How to enable HIPAA-compliant texting and 6 tools to help you do it

Sara Ana Cemazar
June 27, 2023
min read

HIPAA-compliant texting is not easy to set up, but it's important to implement it. In an era where time is of the essence and patients demand convenience, the winds of change have swept through the sacred realm of medicine. Brace yourself, healthcare providers, for what lies ahead is not a fleeting trend but a bona fide telemedicine revolution.

With 62% of patients longing for the ease of virtual consultations, it's clear that healthcare's digital transformation is here to stay. Besides, SMS text messages have a 19% click-through rate (CTR) compared to 4% for emails.

However, before you jump on the telehealth bandwagon, you must navigate the HIPAA obstacle course. As patients seek flexibility, faster care, and the ability to connect with healthcare professionals remotely, the need for HIPAA-compliant communication platforms has never been more critical.

Don't fret, though: we've got your back (and your PHI) covered. Join us as we delve into the world of HIPAA-compliant communication solutions, exploring how these cutting-edge tools empower healthcare providers to embrace the digital shift while safeguarding patient data. Let’s get started.

What is HIPAA-compliant texting?

HIPAA-compliant texting refers to the secure and encrypted exchange of sensitive patient information via text messages while adhering to the requirements outlined in the Health Insurance Portability and Accountability Act (HIPAA).

HIPAA-compliant messaging platforms and applications are used to transmit sensitive patient data securely. These platforms employ encryption and other security measures to protect the confidentiality and integrity of PHI during transmission and storage.

HIPAA-compliant texting allows healthcare providers, staff, and other authorized individuals to communicate efficiently while maintaining the confidentiality of patient information. It offers a convenient and timely means of sharing essential details, discussing treatment plans, coordinating care, and addressing patient concerns, all within the boundaries of HIPAA regulations.

HIPAA-compliant texting solutions: Outline of key features

These solutions provide features and safeguards to ensure the privacy and security of patient data. They typically include:

  • Encryption capabilities to protect the content of the messages
  • User authentication to verify authorized access
  • Audit trails to track message activity
  • Remote wiping of data in case of lost or stolen devices
By employing HIPAA-compliant texting solutions, healthcare organizations can enhance communication workflows, improve patient engagement, and streamline care coordination while safeguarding the privacy and security of sensitive health information.

Is SMS HIPAA-compliant?

SMS texting is not automatically HIPAA-compliant. However, by implementing the appropriate administrative, physical, and technical safeguards, you can ensure that protected health information (PHI) is securely accessed by authorized personnel while maintaining confidentiality.

To achieve HIPAA compliance in SMS texting, the messages related to PHI need to be encrypted during transmission and when in transit. Failure to establish HIPAA compliance and protect sensitive PHI can lead to criminal charges or civil legal actions initiated by patients.

➡️ Learn what are the most common HIPAA violations and how you can avoid them.

Crucial Regulations for healthcare organizations regarding PHI 

HIPAA regulations require healthcare organizations to have security controls in place when handling electronic PHI (ePHI). Some of the key regulations include:

  • Establishing processes and procedures for accessing and using health information.
  • Conducting periodic risk assessments to identify and mitigate threats to data integrity.
  • Implementing encryption and data protection measures for personal mobile devices used to access PHI.
  • Enabling remote deletion of PHI from lost, stolen, or disposed of mobile devices to prevent data breaches.
  • Prohibiting the storage of PHI on mobile devices used by employees and subcontractors.
  • Admissible communication of PHI with patients requires warning them about the risks of unauthorized disclosure and obtaining their consent to communicate via SMS.

What do HIPAA regulations say about sharing PHI over SMS?

HIPAA regulations do not explicitly prohibit sharing Protected Health Information (PHI) over SMS (text messaging) but require specific safeguards to be in place for it to be considered HIPAA compliant.

The HIPAA Security Rule sets standards for protecting electronic PHI (ePHI) and requires covered entities to implement appropriate safeguards to ensure the confidentiality, integrity, and availability of PHI. 

When it comes to sharing PHI over SMS, the following regulations and considerations apply:

1. Administrative safeguards

Covered entities must have policies and procedures in place to govern the access, use, and disclosure of PHI. This includes defining who is authorized to send and receive PHI via SMS and establishing protocols for obtaining patient consent, and providing necessary warnings about the risks of unauthorized disclosure.

2. Authentication

Measures should be taken to protect mobile devices used for SMS communication to prevent unauthorized access. This can include using passcodes or biometric authentication, keeping devices secure when unattended, and promptly reporting lost or stolen devices.

