How to choose HIPAA Сompliant chat API and SDK for your application

How to choose HIPAA Сompliant chat API and SDK for your application

Key takeaways

  • Find out first market leaders with over $525 mln investments in total that comply with rules allowing covered entities to implement technologies properly.

  • Read on HIPAA regulations for providers involved in the healthcare process and similar using sensitive information about individuals.

  • Must-have communication features went beyond familiar messaging capabilities long ago; however, they are based on essential and daily needs and habits of digital era users.

  • Know five technical safeguards defining standards for software solutions, which provide a secure channel for virtual patient-doctor interaction with HIPAA compliant chat API and SDK.

  • Discover the best practices from Aimprosoft to avoid public penalties for violations from regulatory institutions.

In the early of 2021, M.D. Anderson Cancer Center had to break up with $4.3 million in civil penalties for three data breaches experienced eight years ago. It paid for a data breach affecting 35,000 people.

Are you ready to pay even $20,000 for a violation?

If not, keep on reading to know more about developing a HIPAA compliant application with a communication focus, features for text, voice, and video messaging apps, top APIs, and SDKs.

What is HIPAA compliance?

The Health Insurance Portability and Accountability Act (HIPAA) is a USA federal law of 1996 that sets out rules for sharing personal health information and protecting it from unauthorized use. It applies to the collection of personal healthcare information (PHI), paper and electronic records, in hospitals, doctors’ offices, and now via digital channels where health services are provided, as well as in businesses that help service providers manage and store data.

HIPAA is based on two essential ideas in patient care: privacy and confidentiality.

What is PHI?

PHI, or ePHI for electronically processed records, relates to an individual personal data, which under HIPAA means protected health information. It must include one of 18 identifiers (names, dates, biometrics, accounts, billing and insurance information, etc.) that are considered as a subject to the protection under the HIPAA Privacy Rule. Otherwise, the information is de-identified if it doesn’t have any identifiers from the list.

Only when personally identifiable information is connected with medical data that medical data become PHI. Usually, this data makes up comprehensive patient profiles in medical CRM.

When your app must be HIPAA compliant

When you develop a medical mobile app related to the healthcare or telemedicine services, you must take precautions to keep personal data safe—all covered entities or business associates that handle personal health information fall under HIPAA regulations.

How to understand whether you fall under HIPAA rules?

Suppose your covered entity is identified as a healthcare provider, healthcare clearinghouse, or healthcare plan. In that case, you must be HIPAA compliant in your activity, including all software applications you use and are going to use or develop too.

Business associates that process, store, collect, or transmit personal data have to comply with HIPAA as well.

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According to Office for Civil Rights (OCR) there are the following entities:

Who must comply with HIPAA

Covered entities Examples
Healthcare providers
  • clinics, hospitals, nursing homes, pharmacies
  • physicians, chiropractors, psychologists, dentists
Health care clearinghouses
  • repricing companies, billing services, community health management information systems etc.
Health plans
  • health maintenance organizations, health insurance companies, company health plans, health care programs (military and veterans), Medicare, Medicaid
Business associates
  • accounting companies, law offices, medical billing and transcription services, IT vendors, etc.
HIPAA compliant entities are divided into four categories
Image 1. Entities that must comply with HIPAA regulations

However, if an application similar to MyFitnessPal calculates and tracks calories without personal identifiers, it is not going to fall under HIPAA as well as an app MyTherapy that is a pill reminder for patients who want to schedule a medication taking. Same can’t be said when you develop a medical mobile app.

Must-have features for HIPAA compliant text messaging

All app features of health care specialty are designed to enable communication between patients and medical service providers, doctor-to-doctor, or lab-to-doctor/patient, etc. In addition to being secure, communication should be comfortable.

Feature Value
Text chats
  • person-to-person chats are good for consultation to make diagnosis between physician and patient
  • group messaging is used for cross-clinical communication
Saved chat history Messages with the full context should be available for both participants of the chat at any time to revise prescription, recommendations, or any issues related to health care. It is better to add an option to edit or delete the message with notification about changes.
Notifications They help in urgent communication, which ‘patient-to-doctor’ is, informing about an expected message delivery not to miss something vital.
User status and typing indications Both features help, first of all, a patient be sure that help is on the way and show the availability of both conversation participants to communicate online.
Synchronization Messaging sync allows patients and health care professionals to seamlessly switch between devices keeping conversation on during the day.
Media and images Chats enriched with images, audio, and video messaging options help make virtual chatting between patients and healthcare providers very close to in-person appointments.

