Texting tools and HIPAA compliance: The ultimate guide

Texting Tools and HIPAA Compliance: The Ultimate Guide - Paubox

Sending short message service (SMS) messages, or text messages, is a convenient communication tool for covered entities. Employees can both communicate with each other and get in touch with their patients. Text messages can do many tasks like send appointment reminders and in general improve the patient experience.

Text messages may contain electronic protected health information (ePHI), which means they are subject to HIPAA security rules. This means that a text messaging software company is considered a business associate

To stay compliant with the HIPAA Privacy Rule, a covered entity and a business associate must sign a business associate agreement (BAA). This agreement ensures that a business associate will do its part to protect sensitive information.

Some texting tools can be HIPAA compliant. Your healthcare organization needs to be aware of these options and do the research to choose a texting tool that complies with HIPAA. Otherwise, you risk receiving fines and other corrective action for HIPAA violations.

Best practices for texting tools

There are many factors to consider when choosing a texting tool. Here are a few best practices to think about when choosing a texting tool that meets HIPAA guidelines:

  • Choose a provider will sign a BAA
  • Text messages that contain ePHI need encryption both in transit and at rest
  • Unauthorized employees shouldn’t have access to text messages with ePHI
  • Obtain and document authorization from the patient to use text messaging
  • Make all devices secure, including BYOD
  • Implement two-factor authentication
  • Use a secure WiFi network

SEE ALSO: HIPAA Email Encryption Requirements: What You Need to Know

Let’s review whether or not the popular texting tools below are capable of being HIPAA compliant.


Avochato allows healthcare providers to communicate with their patients. It also allows internal teams to keep patient communication organized.

However, the company isn’t HIPAA compliant because it relies on other cloud platforms and telecommunication providers to operate. These cloud platforms and telecommunications providers aren’t necessarily HIPAA compliant.


EZTexting allows businesses to mass communicate with their clients. The SMS marketing software is not HIPAA compliant though. EZTexting won’t sign a BAA, so a covered entity faces fines if it uses this software.


Apple iMessage may be popular, but it’s not HIPAA compliant. Many issues are preventing covered entities from using iMessage. Some of these problems include no BAA, and iCloud may not be properly encrypted to store messages.

SMS Global

SMS Global is used to create, send, and analyze mass texting campaigns. While it has a robust SMS messaging system, it’s not HIPAA compliant.

The company won’t sign a BAA because it doesn’t follow HIPAA security guidelines. 


Tatango is popular software that can send mass text messages for marketing purposes. While convenient for some businesses, Tatango is not HIPAA compliant.

The company isn’t willing to sign a BAA, and it’s not transparent about its data encryption policies.


Zipwhip has software that allows businesses to communicate with clients from their desktop, web browser, or mobile device. Unfortunately, Zipwhip isn’t HIPAA compliant.

The company isn’t transparent about if it is willing to participate in a BAA, and it may be lacking the appropriate HIPAA safety features.


Mosio offers many tools to help a healthcare provider operate, including sending appointment reminders via automated messages. Mosio can be HIPAA compliant, but it’s on a case-by-case basis.

Mosio reviews your request for a BAA and could potentially turn it down. If Mosio does accept, it could be a HIPAA compliant option for you.


QliqSOFT is a smartphone app that offers secure messaging for healthcare providers. Even though QliqSOFT claims it doesn’t have access to PHI because it doesn’t store messages on its server, the company is still willing to sign a BAA. It also has key security features like end-to-end encryption and an encrypted archival unit.

QliqSOFT can be HIPAA compliant.

Spok Mobile

Spok Mobile is a clinical communications platform that helps staff members communicate with each other. Staff can send text messages, images, and video data securely.

Spok Mobile can be HIPAA compliant because it’s willing to sign a BAA and encrypts sensitive data.


TigerConnect is an online communications company that is best known for its instant messaging app. A healthcare provider can easily use TigerConnect to communicate between hospital staff and patients.

TigerConnect can be HIPAA compliant since it will sign a BAA, and it also has appropriate safeguards to protect PHI.


Twilio has many communication features that healthcare providers want, including texting, video calls, and voice calls.

SEE ALSO: VoIP Providers and HIPAA Compliance: The Ultimate Guide

Twilio can be HIPAA compliant, but you need to sign up for the enterprise edition. It’s also important to note that only some features can be HIPAA compliant such as Programmable SMS, Programmable Video, Programmable Voice and SIP, and Runtime Tools.

Which texting tools are HIPAA compliant?

There are a lot of texting tools available, even if you need a HIPAA compliant partner. Some of the companies covered entities might consider include:

  • Mosio
  • QliqSOFT
  • Spok Mobile
  • TigerConnect
  • Twilio

All of these companies are willing to sign a BAA and ensure that they meet HIPAA security rules to protect PHI. You should do your own research to determine which texting tool will match the needs of your healthcare business best.

Keep all of your online communication in compliance with HIPAA

While using the right texting tools is key to staying HIPAA compliant, don’t forget to protect your other online communications. Email is one of the most common communication tools, and Paubox Email Suite allows you to send HIPAA compliant email.

Paubox makes it easy to deliver encrypted emails directly to a patient’s inbox. Paubox seamlessly integrates with your email provider, like Google Workspace or Microsoft 365. Your patients won’t need a third-party app or passwords to communicate with you safely.

Paubox has a BAA included in all of our plans, so you can rest assured that we are continuously updating our technology to keep your emails safe and HIPAA compliant. 

Try Paubox Email Suite for FREE today.

About the author

Sara Nguyen

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