Two-factor authentication (2FA) enhances the security of HIPAA compliant text messaging by adding an extra layer of protection, requiring users to verify their identity through two separate methods, typically something they know (like a password) and something they have (such as a one-time code or authentication app). That reduces the risk of unauthorized access to protected health information (PHI), helping healthcare organizations meet HIPAA’s access control requirements.
Two-factor authentication (2FA) is a security measure requiring users to provide two verification forms before accessing an account or system. It typically combines something the user knows, such as a password, with something the user has, like a mobile device to receive a one-time code. Some systems also include biometric factors like fingerprint or facial recognition as the second step. 2FA reduces the chances of unauthorized access, even if a password is compromised by requiring two layers of authentication.
Read more: What to look out for when using 2FA in healthcare
The HIPAA Privacy and Security Rules protect the confidentiality, integrity, and availability of PHI. Regular SMS texting is generally not HIPAA compliant because it lacks encryption and is vulnerable to unauthorized access. Healthcare organizations must implement access control mechanisms, encryption, and audit controls to protect PHI in transit and at rest to meet the HIPAA technical safeguard requirements.
Related: Is SMS messaging HIPAA compliant?
Two-factor authentication strengthens access control, a component of the HIPAA Security Rule. It ensures that even if an attacker steals a password, they still cannot access the system without the second authentication factor. This additional layer of security helps protect mobile devices, which are prone to loss or theft.
If a healthcare provider communicates with patients or staff via text messaging, 2FA offers an added layer of protection to safeguard PHI from unauthorized access. Using 2FA also helps healthcare organizations show that they’ve taken reasonable and appropriate steps to secure patient data, in case of a security audit or breach investigation.
In a recent memorandum, the Centers for Medicare & Medicaid Services (CMS) said that providers who choose to incorporate texting into their workflows and EHRs are expected to “implement a platform that meets the requirements of the HIPAA Security Rule and the HITECH Act Amendment 2021 as well as the [Conditions of Participation].”.
When choosing a text messaging platform, healthcare organizations must ensure it meets the HIPAA security requirements. A HIPAA compliant text messaging platform should offer encryption, audit logs, and secure access controls, 2FA being one of the most important. Additionally, organizations must sign a business associate agreement (BAA) with the service provider. The contract ensures the provider complies with the HIPAA requirements for safeguarding PHI. Healthcare providers should look for platforms that make it easy to use 2FA without adding unnecessary complexity for staff.
Related: Introducing HIPAA compliant texting API by Paubox
In addition to 2FA, healthcare organizations should implement other security measures to protect PHI:
SMS-based 2FA is a common method but can be vulnerable to attacks like SIM swapping. A more secure option for HIPAA compliance is app-based authentication, which provides stronger protection against unauthorized access.
Not all HIPAA compliant messaging platforms include 2FA by default. Healthcare organizations should verify that their chosen platform offers 2FA as a built-in feature or allows easy integration.
While HIPAA does not mandate 2FA, it does require sufficient access controls. Implementing 2FA is considered a best practice to meet these requirements and significantly strengthens compliance with the HIPAA Security Rule.