Must-have features for HIPAA compliant voice and video calling

To ensure communication with secure PHI transmission, non-public facing video conferencing apps are not enough for purposes other than originally intended by healthcare. All HIPAA-compliant video conferencing API meet security rule standards, which is reflected in the feature set.

Feature Value
Live streaming Video calling makes virtual diagnostics more precise and effective because it is possible to screen patients’ body language cues and physician facial expressions.
Group chats A text messaging and videoconferencing option provides a worthwhile discussion in real-time for patients and medical care groups where all participants can share during their session photos of symptoms, receipts, CT scans, laboratory test results.
Screen recording Recording is useful as a fallback option when patients need to go over again the prescription or exercises. Doctors can refer to the consultation record for some specifications that can turn out highly vital to a patient’s life.
Screen sharing A screen-sharing feature improves collaboration of the patient’s care team engaging all necessary professionals in real-time. Security is guaranteed by HIPAA-compliant chat SDK because only shared commands are transmitted.
Voice and video chat In-app voice and video give the “being there” experience that is of utter importance for patients and healthcare providers to sustain a familiar one-on-one appointment.

How to choose HIPAA compliant chat API and SDK?

Looking for API and SDK as well as when you make a hospital management software, it is worth paying attention to HIPAA Security Standards which stand guard over compliance of rules to protect national personal health information in times of rapid technology advances in the industry.

We streamlined a clinical collaboration in one of the US hospitals with an electronic health records system.

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Why address HIPAA technical safeguards

Choosing HIPAA compliant messaging API, proceed from five main technical safeguards provided by the Security Rule.

  1. Access Control. Software solutions have to be developed in that way to limit access to electronic protected health information for those different to persons or software programs granted to do so.

  2. Audit Controls. It goes for a control over any record modifications that may occur in the software application. Technical infrastructure should have audit control capabilities to ensure safety space.

  3. Integrity Controls. Healthcare requires strong protection of ePHI integrity within technical sources, too, which can be provided by developing secure data transmission channels with End-to-End Encryption SDK, for example.

  4. Person or Entity Authentication. A proof of identity for access-allowed users or software of ePHI should be achieved by unique identifiers such as PIN code, a login-password pair, biometrics, smart card, token or any other authentication method.

  5. Transmission Security. Network communications protocols, data, or message authentication codes help keep the data ‘sent-received’ integrity (Integrity Controls) there. Compatible technology between sender and receiver, such as HTTPS communication protocol, is widely used to encrypt data with SSL/TLS (Encryption).

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Apart from the above mentioned points, take into account the following aspects:

  • Claiming about being HIPAA compliant makes a tool shortlisted for your application development.

  • It is worth paying attention that transmitted text, video, and audio records should be stored in the protected separated facility.

  • Encryption and decryption algorithms are advisable in cases when transmitted information goes beyond the internal server.

  • Vendors dealing with ePHI have to sign a Business Associate Agreement (BAA) with covered entities to regulate their actions regarding data security compliance.

Top 3 HIPAA compliant APIs and SDKs for messaging and video conferencing

There’s no reason why seeing a doctor virtually should be less comfortable and confidential. Below, three market players can make an appropriate atmosphere for all stakeholders.

Twilio

Overview. Twilio is a cloud communications platform that helps developers build and scale the interactions through the most demanded communications channels: SMS, email, chat, VoIP, voice, and video. Businesses can have calls recorded, routed, scripted, tagged. Its audio and video conferencing features are widely used in apps that process sensitive information.

Twilio provides a chat API for most demanded messaging ways
Image 2. Twilio takes the lead in video conferencing software in 2021

HIPAA. In 2020 Twilio joined the ranks of trusted partners for healthcare and telehealth driven by the COVID-19 changes affecting the world. HIPAA Eligible Products and Services include Programmable SMS, Video, Voice and SIP, and Runtime Tools that comply with the Security Rule. It offers a BAA and calls to share responsibility following Twilio’s recommendations about HIPAA.

Price. They offer a ‘Pay-as-you-go’ pricing model, get a discount for the service volume, and have no free version. You can try it with a free trial with full API access. Programmable Voice will cost you from $0.0085/min incoming and $0.013/min outcoming. Chat conversations start at $0.05/user/month.

Best for companies of any size which are eager to build overwhelming real-time customer communications across channels.

Customers: CipherHealth, TeleClinic, MDLIVE.

PubNub

Overview. PubNub is a real-time in-app chat and communication platform recognized by API World as the Best Communications API in 2020. PubNub’s SDKs are available for every programming language to enable two-way communication. Proactive chat, one-on-one chat, group chats, community chat streams, AI-driven chatbots, typing indicators, messages history, push notifications, analytics, reporting, and more features make it a choice for medical use.

