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Are Your Text Messages to Patients HIPAA Compliant?

Are Your Text Messages to Patients HIPAA Compliant?

HIPAA-compliant texting is a complicated topic in healthcare. On one hand, texting patients without their consent or mishandling personal medical information can lead to consequences for you and your healthcare facility. Without the right security and access control in place, an employee’s honest mistake can turn into a severe penalty. 

On the other hand, there are ways to implement convenient text messaging solutions that align with HIPAA regulations and keep you compliant. By using a unified healthcare platform that helps you stay compliant with HIPAA, you can build digital engagement among your patients, increase revenue for your facility and provide better patient journeys.

What Is HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA) is a law Congress passed in 1996. This law created national requirements and standards to protect private patient health information, such as medical records and identifying health information, from being shared without the patient’s knowledge or consent

HIPAA sets limits and conditions on how healthcare professionals use protected health information without an individual’s authorization, including the right to obtain and examine a copy of a patient’s health records. Protected health information is any information that identifies an individual contained in an electronic or hard copy.

The primary purpose of HIPAA is to standardize the electronic transmission of financial and administrative transactions while combatting fraud, waste and abuse in the healthcare system. 

Since its creation, HIPAA has required the United States Department of Health and Human Services (HHS) to create additional regulations addressing data privacy. These regulations prompted the Privacy Rule and the Security Rule, which define standards for handling all personal health information (PHI) and ending the unnecessary collection of Social Security Numbers (SSN)

What Is a HIPAA Violation? 

HIPAA violations occur when an employee or healthcare professional acquires, accesses or discloses PHI in a way that poses a significant personal risk to a patient. These regulation violations can apply to anyone that works with or performs any function involving PHI. Some HIPAA violation examples include:

  • Failure to conduct a risk analysis
  • Failure to manage risks to the availability and confidentiality of PHI
  • Texting unencrypted PHI
  • Failure to encrypt PHI 
  • Failure to implement security measures to ensure the integrity of PHI
  • Failure to monitor PHI access logs
  • Failure to terminate access to PHI to users when no longer required
  • Sharing of PHI online or via social media without permission
  • Mishandling and mis-mailing PHI

What Are the Penalties for a HIPAA Violation?

Violations of HIPAA rules come with penalties. These penalties depend on the nature of the violation, how much harm was caused by the violation, the level of culpability and the efforts made to mitigate the impact. In some cases, the penalty will include a corrective action plan, but many HIPAA violations may result in significant financial civil or criminal penalties

Civil Penalties

Civil penalties occur if the violation committed is without malicious intent. There are four tiers of civil penalties for violating HIPAA:

  • Tier 1: Committing violations while unaware of the violation may result in a $100 fine per violation. 
  • Tier 2: Violating HIPAA with reasonable cause but with willful neglect may result in a minimum fine of $1,000.
  • Tier 3: Acting with willful neglect but attempting to or fixing the issue may lead to a minimum fine of $10,000. 
  • Tier 4: Acting with willful neglect without attempting to or fixing the issue may result in a fine of $50,000. 

Criminal Penalties

More severe HIPAA violations can result in criminal penalties, particularly if the individual committing the violation does so with malicious intent. The three different tiers for criminal penalties include: 

  • Tier 1: Knowingly and willingly obtaining and disclosing PHI can lead to a penalty of up to $50,000 and jail time for up to a year.
  • Tier 2: Committing HIPAA violations with PHI under false pretenses may result in a maximum fine of $100,000 and jail time for up to five years. 
  • Tier 3: Committing violations for personal gain, such as selling, transferring or using PHI to harm a patient, may result in a penalty of up to $250,000 and jail time for up to 10 years. 

Common Ways HIPAA Compliance Is Broken

Common Ways HIPAA Compliance Is Broken

Here are the common ways you may break HIPAA compliance in your healthcare facility or practice:

  • Employees disclosing information: Under HIPAA, employees are not permitted to discuss personal information about patients or share details about their medical records unless medically necessary in a private medical setting. This includes casually sharing information with family members and colleagues. 
  • Texting from a personal phone: One of the top prohibited uses of texting patients is using a personal phone or device without the use of a protected platform and secure login. 
  • Getting hacked: Healthcare security breaches reached an all-time high in 2021, which can result from hackers selling PHI to third parties or using ransomware to take over patient data. This type of hacking can lead to a HIPAA violation.
  • Unauthorized access: Employees who access PHI they are not authorized to see, whether accidentally, out of curiosity or intentionally, can break HIPAA regulations. 
  • Improper disposal of PHI: As with any medical records, all employees must know the proper procedure for deleting or disposing of a physical or digital document containing PHI. If someone accidentally throws a document in the trash or leaves it on a table, it can get into the wrong hands and result in a compliance violation.

Are Text Messages to Patients

HIPAA Compliant?

There are certain circumstances where texting patients in healthcare is compliant with HIPAA regulations. However, texting through traditional platforms, such as iMessage or WhatsApp, is not compliant if the patient has not given their consent to receive text communications about their PHI. Providers or healthcare employees who share something as simple as a patient’s name or another identifier will likely violate HIPAA without permission. HIPAA consent guidelines state that the patient must give the Covered Entity (CE) permission for specific communications through text. 

For instance, a patient may give the CE consent to communicate appointment reminders through text message, but they may not give their permission to share PHI or any medical information in this format. Providers must advise patients that this method is not secure and receive explicit written consent before engaging in this communication. 

The HIPAA Security Rule also defines standards for communicating over text, such as implementing access controls, encryption and audit controls to protect PHI, which is why texting on commonly used platforms is not encouraged. These violations can also create substantial liability with The Federal Communications Commission (FCC). FCC-compliant texting requires communities to only send authorized texts to recipients to prevent widespread fraud and spam

How to Ensure Your Text Messages to Patients Are HIPAA Compliant

Follow the HIPAA-compliant texting tips below if your healthcare facility wants to start communicating with patients through text messaging. 

Get Permission

Before engaging in any kind of electronic communication with your patients regarding PHI or medical record data, get their permission first. Provide patients with a written or electronic form or text message reply option that signifies their consent to receive text messages regarding their PHI. Sending texts to patients without their consent can violate HIPAA, so prioritize informed consent and require all patients to opt-in for text messages before sharing PHI with them. 

Control Access

All healthcare facilities must take precautions to control who has access to PHI and medical record information and warn patients about the risks of unauthorized disclosure in writing. The HIPAA Security Rule requires access controls for all PHI, including automatic logoff and unique user ID features.

Integrate an End-to-End Solution for Patient Communication 

An effective way to prevent HIPAA violations is to integrate a compliant solution that enables you to communicate with your patients through messaging to pre-decided phone numbers. Whether you need to send appointment confirmations and reminders, send digital forms for signatures or update family members in the waiting room on the patient’s status, you can benefit from healthcare communication solutions that optimize the experience of the visit and remain HIPAA compliant. 

Millennia Is Your Patient Engagement Solution 

Communicating with patients through text messaging is an efficient and convenient way to keep them informed and increase patient satisfaction. At Millennia, we know how important it is to effectively engage with patients while upholding HIPAA regulations. With Millennia Complete, your healthcare facility gains access to a comprehensive solution that integrates with your existing system to enhance the patient journey and make text messaging easier and more compliant. 

Our all-in-one tool with combined features from our Millennia Access and Millennia Recover unified patient solutions allows you to simplify payments, send real-time updates and improve patient communication. To learn more about the key features of Millennia Complete, request a demo today to start providing your patients with the flexibility and convenience they need. 

Millennia Is Your Patient Engagement Solution