Thoughts and ideas from My IT
Can I Text ePHI?
January 5, 2017 at 5:00 AM
by My IT
Doctor with a stethoscope

We get this question from our healthcare clients frequently – can I text ePHI (Electronic Private Health Information)?

Simply put, no.

This may surprise you, because many non-medical companies frequently exchange texts with clients. (You probably know dozens of doctors that frequently text patients too.) HIPAA does not allow for texting any private information, even directly to the patient.

Also, the Joint Commission has varied in their opinion of the legality of texting medical orders too. In 2011, they banned secure-texted medical orders. In May 2016, that opinion was reversed, only to be reinstated in December that same year. [Read more at]

Why can’t a doctor text a patient?

A doctor can’t text a patient because the doctor can not verify the environment that patient’s phone is in.

For example, a patient may be having lunch with a friend and her phone is sitting on the table. The patient may not want a text from her doctor stating that her pregnancy test was positive. Most phones show a preview of the text message in the lock screen, showing the content of the message to everyone in sight of the phone. For this reason, text messaging is not a confidential method of communication. 

How can you text a patient securely then?

Some medical practices will require patients to sign a waiver thus allowing them to transmit ePHI via text. This waiver may hold up in court, but it isn’t the best practice. Instead, you can send a text with a link to the message (much like sending a secure/encrypted email).

How big of a deal is non-HIPAA compliant messaging?

According to an Infinite Convergence Solutions study, 92% of healthcare institutions use a non-HIPAA compliant messaging app. Additionally, the study found that only 25% of medical institutions use an internal, company-authorized app. 52% of respondents reported using a third-party messaging app such as GChat, Facebook Messenger, and WhatsApp.

65% of healthcare respondents use email most frequently to communicate with patients, followed by 22% using mobile messaging and 13% use voice calling.

Most participants cited not using mobile messaging because they prefer to send emails or make calls. Some cited a lack of a paper trail with mobile messaging, a lack of security, the process being too informal, or the method not being authorized by the company.

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