Group therapy practitioners should manage text threads to protect patient privacy and be compliant with HIPAA.
Organizations should obtain informed consent from all participants, limit the sharing of PHI, enforce confidentiality agreements, and implement strong access controls like multi-factor authentication.
Understanding HIPAA and text messaging
HIPAA sets strict rules for electronic communications involving PHI, including text messaging. The Privacy Rule mandates that any disclosure of PHI is limited to the minimum necessary information. The Security Rule requires safeguards like encryption to protect data. Standard text messaging apps, such as SMS or iMessage, do not offer the level of security needed to meet HIPAA standards. They lack encryption, secure storage, and access controls, which means using them for group therapy discussions can expose patient data to unauthorized access and result in HIPAA violations.
Read more: Is SMS messaging HIPAA compliant?
The importance of using HIPAA compliant messaging platforms
Healthcare providers must use HIPAA compliant messaging platforms that offer encryption and other safeguards to comply with HIPAA. Platforms like Paubox Texting are designed specifically for healthcare, with features such as encryption in transit and at rest, secure storage, access control, and audit trails.
At the ViVE 2024 conference, speakers discussed how “healthcare businesses plan to use texting for appointment reminders, sharing test results, prescription reminders, explanation of benefits (EOB) messages, care acknowledgments, and billing reminders.” It also allows group communication without risking PHI exposure, ensuring only authorized individuals can access sensitive information.
Best Practices
Obtain informed consent from group therapy participants
Each member must be aware of the potential risks involved in electronic communication and agree to participate. A HIPAA compliant consent form should clearly explain how information will be shared within the group, how it will be protected, and the risks of potential privacy breaches.
Limit PHI in group therapy text messages
When managing group therapy threads, limit the amount of PHI shared in messages. Avoid discussing detailed medical information or sensitive personal details. Instead, use the platform for logistical information, such as scheduling, reminders, or other administrative purposes. When PHI must be included, keep it minimal, anonymized where possible, and shared only on a secure platform.
Establish confidentiality guidelines for group participants
All participants should sign a confidentiality agreement, committing to not sharing the content of the messages with anyone outside the group. Regularly remind group members of their responsibility to maintain privacy.
Implementing secure access controls
HIPAA requires strict access controls to ensure that only authorized individuals can view or send messages containing PHI. Multi-factor authentication (MFA) and strong password policies help protect access to group messages. Additionally, messaging platforms should provide audit logs to track who accesses or sends information.
Manage the risk of information sharing
One of the biggest risks in group therapy text threads is the potential for participants to share messages outside the group. Restrict the ability to forward or share messages using the HIPAA compliant platform’s built-in security features. Encourage participants to avoid sharing or forwarding messages and educate them on the importance of confidentiality within group therapy.
Use business associate agreements (BAAs) with messaging vendors
If you are using a third-party messaging platform, sign a BAA with the vendor. The BAA ensures that the vendor complies with HIPAA requirements for protecting PHI. The agreement must be in place before using any third-party platform for group therapy communication.
Address patient communication preferences
Always offer participants the option to opt out of group text messaging if they are uncomfortable with it. Respect patient communication preferences and provide alternative methods, such as encrypted email platforms like Paubox, for those who prefer not to use text messaging.
FAQs
What should be done if a HIPAA breach occurs in a group therapy text thread?
If a breach occurs, healthcare providers must report it according to HIPAA's breach notification requirements, assess the scope of the breach, and implement corrective measures to prevent future incidents.
Can therapists use personal mobile devices for managing group therapy text threads?
Personal devices can be used if they are secured with encryption and strong passwords, and comply with organizational policies. The device must connect only to HIPAA compliant platforms and be updated regularly.
Liyanda Tembani
