You can include patient names in text message communication under HIPAA, but it must be done with appropriate safeguards and compliance measures to protect the confidentiality and security of the patient's protected health information (PHI).
HIPAA sets the standards for safeguarding PHI. PHI includes any individually identifiable health information, and patient names are a key element in identifying individuals. Therefore, healthcare organizations must understand how HIPAA regulations apply to text message communication in healthcare.
HIPAA consists of two rules relevant to this discussion:
Related: What are the 18 PHI identifiers?
Text messaging offers several advantages in healthcare communication, such as quick and convenient communication with patients, appointment reminders, and sharing test results. However, as with any form of electronic communication, there are challenges to ensuring the security and privacy of patient information.
Including patient names in text messages is permissible under HIPAA, but it must be done with appropriate safeguards. Additionally, "providers working in hospitals and critical access hospitals may now text patient information and patient orders among care team members without landing on the wrong side of Medicare’s Conditions of Participation," the Centers for Medicare & Medicaid Services (CMS) wrote in a recent memorandum to state survey agencies. The catch, per the notice, is that the providers must send the texts through a secure texting platform compliant with HIPAA. HIPAA requires healthcare providers and organizations to protect the confidentiality and security of PHI. When it comes to text messaging, this means:
Use HIPAA compliant text messaging platforms that encrypt the content of text messages to protect PHI during transmission. Encryption ensures that PHI remains confidential and is not accessible to unauthorized individuals. Secure messaging platforms also often include features like message expiration to further enhance security.
Ensure that only authorized individuals can access the text messages containing patient names and other PHI. Implement authentication methods to verify the identity of users. Multi-factor authentication (MFA) can provide an additional layer of security by requiring users to provide two or more forms of identification before accessing PHI.
Maintain audit trails that record the activity related to the transmission of PHI via text messages. Audit logs should capture who accessed the information, when they accessed it, and what actions they performed. These logs help monitor and review any unauthorized access or security incidents.
You must always obtain patient consent to communicate via text message, especially when sending PHI. Patients should be informed about the potential risks and benefits of using text messaging for healthcare communication. Consent should be documented, and patients should be able to withdraw consent at any time.
Related: Obtaining patient consent for text message communication
If using third-party texting services, ensure that business associate agreements (BAAs) are in place with these service providers. Business associates are entities that handle PHI on behalf of covered entities, and they are required to comply with HIPAA regulations. The BAA outlines the responsibilities of the business associate in protecting PHI.
Using popular messaging apps may pose risks to HIPAA compliance due to potential security vulnerabilities. Healthcare providers should rely on specialized, HIPAA compliant text messaging platforms like Paubox to ensure the secure transmission of patient names and other PHI.
Healthcare organizations must thoroughly investigate the incident and take corrective actions. This includes notifying affected individuals and reporting the breach as required by the HIPAA Breach Notification Rule.
HIPAA does not explicitly mandate specific devices for text message communication. However, healthcare providers must ensure that the chosen devices comply with security measures outlined in the Security Rule.