Communication Platforms & HIPAA: Best Choices & Key Requirements

Choosing the right communication platform can make or break your HIPAA compliance. With sensitive data traveling across chat, video, and file-sharing systems, healthcare organizations must be vigilant. The rules for HIPAA-compliant messaging aren’t just about choosing a popular tool—they’re about meeting strict legal and technical standards that protect patient privacy at every step.

Understanding what makes a platform truly secure for protected health information (PHI) is essential. From robust encryption protocols and multi-factor authentication (MFA) to signed Business Associate Agreements (BAAs) and audit trails, every element matters. We’ll break down these key requirements and show you how to evaluate solutions for security, archiving, and real-world telehealth messaging.

We know how overwhelming it can feel to navigate all the jargon and legalities. That’s why our guide goes beyond buzzwords, helping you spot the must-have features—like eDiscovery, retention policies, and PHI handling in chat—that keep you compliant and your patients’ data safe. Let’s dive in and find the platforms that meet both your workflow needs and HIPAA’s strict demands.

Security criteria and due diligence

When selecting a communication platform for healthcare, security isn’t optional—it’s a legal obligation. We need to go beyond marketing claims and perform rigorous due diligence to ensure true HIPAA compliance. Here’s what to look for and why each element matters:

• Business Associate Agreement (BAA): Before you ever send PHI in chat or through telehealth messaging, confirm the provider will sign a BAA. This contract legally binds the vendor to safeguard health information and outlines each party’s responsibilities.
• Encryption: Data encryption should be enforced both in transit and at rest. This means messages and files remain unreadable to unauthorized parties—even if intercepted. End-to-end encryption is ideal for the highest level of protection.
• Multi-Factor Authentication (MFA): Requiring more than just a password to access PHI in chat or video platforms drastically reduces the risk of unauthorized access. MFA adds a critical layer of security, especially with remote or hybrid teams.
• Audit Trail: Every access, edit, and transmission of PHI needs to be logged. A robust audit trail makes it possible to monitor user activity, detect potential breaches, and support investigations if a security incident occurs.
• Archiving and eDiscovery: The platform should support secure archiving of all communications, including telehealth messaging and file transfers. This is essential for compliance, legal discovery, and internal reviews. Effective eDiscovery tools enable quick retrieval of relevant records without compromising privacy.
• Retention Policy Controls: Can you define how long PHI in chat, calls, or shared files is stored? Make sure the platform allows customizable retention policies, so you don’t keep sensitive data longer than regulatory requirements—or your organization's risk threshold.

Vetting platforms for these criteria is a non-negotiable. Start by requesting detailed security documentation from potential vendors. Ask for proof of HIPAA-compliance certifications, penetration testing results, and real-world case studies. If a platform is vague about any of these elements, consider it a red flag.

Remember, telehealth messaging and other digital communications are only as secure as the platform you build them on. Conducting due diligence now prevents costly HIPAA violations—and protects both your practice and your patients’ trust.

BAA essentials and vendor vetting

Business Associate Agreements (BAAs) are the foundation of HIPAA-compliant messaging. When we choose a vendor to handle protected health information (PHI)—whether in chat, telehealth messaging, or file sharing—a signed BAA is non-negotiable. This legal contract ensures the vendor recognizes their responsibilities under HIPAA and explicitly commits to safeguarding PHI in every interaction.

But a BAA alone isn’t enough. True compliance requires thorough vendor vetting. We must look beyond marketing promises and dig deep into the technical controls and operational practices of each platform. Here’s a practical approach to vetting communication vendors for HIPAA compliance:

• Confirm BAA Willingness: Not all platforms offer BAAs. Make sure the vendor is ready to sign one that covers all features you'll use, especially if PHI will be present in chat, telehealth messaging, or video.
• Assess Encryption Standards: Ask about end-to-end encryption for data in transit and at rest. This protects PHI from interception and unauthorized access, which is vital for both real-time and archived messages.
• Check for Multi-Factor Authentication (MFA): MFA is a must-have. It adds a critical extra layer of security, making it much harder for unauthorized users to access sensitive data—even if passwords are compromised.
• Evaluate Archiving and Retention Policies: Ensure the platform allows custom retention policies that align with your organization’s needs and HIPAA’s requirements. Proper archiving supports eDiscovery, compliance audits, and legal hold scenarios.
• Demand Robust Audit Trails: The ability to track who accessed or modified PHI in chat or telehealth messaging is essential. Look for detailed, immutable logs that make compliance reviews straightforward and defensible.
• Review eDiscovery Capabilities: Your chosen platform should make it easy to search, retrieve, and export PHI-related messages and attachments for legal or compliance purposes.