PubNub is a real-time in-app chat and communication platform for messaging and video conferencing
Image 3. PubNub, a Series D-funded provider of telemedicine solutions with HIPAA compliant APIs and SDKs

HIPAA. The platform announced its full compliance with the regulations in 2015, allowing healthcare stakeholders to send ePHI through a secure network. They manage permission to the real-time data using AES and TLS/SSL encryption standards.

Price. You won’t be charged for a basic limited package for POC (proof of concept) with 200 testing monthly active users; however, the starter plan costs $49/month with MAUs. Those, who require special treatment for their use cases, can get a Pro plan with prices that have to be discussed privately.

Best for businesses with a need to develop or upgrade their existing real-time functionality, high-performance requirements, and flexibility in integration with custom applications.

Customers: MedX, NurseGrid, Babylon Health.

SendBird

Overview. SendBird is a messaging platform that supports video and voice calls available for web and mobile usage. An available HIPAA compliant messaging SDK makes it the perfect solution for a data protection-dependent healthcare industry. Users can experience one-on-one and group messaging, audio and video chats, conversational bots, media file transfer, typing indicators, notifications, and other features.

SendBird is a platform with HIPAA compliant SDK for video conferencing
Image 4. SendBird was picked by Steadfast Financial to get $100 mln in Series C

HIPAA. SendBird claims to provide secure in-app chat and HIPAA compliant texting messaging API documenting the policies for reporting breaches, monitoring, assessing risk.

Price. It offers several subscription plans with a free trial. This price starts from $799/month for a chat set and $1/1000 users in a peer-to-peer voice model, and $1,4/1000 users for video calls.

Best for all covered entities under HIPAA Security Rule to safely send PHI in a text, audio, or video format. SendBird complies with the HHS guidelines by HITECH having organizational, administrative, technical, and physical safeguards that are required also if you develop an EHR.

Customers: Teladoc, Careem, Docplanner.

Our experience in app development using HIPAA compliant messaging and video conferencing API and SDK

Being engaged in several app development solutions including healthcare DMS, pharmaceutical DMS, text messaging, video conferencing apps and other sensitive cases under NDA, Aimprosoft can’t reveal the names, but we can share some best practices.

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  1. One of the best practices to protect data against potential vulnerabilities in the sandbox is SQLite Database Encryption Modules for databases.

  2. We recommend protecting sensitive information with file-level encryption that has been used in multiple platforms cases.

  3. Keep your eye on the ball of the cryptography novelties. AES with 512-bit encryption, SHA-256, as well as 256-bit encryption, is efficient to make your app’s hashing secured.

  4. An SSL or VPN protocol is necessary to prevent data-in-transit from data leaks and theft while data transitions from the client to the server.

  5. Take the authentication concerns seriously, developing the apps with strong requirements for alphanumeric passwords, biometrics, retina scan and more to avoid security breaches.

  6. Aimprosoft’s developers build apps with limited access to the storing data, or if there is no other option apart from local memory storage, we use encrypted data containers, keychain, or add the auto-delete feature.

  7. We were quite satisfied with Twilio and PubNub APIs and SDKs developing HIPAA compliant apps for healthcare and pharmaceutical inquiries. You can rely on them for your use cases.

Every case is unique, demanding a single approach. For this reason, Aimprosoft experiences developing custom chat API to deliver text and other records under HIPAA.

Conclusion

While your software app might conform with the country laws of your target market, many security layers have to be worked out within the organization that is going to use your app. Finding APIs or SDKs on the market isn’t tough, moreover a software vendor can develop a custom one. There is still uncertainty with HIPAA compliant SMS API because in the epoch of messaging platforms development, there is a recession of SMS as a communication means, especially for transmission of confidential information. Contact us to discuss with our Technical Lead how to make a HIPAA compliant chat.

Before you go, check out our FAQ to get extra info to complete the picture.

FAQ

What are the benefits of HIPAA compliance?
HIPAA compliant apps are in high demand because they accelerate the communications cycle, workflows, and staff productivity resulting in overall patient satisfaction. Secure solutions become a choice for many healthcare entities faster, delivering extra value.
What are the requirements for secure SDK?
Some libraries and frameworks collect and store data for authorization on their servers. SDK doesn’t have to share data outside or be applied for analytics use. Secure HIPAA chat SDK has to be one-way to enable the web client to interact with it but prevent sending information to the third parties and saving to the sources accessed by third parties.
Is an SMS channel secure for communication with PHI?
That is the fact, everyone uses mobile Internet and Wi-Fi for communication and despite an opening 99% ratio of SMS messages this way of communication becomes the past particularly through the obstacles to find HIPAA compliant SMS API providers.