Health Information Management

Security Q&A: EHR notes, encrypting email, and telehealth security

Briefings on HIPAA, October 1, 2016

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Q: Our clinic sends appointment reminders via text message to patients. Patients are given the option to specifically request this be done. They may do this by indicating a preference on the new patient paperwork, on the patient portal, or verbally requesting the change be made. The appointment reminders are not encrypted and include the date, time, and location of the appointment but not the patients' name. I'm concerned that some patients may not notify us immediately if they change their phone number or someone else may see the messages.


A: As long as the patient signed off on it and the risks associated with sending PHI via text message were communicated to patients, sending appointment reminders via text message would not be considered a HIPAA violation. This is similar to sending unencrypted email to patients. There's a better chance that someone other than the patient will hear the appointment reminder left on an answering machine than a text message sent to a phone number the patient is no longer using. In the end, if the patient signs up for texted appointment reminders, the patient accepts the risk if the wrong person reads the text message.

Editor's note

Chris Apgar is president of Apgar & Associates, LLC, in Portland, Oregon. He is also a BOH editorial advisory board member. This information does not constitute legal advice. Consult legal counsel for answers to specific privacy and security questions. Opinions expressed are that of the author and do not represent HCPro or ACDIS. Email your HIPAA questions to Associate Editor Nicole Votta at

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Briefings on HIPAA.

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