RST Software
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Magdalena Jackiewicz
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HIPAA-compliant messaging: key features, use cases, and how to build your own app

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Think about building your own HIPAA-compliant solution to unlock greater efficiency in healthcare communications? It is not only about balancing fast, efficient messaging with the responsibility of safeguarding sensitive patient data. Learn what else sets HIPAA-compliant, healthcare-optimized messaging systems apart from everyday save messaging platforms.

HIPAA – what is this for? 

At its core, HIPAA aims to ensure that everyone's health information is protected while allowing communication open enough to provide and promote high-quality healthcare. But what kind of information does HIPAA protect? Simply any data in a medical record used to identify a person and link them with a treatment provided. From a patient's name and address to their medical history and payment information – all fall under the protective umbrella of HIPAA.

Enacted in 1996, HIPAA stands for the Health Insurance Portability and Accountability Act. It establishes standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers in the United States.

HIPAA-compliant messaging

“Is WhatsApp secure for businesses dealing with PHI?”, “Is Teams HIPAA-compliant?” – you may wonder why you couldn't simply use one of the popular chat applications. The short answer is: “They are not safe enough”. HIPAA-compliant messaging protects digital communication and aligns with the rigorous requirements, including a range of tools, practices, and protocols designed to safeguard Protected Health Information (PHI) at every stage of transmission and storage. HIPAA-compliant communication aims at improving care coordination and enhancing its outcomes, as in the first place HIPAA-compliant messaging empowers healthcare providers to make timely decisions, collaborate, and engage patients more effectively.

HIPAA-compliant communication ensures that any exchange of Protected Health Information (PHI) is conducted securely and with the utmost respect for patient privacy – whether it is 

  • between healthcare providers, 
  • between providers and patients, and
  • among related entities. 

Compliance requirements extend to all forms of communication, including not only electronic channels, but also written and verbal communication.

What does HIPAA-compliant messaging mean for businesses? 

The penalties for HIPAA violations can be steep, ranging from $67 to almost $70,000, with a maximum penalty of $2 million per year for each violation. Moreover, HIPAA violations can result in criminal charges in cases of willful neglect or intentional disclosure of PHI. However, The Office for Civil Rights (OCR) revealed that the majority of HIPAA violations occur due to unintentional human error. What does it mean for business? Not surprisingly, HIPAA-compliant messaging systems play a vital role here. For businesses adjacent to the healthcare sector, it minimizes the risk of inadvertent disclosures and costly data breaches.

But there is also good news. HIPAA-compliant messaging opens up new and promising opportunities for businesses. In the healthcare sector, efficient and secure communication is a competitive advantage. Healthcare organizations that can demonstrate HIPAA compliance in their messaging systems are likely to win contracts and partnerships, as they represent lower risk to potential collaborators.

Use cases for HIPAA chat

HIPAA-compliant chat solutions find application in many scenarios within the healthcare ecosystem. They are used for:

  • secure patient consultations,
  • collaboration among medical teams
  • patient engagement and follow-up care,
  • sharing of test results and medical records,
  • coordination of care between different healthcare providers,
  • appointment scheduling and reminders,
  • telemedicine consultations
  • medication management, and
  • remote patient monitoring.

Let’s have a closer look at some of these use cases.

Healthcare provider communication 

HIPAA-compliant messaging offers a secure and efficient channel for exchanging sensitive patient information. This use case is particularly crucial where timely and accurate communication can impact patient outcomes, such as:

  1. Coordination of care. Hospital departments are able to communicate efficiently about a patient's treatment plan, e.g., the emergency department can immediately update the cardiology department about an oncoming heart attack patient, ensuring coordination of care.
  2. Sharing test results. Lab technicians can securely send test results directly to the ordering physician, speeding up diagnosis and treatment decisions, which is particularly valuable in time-sensitive situations.
  3. Remote patient monitoring, Healthcare providers can use HIPAA-compliant messaging to communicate with patients about their symptoms, enabling effective remote care.

Medical teams coordination

HIPAA-compliant messaging facilitates coordination between medical teams, impacting patient outcomes and operational efficiency. It is crucial for complex care scenarios requiring collaboration among multiple specialists. Key uses include:

  1. Multidisciplinary care planning. For complex cases requiring input from multiple specialties, HIPAA-compliant chat allows teams to discuss and plan patient care securely. 
  2. Handoffs between shifts. To ensure frictionless transitions between shifts, medical staff can use a secure messaging app. 
  3. Patient transfers coordination. Helps to provide continuity of care when patients need to be transferred between facilities or departments.