3. Encryption and data privacy

Encryption is a critical requirement for HIPAA compliance when transmitting ePHI. The use of encryption helps protect the content of SMS messages, making it more difficult for unauthorized individuals to intercept or access PHI. Additionally, appropriate security measures should be implemented to ensure the secure storage and handling of ePHI on mobile devices.

4. Minimum necessary standard

PHI shared via SMS should be limited to the minimum necessary information required to accomplish the intended purpose. This principle emphasizes the need to avoid unnecessary disclosure of PHI.

5. Business associate agreements

If a third-party messaging provider is involved in facilitating SMS communication, covered entities must have a business associate agreement (BAA) in place. A BAA outlines the responsibilities and requirements for the business associate to maintain the privacy and security of PHI.

7 best tools for HIPPA compliant texting

There are several tools available that can help facilitate HIPAA-compliant texting and secure communication in the healthcare industry. Let’s go over the list of top 7 popular options:

1. Rocket.Chat

hipaa compliant texting

Rocket.Chat is an open-source, robust communication platform that emphasizes security and compliance, including adherence to crucial regulations such as HIPAA and GDPR. It can be configured for communication across various channels, including live chat, while ensuring strict compliance with these regulations.

It provides HIPAA-compliant texting among staff in addition to patient chat capabilities.


To provide live chat services to patients using Rocket.Chat, there are different options available requiring varying levels of development effort. The simpler option is to use a chat widget, which can be customized to match your brand's aesthetics and easily integrated into your website by pasting a code snippet into the source code. 

Alternatively, if you have more developer resources, you can embed Rocket.Chat's chat engine into your existing web and mobile applications to create a more personalized patient experience.


Once the live chat functionality is implemented for patients, your team can manage incoming messages through a shared workspace. This workspace offers useful features such as canned responses, private notes, and the ability to share files and images. 

Internal communication

For internal communications, Rocket.Chat provides a Slack-like experience, including direct messaging, group discussion channels, conversation threads, reactions, and the ability to involve vendors who use other platforms.

➡️ Learn whether Slack is HIPAA-compliant here. Also, learn why popular consumer chat apps like WhatsApp should be used with extra carefulness in the healthcare industry.


While Rocket.Chat offers a free plan with features like two-factor authentication (2FA) and end-to-end encryption, healthcare organizations may need to opt for the Enterprise plan to access the features necessary for meeting HIPAA compliance requirements and fully leveraging the platform.

2. Twilio

HIPAA compliant chat

Twilio is a versatile technology platform that offers various communication channels, including live chat, SMS, messaging, voice, and video conferencing, with the ability to configure them to be HIPAA compliant. 

The platform primarily focuses on providing access to its APIs, allowing organizations to build customized and personalized patient or customer experiences. This flexibility empowers businesses to create tailored solutions according to their specific needs.

Twilio Flex

For smaller groups without extensive technical resources, Twilio offers a more accessible product called Twilio Flex. It enables the setup of a contact center using pre-built themes, components, and plugins. 

With Flex, you can incorporate channels like live chat, messaging, or SMS and integrate the platform with other software in your tech stack, such as EHR, billing software, and scheduling systems, to streamline communication and enhance patient care.

3. pMD

HIPAA compliant texting

pMD is a HIPAA-compliant texting app and secure communication platform designed for healthcare providers. It offers real-time and unlimited chat, video, and voice capabilities, allowing healthcare professionals to communicate securely with colleagues and patients. Just like other similar tools, pMD helps healthcare organizations improve patient experience.

pMD's messaging solution enables healthcare professionals to send HIPAA-compliant SMS messages, ensuring the security and privacy of sensitive patient information. 

Some other key features of pMD's secure messaging app include:

Secure messaging app

pMD provides a secure messaging app that allows healthcare professionals to communicate via SMS while maintaining HIPAA compliance.


pMD uses encryption technology to secure SMS messages during transmission. This ensures that the content of the messages is protected and inaccessible to unauthorized individuals.

User authentication

Users of the pMD messaging app are required to authenticate their identities with usernames and passwords. This authentication process ensures that only authorized individuals have access to the messaging platform and can send SMS messages.

Group chats and message controls

pMD allows users to create group chats, enabling collaborative discussions among healthcare team members. 

Secure file sharing

In addition to SMS texting, pMD allows for secure file sharing. Users can share sensitive patient information, such as documents or images, within the messaging app while maintaining HIPAA compliance.

