Introduction

Healthcare teams text because it is fast. HIPAA exists because the wrong message in the wrong place becomes a breach.

This guide covers what “HIPAA-compliant messaging” actually means in practice, the security capabilities you should require, and a curated list of well-known products teams evaluate for secure clinical and patient communication.

Not legal advice. HIPAA compliance depends on how a tool is configured and how your organization uses it.

TL;DR

• Best for hospital-grade clinical collaboration: TigerConnect (secure text + clinical workflows, common in health systems).

• Best for patient texting that reduces phone tag: OhMD (patient communication and outreach focus).

• Best all-in-one for smaller practices: Spruce Health (voice, video, secure messaging in one hub).

• Best for secure texting plus alerting/escalation: OnPage (messaging with paging/incident style escalation).

• Best for care team secure chat option: QliqSOFT (QliqCHAT) (HIPAA secure texting positioning for care teams).

• Best “HIPAA-focused phone + texting” concept: iPlum (business line with HIPAA texting positioning).

What makes a messaging app HIPAA-compliant?

HIPAA is not a “badge” an app earns once. HIPAA compliance is a combination of:

1. Product capabilities (security features)

2. A signed Business Associate Agreement (BAA) when the vendor is a Business Associate

3. Your policies, training, configuration, and controls

4. Risk analysis and ongoing monitoring

HIPAA’s Security Rule requires covered entities and business associates to implement administrative, physical, and technical safeguards to protect electronic PHI (ePHI).

For messaging, that typically translates into requirements like:

• Access control, unique user IDs, role-based access

• Audit controls (logs)

• Transmission security (protect data in transit)

• Device controls (lock, wipe, prevent local PHI storage where possible)

And if something goes wrong, the HIPAA Breach Notification Rule dictates notification obligations depending on the incident.

Why standard texting (SMS) is usually a bad idea for PHI

Standard SMS and consumer messaging apps often fail the “messaging-grade” requirements healthcare needs because they commonly lack:

• Central admin controls (disable access instantly when staff leave)

• Auditable access logs

• Device-level protections and data retention controls

• Reliable identity and policy enforcement across staff devices

HIPAA-compliant platforms exist to reduce those risks with purpose-built safeguards.

A practical checklist for evaluating HIPAA-compliant messaging apps

Use this list in demos and security reviews.

1) Compliance basics

• BAA available (non-negotiable if the vendor touches ePHI)

• Clear data handling and subcontractor disclosures

• Documented security program and incident response

2) Security controls that matter in real life

• Encryption in transit and at rest

• Strong authentication (SSO/MFA options)

• Role-based access, groups, directory sync

• Remote wipe / MDM compatibility for BYOD

• Message expiration and retention controls

• Attachment controls (photos, files, screen captures)

• Admin ability to revoke access immediately

3) Auditability and accountability

• Audit logs for message events and access

• Exportable logs for compliance audits

• Read receipts and delivery confirmation (useful operationally, but not a compliance substitute)

4) Workflow fit

• Clinical team messaging vs patient texting are different products

• Escalation rules, on-call scheduling, routing

• Integration needs: EHR, directory, ticketing, call center, secure forms

The main categories of HIPAA-compliant messaging

A) Clinical team secure texting (staff-to-staff)

Best for nurses, providers, care coordinators, on-call, escalations.

Common must-haves: escalation, groups, roles, audit logs, directory, clinical context, on-call routing.

B) Patient communication (staff-to-patient)

Best for appointment coordination, intake, follow-ups, outreach campaigns, reducing inbound calls.

Common must-haves: consent workflows, templates, staff routing, attachments, secure links, patient identity controls.

C) Secure messaging plus alerting and escalation

Best for urgent communications, paging replacements, critical results, incident response.

Common must-haves: escalation policies, redundancy, priority alerts, delivery guarantees, on-call schedules.

Best HIPAA-compliant messaging apps to consider (with who they fit)

Below is a practical shortlist, not an attempt to name every tool on the market.