Patient engagement and reminders 

HIPAA-compliant chat has emerged as a powerful tool for enhancing patient engagement. First of all, it delivers timely reminders, improving health outcomes and satisfaction. Leveraging secure communication channels to keep patients informed and adherent to their treatment plans, this use case includes:

  • medication adherence,
  • appointment reminders,
  • follow-up care instructions. 

For healthcare organizations, the benefits of leveraging HIPAA-compliant messaging for patient engagement and reminders include improved patient satisfaction, enhanced treatment adherence, and streamlined administrative tasks.

Examples of HIPAA messaging tools  

HIPAA compliant messaging tools come in various forms, including:

  • standalone secure messaging apps,
  • integrated communication platforms,
  • APIs for building custom HIPAA-compliant chat solutions, and
  • secure texting services.

Each of them caters to different organizational needs and use cases. Let’s examine some tools designed to handle Protected Health Information. 

Rocket Chat

Are you wondering if Slack is HIPAA-compliant? The answer is no. However, Rocket Chat offers HIPAA-compliant messaging tools similar to Slack, including direct messaging, group discussions, and file sharing. It supports patient communication, secure collaboration among medical experts, and helps healthcare organizations to centralize communication across various channels, including live chat, email, and social media.

Screen of Rocket Chat - HIPAA compliant messaging

Being open-source, it allows customization, in order to meet the specific needs and compliance requirements of your organization. Rocket Chat’s key features include:

  • end-to-end encryption, 
  • customizable access controls, and 
  • detailed audit logs, as well as
  • ISO 27001 certification, adding an extra layer of security assurance.

Unfortunately, users have reported that Rocket Chat recently lacks consistent maintenance. It also suffers from dated documentation that makes it hard to perform troubleshooting. Hence, it can be challenging for organizations to implement and manage effectively.

PubNub

While not a standalone chat, PubNub is a real-time communication platform focused on providing a scalable infrastructure. It offers APIs and all the necessary tools for building HIPAA-compliant chat applications. For instance, the PubNub Access Manager (PAM) allows for granular control over user permissions and access to resources.

Definitely it is not a solution for those wondering if WhatsApp is HIPAA-compliant. Organizations without a strong development team may find it challenging to leverage its full capabilities, this solution is particularly valuable for those looking to develop custom messaging tools. PubNub's HIPAA-compliant features include end-to-end encryption, access controls, and audit logging. PubNub is also SOC 2 Type II and ISO 27001 certified, which means information security commitment.

Spok

Spok is a healthcare-specific platform with priority messaging and on-call scheduling integration, as well as secure image sharing, all while maintaining HIPAA compliance. It features secure messaging across various devices, including smartphones and pagers, which is crucial for healthcare settings where staff may use personal devices (BYOD, Bring Your Own Device).

While Spok offers great integration capabilities, it provides a limited customization and flexibility in adapting the platform to specific organizational needs.

Key features of HIPAA-compliant messaging apps

What features make an app HIPAA-compliant? Confidentiality, integrity, and availability of Protected Health Information (PHI) are the most important for apps created for HIPAA compliance. As long as apps are not created equal, all the truly HIPAA-compliant messaging apps need to provide a list of features.

Feature 1: End-to-end encryption 

End-to-end encryption ensures that data remains encrypted from the moment it leaves the sender's device until it reaches the intended recipient's device. The industry standard for this level of encryption is the 256-bit Advanced Encryption Standard (AES), considered unbreakable – at least with current technology.

End-to-end encryption works by using a pair of keys — a public and a private key. The public key is used to encrypt the message, while the private key, held only by the intended recipient, is used to decrypt it. This ensures that only the intended recipient can read the message, even if it's intercepted during transmission.

Feature 2: Access controls and authentication 

HIPAA-compliant apps need to follow "minimum necessary" access. It means that users should only have access to the PHI required to perform their specific job functions. Implementation of this feature usually involves:

  • MFA – multi-factor authentication – includes something the user knows (e.g. password), something the user has (like a smartphone for receiving a verification code), and something the user is (like a fingerprint or facial recognition),
  • RBAC – role-based access control – for example, a nurse has access to patient messages related to their department, while a doctor might have broader access across multiple departments,
  • automatic log-off – security is improved by a mechanism automatically terminating inactive sessions after a predetermined period,
  • detailed audit trails – logs recording who accessed what information and when. Create a detailed history that allows unusual patterns detection.

