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Texting About Health: What Does HIPAA Say?

A new article in the American Journal of Public Health features work by NWCPHP researchers and collaborators exploring the legal and privacy considerations for using text messaging to distribute public health messages.

A new article in the American Journal of Public Health features work by NWCPHP researchers and collaborators exploring the legal and privacy considerations for using text messaging to distribute public health messages.

March 5, 2013

When is texting most appropriate and effective? How can health departments craft messages that avoid triggering the HIPAA Security Rule? What's involved in working with the texting vendors that move messages from databases to wireless telephone carriers?

In a recent American Journal of Public Health article, Hilary Karasz, Amy Eiden, and Sharon Bogan discuss the use of text messaging to distribute health messages, specifically looking at the effects of the Health Insurance Portability and Accountability Act (HIPAA) Security Rule, which protects the privacy of electronic health information.

“We know there is a need for a larger conversation about texting and HIPAA, and we’re pleased that the American Journal of Public Health was willing to give the issue national attention.” Karasz said of the recent publication. While there are numerous new technologies, Karasz and Bogan, who both work at Public Health - Seattle & King County in Seattle, Washington, are particularly excited about text messaging because it is an evidenced-based, low cost technology that is accessible and effective for the populations public health serves.

In the absence of clear federal guidelines on how the HIPAA Security Rule applies to text messaging, the team analyzed the potential risks involved in texting personal health information, and identified possible mitigation strategies. Part of their work involved conducting a pilot project in which parents were sent text messages to remind them about their child’s need for a second dose of flu vaccine. Pilot project and other findings are described in the American Journal of Public Health article.

The article represents collaboration between NWCPHP researchers, Public Health - Seattle & King County, and the King County Prosecuting Attorney's office. The project began in 2008 when the communications team at Public Health - Seattle & King County embarked on a five-year project to explore how to use text messaging to communicate important health information to targeted segments of the community.

Noting that no communication channel is 100% secure, Karasz advocates that “Text messaging is a viable option to consider, even when sending protected health information.” She adds, “Public health must continue to ensure that all communities have access to the health information they need by promoting technologies that can bridge communication gaps.”

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