages and requests to patients.

Here are some ideas that the top healthcare practices are implementing to foster patient engagement and drive conversions.

1. Appointment confirmations

A confirmation message acts as an acknowledgment for booking an appointment online. Not only do these increase the attendance rate of your patients, but it also helps ease your patients mind prior to an appointment, as you confirm you’re ready for them. Ultimately, confirmation messages help you ensure patients will attend their appointment, and gives you a chance to book a replacement in the event they can’t make their appointment.

2. Dental Reminder Texts

Sending out dental reminder texts (or multiple reminders) before the appointment ensures that patients don’t forget about their visit and gives them enough time to reschedule if they can’t attend. Missed appointments by no shows leave gaps in your calendar that are too late to fill, causing a loss in revenue.

3. Prescription reminder texts

While healthcare may take a backseat in your patient’s life, as their healthcare provider you can drop a message when it is time to refill their prescription or to take their medicines on time, to support the care provided by your practice. By sending this reminder, you are showing that you care and have the patients’ best interests in mind.

4. Follow-up

A follow-up message can be sent to the patient to check on how they are doing after their visit or if they have any concerns that they need to discuss with the care team. Along with contributing to patient engagement, it silently communicates that your practice is on top of everything to make sure that patients are comfortable and well.

5. Recall

Having a HIPAA-compliant messaging solution can be used to strengthen your practice’s recall efforts. By setting up automated outreach messages to patients who are due for a visit, you can make sure that nobody falls through the cracks.

6. Staff communication

Apart from communicating with your patients and vendors, you can also send out text messages to your staff to notify them of organizational updates or schedule changes. Since your staff is comfortable using the HIPAA messaging solution, you can rest assured that your communication won’t go unnoticed and will save you valuable administrative time notifying everyone.

7. Public health notification

If the government issues a warning that affects the whole city, state, or country, your practice can send out guidelines to patients that speak to their safety concerns. This could include precautionary measures, available resources, or helplines that patients can reach out to.

8. Waitlist

When you find gaps in your calendar due to a cancellation, you can send out a message to patients who would like to move up their appointment. With NexHealth’s ASAP List feature, an automated outreach message can be sent to patients who can simply respond with a Y or N, helping you achieve your goal of 100% calendar fulfillment. This saves your staff the trouble of making phone calls and confirmations automatically sync with your practice management system.

9. Making payments

Your HIPAA-compliant SMS solution can also be used to send out payment links to patients at the end of their appointment so that they can securely pay from their devices. NexHealth allows your practice to set up automated text and email messages for patients to make their payments without having the need to create a login or password. This automation not only saves your staff time following up with patients but also helps you increase payment collection.

10. Online forms

Gone are the days of handing your patients a clipboard and a pen to get them onboarded. By sending out a form link that conveniently opens up on your device, your patients can complete their intake formalities whenever and wherever they want. NexHealth’s online form feature captures patient details on any smart device and instantly syncs the responses with your practice management system.

11. Surveys & feedback forms

By collecting feedback from your patients, you can gain valuable insights into what they like about your practice and the areas that have room for improvement. NexHealth’s HIPAA compliant text messaging system can automate your feedback collection process by sending out a text message at the end of each visit. Positive reviews automatically contribute to Google, Facebook, and Yelp ratings and honest feedback can be evaluated for ongoing practice improvements.

10 best HIPAA compliant SMS and text messaging solutions

There is no shortage of HIPAA compliant text messaging available in the market today. To get the best results for your practice, you’ll need to pick the solution that’s right for you.

Now that you know what to look for in a solution, we’ll compare the top solutions to choose from.

1. NexHealth

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Cost: Contact for quote

NexHealth is a patient engagement platform for your healthcare practice that offers a full suite of practice management and healthcare marketing tools. With NexHealth you don’t just get a HIPAA compliant messaging platform, your practice can go completely digital and paperless with online scheduling, digital intake forms, email and text marketing capabilities, automated reminders, and a detailed insights report to guide your practice towards growth.

2. Twilio‍

Image Credit: Twilio

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Cost: Contact for quote

Twilio enables your healthcare practice to build personalized experiences for patients through their wellness journey. With appointment management capabilities, video telehealth services, and reminders to monitor their care, Twilio seamlessly integrates and automates your workflows.

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3. TigerConnect

Image Credit: TigerConnect

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Cost: Contact for quote

TigerConnect is a healthcare communication platform that can be used to share data and alerts with care providers (physicians, nurses, IT teams). TigerConnect improves collaboration with HIPAA compliant text messaging, making communication easy and part of your clinical workflow to provide better healthcare outcomes for your patients.

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4. Vonage

Image Credit: Vonage

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Cost: Contact for quote

Vonage is a cloud-based communication service that connects healthcare practitioners with patients via video, voice, SMS, or social media. With Vonage’s HIPAA-compliant solution, your practice can manage appointment scheduling, manage patient relationships, digital health surveys, and be prepared to send out emergency and critical alerts.

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5. MessageMedia

Image Credit: MessageMedia

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Cost: $49 - $199/mo

MessageMedia is an integrated text messaging solution that can help your patients and staff with critical communication by improving appointment attendance and streamlining your operations. Using two-factor authentication to protect your valuable patient and clinic data, you can stay in touch with patients on a one-on-one basis and keep track of your interactions for better access.

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6. SimpleTexting

Image Credit: SimpleTexting

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Cost: $25 - $625/mo

SimpleTexting is an all-in-one text messaging service that helps you send out appointment reminders, inter-office communication, and prescription notifications to stay engaged with your patients. With SimpleTexting you can build your list or import existing contacts to rapidly collect phone numbers.

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7. MessageDesk

Image Credit: MessageDesk

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Reminders

Waitlist

Messaging

Payment

Recall

Reviews

Cost: $29 - $79/mo

MessageDesk is a one-on-one and team messaging service that is HIPAA compliant and allows you to send reminders, updates, and follow-ups. Practices can make use of ready-to-use templates to schedule one-time or recurring messages well in advance.

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8. pMD

Image Credit: pMD

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Cost: $25 - $625/mo

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9. Spok

Image Credit: Spok

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Cost: Contact for quote

Spok is an AWS-backed cloud-native solution that eliminates communication gaps across your health system and allows you to securely automate clinical workflows. With a centralized directory for all roles across your hospital, you can manage contact details, schedules, and messaging with higher accuracy.

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10. Providertech

Image Credit: Providertech

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Cost: Contact for quote

Providertech helps you reach more patients virtually and in person, keeping the focus on delivering care. You can deliver test results electronically, provide contact-free check-in and appointment management, send real-time secure messages, conduct population health outreach, and vaccination management services.

NexHealth’s patient texting platform

Secure texting not only gives you instant access to your patients but also reduces your call volume, making your front office operations more streamlined and productive. NexHealth’s HIPAA compliant patient texting platform is a one-stop solution for healthcare practices that integrates with practice management systems and creates a digital hub for storing PHI and all communications.

Schedule your demo with NexHealth today to build a secure, stable, and profitable healthcare practice.