Feature 3: Audit controls and activity logs

HIPAA requires mechanisms to record and examine access and other activity in information systems containing PHI. These audit logs are crucial for automatic prevention, detection, investigation and response to data breaches, and serve multiple critical functions, such as:

1. Deterrence. The knowledge that all actions are being logged can deter potential misuse of PHI.

2. Detection. Audit logs help identify unusual patterns or potential security breaches quickly.

3. Forensics. In case of a security incident, audit logs provide crucial information for investigations.

4. Compliance. Detailed activity logs are essential for demonstrating HIPAA compliance during audits.

Activity logs typically include information such as user login attempts, message timestamps, file uploads and downloads, and changes to user permissions, hence they need to be strictly protected from modification and deletion.

Feature 4: Data backup and recovery plans

Emergency measures and disaster recovery plans ensure that PHI remains accessible and protected even in the event of system failures or natural disasters. The contingency plan consists of:

  • data backup plan – including regular, automated backups of all PHI, 
  • disaster recovery plan with detailed steps for recovering lost data, supported by regular testing of backup systems to ensure data can be successfully restored, and 
  • emergency mode operation plan with alternate processing sites in case primary facilities are unavailable, ensuring that critical processes can continue during and after a crisis. 

Physical storage security is often overlooked, but HIPAA-compliant apps must ensure that the physical locations where data is stored are secure and protected against unauthorized access or environmental hazards.

Building your own HIPAA-compliant messaging app  

Off-the-shelf solutions do not always meet the specific needs of healthcare organizations. As a result, building a custom HIPAA-compliant messaging app is often a compelling option. This approach allows organizations to tailor their communication tools to their unique workflows, security requirements, and integration needs. 

Custom vs. off-the-shelf solutions

When it comes to HIPAA-compliant texting, healthcare organizations face a crucial decision – whether to opt for an off-the-shelf solution or invest in building a custom app. Here are the seven key advantages of custom solutions:

  • flexibility – easier to modify and update as regulations or needs change,
  • tailored functionality – designed to perfectly align with specific workflows and needs,
  • scalability – built to grow with the organization, accommodating future needs,
  • integration capabilities – integrates with existing systems like EHRs,
  • branding and user experience – reflects organizational brand and provides a tailored user experience,
  • enhanced control over compliance features – allows for more granular control over security measures,
  • customized data analytics – provides insights specific to the organization's needs.

What steps to take to build one? 

Steps to develop a HIPAA-compliant messaging app

Developing a HIPAA compliant tool requires careful planning and execution. Here are the key steps involved:

  1. Requirements gathering. Begin by identifying the specific needs of your organization and outlining HIPAA compliance requirements. For example, a hospital might need secure messaging between doctors and nurses, as well as the ability to send encrypted medical files to external specialists
  2. Design and architecture. The second step is planning the app's structure with security in mind. For instance, a mobile messaging app could be designed with role-based access control, ensuring that only authorized personnel can view or send sensitive patient information.
  3. Security implementation. End-to-end encryption, multi-factor authentication, and secure data storage are essential security features for HIPAA-compliant messaging tools. A practical example would be encrypting all messages and file transfers, ensuring they are unreadable to unauthorized users during transmission.
  4. User interface development. Create a user-friendly interface for your HIPAA-compliant messaging app. For example, a messaging app for doctors could include easy-to-use navigation for quickly sending secure messages during emergencies while still requiring biometric authentication for access.
  5. Backend development. Build robust server-side components to securely process and store PHI. In most cases, the backend includes encrypted cloud storage, which ensures patient records are safe and accessible only through verified requests.
  6. Testing and quality assurance. Conduct thorough testing, including penetration testing to identify vulnerabilities and stress tests on the system to handle heavy loads. For example, simulate real-world scenarios like a large influx of patient data during a medical crisis to ensure system stability.
  7. Compliance verification. Perform a final review to ensure that all the elements of the app meet HIPAA requirements. For instance, bring an external auditor in to assess whether the app’s encryption protocols and data handling practices fully align with HIPAA’s security and privacy rules.
  8. Roll out and train. Present the app to users and show them how to use it. For instance, conduct workshops with medical staff to teach them the importance of using secure messaging for patient communications and how to log in using two-factor authentication.
  9. Ongoing maintenance and updates. Regularly improve, update, and patch the app. A practical example is releasing a patch for a discovered vulnerability in the encryption algorithm.

Each step is crucial in developing a secure, compliant, and effective messaging solution. 

Take the next step with RST Software

Developing a HIPAA-compliant messaging app is a complex process that requires careful planning and execution. It requires expertise in both healthcare regulations and software development, and involves stakeholders from various departments, including IT, legal, and healthcare providers, to ensure the app meets all necessary requirements. 

As technology continues to evolve and security threats become an everyday challenge, HIPAA compliance plays an increasingly crucial role in protecting sensitive patient information. Contact us to schedule a consultation and start building your custom HIPAA-compliant messaging app with RST.

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