Bridging barriers for immigrant patients with HIPAA compliant emails

Emails are a convenient and accessible means of communication. HIPAA compliant emails can bridge language barriers among immigrant patients.

Understanding HIPAA compliance and immigration status

HIPAA sets the standard for protecting sensitive patient data, known as protected health information (PHI). Covered entities, including healthcare providers, must adhere to HIPAA regulations to safeguard PHI. Failure to comply with HIPAA can result in severe penalties, including hefty fines and legal repercussions.

Network for Public Health Law states that “HIPAA protects the information and not the person, so PHI gathered and maintained about an undocumented immigrant would be protected under HIPAA. A health care provider may not disclose any patient information without the patient's authorization unless the disclosure falls under an exception.”

Such exceptions include:

• If there is an administrative request
• If there is a court order or court-ordered warrant, a subpoena or summons issued by a judicial officer
• If the covered entity reasonably believes the PHI to be evidence of a crime that occurred on the covered entity's property

Providers must protect patient privacy and confidentiality in all aspects. This includes a patient’s immigration status.

The AMA Journal of Ethics supports the legal argument with clinical data concluding: “Immigration status should be regarded as PHI not subject to valid exception for release without patient authorization… Covered entities (e.g., hospitals and health care professionals) are legally precluded under the HIPAA Privacy Rule from disclosing a patient's immigration status.”

Overcoming language barriers with email

Immigrants are often faced with language barriers, cultural differences, and unfamiliarity with healthcare systems. Emails can bridge these gaps, allowing healthcare providers to offer remote guidance, help them schedule appointments, and share health-related information.

A recent cross-sectional study found that “Using emails to communicate with clinicians [was not] significantly impacted by language preference. These findings may suggest that the usefulness or ease of using emails is not significantly different for individuals who prefer English vs non-English languages.”

This study shows that emails can transcend language barriers, which could lead to better patient engagement for diverse immigrant populations. More specifically, because emails are a familiar and accessible mode of communication, providers can have meaningful interactions with patients from different language backgrounds. 

Additionally, providers could use translation services to send important health information. This could improve their accessibility and understanding of the information.

Read also: Personalization in text message-based interventions across different demographics

Strategies for HIPAA compliant email communication with immigrant populations

• Language preferences: Offer email communication in multiple languages commonly spoken within immigrant communities to ensure inclusivity and accessibility for all patients.
• Cultural sensitivity training: Provide healthcare staff with cultural sensitivity training to address unique privacy concerns and cultural sensitivities among immigrant patients.
• Secure email platforms: Providers should use a secure email platform, like Paubox, that meets HIPAA requirements to safeguard the transmission of protected health information (PHI) and alleviate privacy concerns among immigrant populations.
• Patient authorization: Obtain authorization from all patients before email communication, ensuring transparency and respect for their privacy preferences.
• Two-Factor Authentication: Implement robust authentication methods, like two-factor authentication, to protect patient information from unauthorized access.
• Education on email security: Educate immigrant patients on email security best practices to mitigate risks associated with phishing scams, password security, and data protection.
• Patient feedback: Regularly assess the effectiveness of email communication strategies with immigrant populations, seeking feedback to adapt approaches and improve accessibility and engagement.

FAQs

Does HIPAA apply to undocumented immigrant patients?

Yes, HIPAA regulations apply to all patients, regardless of their immigration status. Healthcare providers must protect the privacy and confidentiality of all patients, including undocumented immigrants, under HIPAA guidelines.

What should providers do if patients are reluctant to share personal information via email?

Providers must respect patient privacy and obtain patient authorization before sending emails. If patients do not prefer email, providers can suggest HIPAA compliant texting.

Can providers email immigrant patients who are minors?

Healthcare providers must obtain consent from parents or legal guardians before emailing any patients who are minors or have guardianship issues. Emails should only be sent to authorized recipients to protect minors' privacy and confidentiality.