1) TigerConnect (clinical collaboration, hospitals)

TigerConnect positions its secure text messaging as HIPAA-compliant for healthcare teams and is commonly evaluated by larger organizations that need clinical collaboration features.
Best fit: hospitals, health systems, multi-department clinical messaging
Watch for: implementation complexity and integration requirements in larger environments

2) OhMD (patient texting and engagement)

OhMD positions itself as HIPAA-compliant patient communication software designed to reduce patient call volume and enable texting workflows.
Best fit: clinics and practices prioritizing staff-to-patient texting
Watch for: whether it covers all internal team collaboration needs, or if you still need a staff secure chat tool

3) Spruce Health (all-in-one for practices)

Spruce positions as a communication hub for practices, typically spanning secure messaging plus voice/video and patient communication features.
Best fit: small to mid-sized practices wanting fewer tools
Watch for: how it handles multi-location routing, permissions, and retention if you scale

4) QliqSOFT (QliqCHAT) (secure texting for care teams)

QliqSOFT markets QliqCHAT as a HIPAA-compliant secure texting solution for healthcare.
Best fit: care team messaging where secure texting is the core requirement
Watch for: integration depth depending on your workflows

5) OnPage (secure messaging plus alerting)

OnPage publishes guidance and positions its solution around HIPAA-compliant messaging plus alerting and escalation.
Best fit: urgent messaging and escalation-heavy environments (critical results, on-call)
Watch for: whether your org needs a full clinical collaboration suite versus alert-first messaging

6) iPlum (HIPAA-focused texting/phone line concept)

iPlum positions a “business phone” style product with HIPAA-compliant texting/calling claims and guidance content.
Best fit: small practices that want a separate work line plus texting
Watch for: ensure you validate BAA availability and admin/audit controls for your risk profile

Quick comparison table (use this in your internal review)

Use the table to pick the category first, then choose a vendor.

Common “gotchas” that create HIPAA risk even with the right app

1. No BAA (or the wrong entity signs it)

2. Staff use personal accounts instead of managed identities

3. PHI leaks via screenshots, photo roll, or file downloads

4. No offboarding process (ex-staff still have access)

5. No retention policy (messages linger forever without governance)

6. No audit review (logs exist but nobody looks)

HIPAA is as much operations as it is software. The Security Rule focuses on safeguards and “reasonable and appropriate” implementation, not branding.

How Tadabase fits (without replacing your messaging vendor)

Most teams do not need a single “everything app.” They need:

• A HIPAA-appropriate messaging tool for PHI communication

• Plus a secure operations layer around it (intake, permissions, tracking, audits, workflows)

With Tadabase, you can build the operational workflows and portals that surround messaging, for example:

• Patient intake forms and routing

• Staff directories and role-based portals

• “Message request” queues that trigger tasks and alerts

• Audit-ready workflow logs and approvals

• Integrations that connect messaging events to your internal tools

In other words: use a purpose-built HIPAA messaging vendor for the messaging channel, and use Tadabase to own the workflows, data model, and portals around it.

Frequently asked questions

What messaging apps are HIPAA-compliant?

Apps can support HIPAA-compliant use when they offer the necessary safeguards, you sign a BAA where required, and you configure and govern usage correctly. HIPAA’s Security Rule is about safeguards for ePHI.

Is iMessage or WhatsApp HIPAA-compliant?

In most healthcare environments, consumer apps are not treated as HIPAA-compliant messaging for PHI because you typically lack the required administrative controls, auditability, and BAA relationships. Validate with your compliance and security team.

Can we text patients appointment reminders?

Many organizations do, but you still need policies, consent where appropriate, and you should avoid including unnecessary PHI. Your compliance team should define what is permitted.

Do we need secure messaging if we already have an EHR portal?

Portals are great for documents and formal messages. Secure texting tools are usually about speed, coordination, and reducing phone calls. Many orgs use both.

What should I ask vendors on the first call?

• Do you sign a BAA?

• What are your access controls, audit logs, retention options, and device controls?

• Do you support SSO/MFA?

• Where is data stored and how is it encrypted?

• How do you handle offboarding and remote wipe?

• What integrations exist for our workflows?

Conclusion

Pick your category first (clinical collaboration, patient communication, or alerting). Then buy the messaging tool that fits that job best. Finally, make sure your security configuration, offboarding, and retention policies are real, enforced, and audited.