Informed consent for HIPAA compliant text messaging

The ease of use associated with text messaging makes it particularly useful in healthcare settings for quick exchanges of information between healthcare providers and patients. However, when handling protected health information (PHI) in accordance with HIPAA, text messaging requires informed consent to ensure compliance with privacy and security regulations.

Why is informed consent necessary?

The HHS provides that, “The Privacy Rule permits, but does not require, a covered entity voluntarily to obtain patient consent for uses and disclosures of protected health information for treatment, payment, and health care operations.” 

By obtaining consent, healthcare entities respect patients' autonomy and provide them with the ability to choose whether their information can be shared via text messaging or other communication channels. It enables individuals to understand the potential risks and benefits associated with the transmission of their health information through text messaging or any other form of communication.

Informed consent also serves as evidence that the healthcare entity has fulfilled its obligations under HIPAA and is acting in compliance with the law. It provides a necessary legal foundation for the transmission of PHI through text messaging while maintaining HIPAA compliance.

Is text messaging HIPAA compliant?

Text messaging itself is not inherently as HIPAA compliant. However, it is possible for text messaging to be used in a manner that complies with HIPAA and making use of HIPAA compliant text messaging services like Paubox Text Messaging. The patient's informed consent is another of those measures. 

Related: Texting tools and HIPAA compliance: The ultimate guide

How to request consent from patients

1. Inform patients: Clearly communicate to patients the purpose and nature of the communication through text messaging. 
2. Explain privacy and security: Describe the measures in place to protect the privacy and security of their PHI during text messaging. 
3. Provide opt-in or opt-out options: Clearly explain that by opting in, they consent to the use of text messaging for exchanging their health information. 
4. Consent forms: Develop a written consent form specifically for text messaging, ensuring it contains all necessary elements required by HIPAA
5. Signature or acknowledgment: Obtain patients' written or electronic signatures on the consent form, indicating their agreement to participate in text messaging communication.
6. Documentation: Maintain accurate records of the consent process, including the signed consent forms or electronic acknowledgments. 
7. Revocation process: Clearly explain to patients how they can revoke their consent for text messaging at any time. 

How to ensure valid informed consent

Healthcare organizations should use clear and unambiguous language in the consent message. This goes hand in hand with a written consent form specifically tailored to the type of communication they are requesting consent for such as text messaging. Additionally, organizations can implement a verification process to confirm the identity of the patient giving consent, utilizing unique identifiers or authentication methods. 

Potential risks related to text messaging in healthcare organizations 

Note that compliance with HIPAA extends beyond the use of text messaging and encompasses various aspects of privacy, security, and data protection. Text messaging software is not often designed with HIPAA compliance in mind and therefore may not include the security measures required to secure PHI. It is also a more informal method of communicating and can blur professional boundaries between healthcare providers and patients if not used correctly. 

Related: How software can assist with the de-identification process of PHI?

FAQs

What is authorization? 

A formal permission from a patient allows a healthcare provider to use or disclose their PHI for purposes such as research. 

When is consent legally required if the Privacy Rule provides that it’s only an option? 

Consent is legally required when a patient shares their information for reasons other than treatment, operations or billing. 

Can consent forms be included in the Notice of Privacy Practices?

Yes, consent forms can be included in the NPP, but they must be separate documents.