4. TigerConnect

HIPAA compliant texting

TigerConnect is a secure patient messaging and communication platform designed for healthcare organizations. It enables HIPAA-compliant texting and collaboration among healthcare professionals. 

Here's how it facilitates HIPAA-compliant texting:


TigerConnect employs 256-bit AES encryption for all message transmissions. This encryption ensures that the content of the messages is secure and protected from unauthorized access.

Secure infrastructure

The platform provides a secure infrastructure to transmit SMS messages. It uses secure servers and protocols to prevent interception or unauthorized access to messages during transmission.

Message access control

Users are required to authenticate their identities with unique usernames and passwords before accessing the TigerConnect platform. This helps ensure that only authorized individuals can access and send SMS messages.

Message erasure

TigerConnect provides the option to automatically erase sent messages after a specified period. This helps maintain data privacy and ensures that sensitive information is not stored indefinitely on devices or within the messaging system.

User access controls

The platform offers granular user access controls, allowing administrators to manage and control user permissions. This ensures that only authorized individuals have access to sensitive patient information and can send SMS messages within the HIPAA-compliant guidelines.

5. OhMD

HIPAA compliant texting

As an effective medical chat tool, OhMD ensures HIPAA compliant texting through its platform by implementing the following features:

Secure messaging platform

OhMD provides a secure messaging platform specifically designed for healthcare communication. The platform ensures that patient information shared via SMS is protected and compliant with HIPAA regulations.

Robust encryption

OhMD uses encryption technology to safeguard SMS messages and ensure that patient data remains confidential during transmission. The encryption ensures that only authorized individuals can access and read the messages.

EHR integration

OhMD seamlessly integrates with electronic health record (EHR) systems, allowing for the secure transfer of patient information and conversations. This integration ensures that all communication is properly documented and accessible within the patient's medical record.

EHR-connected conversations

The platform enables clinicians and staff to have secure conversations with patients directly within their EHR system. This eliminates the need for separate messaging apps or systems, streamlining communication and maintaining HIPAA compliance.

6. NexHealth

HIPAA compliant texting

NexHealth is a patient experience platform that provides HIPAA-compliant online scheduling software for dental clinics, doctor offices, hospitals, and other medical practices. The software allows these practices to manage patient appointments and, in some cases, enables patients to schedule appointments themselves. 

Here's how NexHealth ensures HIPAA compliance for SMS texting:

Secure infrastructure

NexHealth utilizes a secure infrastructure to protect the confidentiality, integrity, and availability of the transmitted data. This includes implementing encryption protocols and secure storage mechanisms to safeguard patient information.

Business associate agreement (BAA)

NexHealth signs a Business Associate Agreement (BAA) with healthcare providers who use their platform. This agreement establishes the responsibilities and obligations of both parties regarding the handling of protected health information (PHI) in accordance with HIPAA regulations.

Secure transmission

NexHealth ensures that all SMS messages containing PHI are transmitted securely. This involves encrypting the messages during transmission, making it difficult for unauthorized individuals to intercept or access the information.

Data retention policies

NexHealth follows proper data retention policies to ensure that SMS messages containing PHI are stored securely and for the appropriate duration. This includes securely deleting or archiving messages based on HIPAA requirements.

Audit trails and access controls 

NexHealth maintains audit trails and access controls to monitor and track access to SMS messages containing PHI. This helps ensure accountability and allows for traceability in case of any security incidents or breaches.

Employee training and policies

NexHealth provides proper training to its employees regarding HIPAA compliance and the handling of PHI. They also have policies and procedures in place to guide employees on the secure and compliant use of SMS texting within the platform.

Rocket.Chat: Send HIPAA-compliant texts securely and quickly

Enabling HIPAA-compliant text messaging is essential for healthcare providers to communicate with patients securely while adhering to privacy regulations. By adopting the right tools and strategies, healthcare organizations can leverage the convenience and effectiveness of text messaging without compromising patient data security.

If you're a healthcare provider looking to implement HIPAA-compliant text messaging, consider exploring Rocket.Chat's robust and intuitive features for healthcare. As a versatile and open-sourced communication platform Rocket.Chat offers secure messaging, video conferencing, and collaboration tools tailored for healthcare settings. 

Contact us to learn more about how our platform can support your HIPAA-compliant communication needs. 

Get started with Rocket.Chat’s secure collaboration platform

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Sara is an SEO Strategist at Rocket.Chat. She is passionate about topics around digital transformation, workplace experience, open source, and data privacy and security.
Sara Ana Cemazar
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