We recommend documenting your vetting process for every vendor you consider. Keep records of your due diligence—ask for security whitepapers, compliance attestations, and references from other healthcare clients. This not only makes internal audits smoother but also demonstrates your commitment to HIPAA compliance if regulators ever come knocking.

Remember, HIPAA-compliant messaging depends on more than just technology—it’s about trust, transparency, and diligence. By thoroughly vetting vendors and securing strong BAAs, we set the stage for secure, compliant communication that keeps patient data protected, no matter where or how it’s shared.

Encryption (E2E vs TLS)

Encryption (E2E vs TLS)

When it comes to HIPAA-compliant messaging, encryption isn’t just a buzzword—it’s a foundational requirement. Encryption ensures that protected health information (PHI) remains confidential, even if data is intercepted during transmission or compromised at rest. But not all encryption is created equal. The two most common types you'll see are end-to-end encryption (E2E) and transport layer security (TLS). Understanding the difference is critical for compliance and patient safety.

End-to-End Encryption (E2E) means that messages are encrypted on the sender’s device and only decrypted on the recipient’s device. No intermediary—including the platform provider—can access the message content. This offers the highest level of privacy for PHI in chat, as data is protected every step of the way. For organizations handling highly sensitive information or offering telehealth messaging, E2E is the gold standard. However, there’s a catch: E2E can complicate compliance with retention policy, archiving, eDiscovery, and audit trail requirements, since the provider can’t access or search message contents for legal or operational needs.

Transport Layer Security (TLS) encrypts data while it’s in transit between devices and servers. Once the data reaches the server, it’s decrypted—for example, to allow search, archiving, or integration with other tools. TLS is widely adopted and can meet HIPAA’s encryption standard if supported by strong access controls, MFA (multi-factor authentication), and proper server-side protections. It’s often preferred by organizations that need robust compliance features like archiving, eDiscovery, and real-time monitoring.

• E2E Encryption
  • Best for: Absolute privacy, highly sensitive PHI, secure telehealth messaging.
  • Challenges: Can hinder archiving, retention policy enforcement, audit trail, and eDiscovery.
• TLS Encryption
  • Best for: Flexible compliance, archiving, legal holds, and integration with compliance tools.
  • Challenges: Data is accessible to the provider/server, making strict access management and BAAs essential.

Making the right choice depends on your organization’s needs. If you require airtight privacy for patient consultations, look for platforms offering E2E. If you’re more concerned with compliance features like retention, archiving, and legal discovery, a robust TLS solution—backed by a signed business associate agreement (BAA) and strict security controls—might be the better fit. Always confirm that your chosen platform’s encryption meets HIPAA’s specifications and supports your overall compliance program.

Identity management and MFA

Identity management and multi-factor authentication (MFA) are critical pillars for HIPAA-compliant messaging. When it comes to protecting PHI in chat, file sharing, or telehealth messaging, verifying the right people have access—at the right time and for the right reasons—cannot be left to chance.

Effective identity management isn’t just about assigning usernames and passwords. It’s about controlling and monitoring user access throughout the lifecycle of every account. Each individual—whether a clinician, administrative staff, or IT support—must have the minimum necessary access to PHI based on their role. This principle of least privilege dramatically reduces the risk of accidental or malicious exposure.

MFA adds a crucial security layer beyond simple passwords. With MFA, users must provide multiple forms of verification—such as a code sent to their phone or a secure authentication app—before accessing sensitive systems. This extra step makes it much harder for unauthorized users to gain entry, even if passwords are compromised. In the context of telehealth messaging or any platform handling PHI, MFA can be the difference between a foiled breach and a costly HIPAA violation.

For compliance, here’s what to look for in identity management and MFA features:

• Integration with your existing directory services (like Microsoft Active Directory or Google Workspace) for streamlined onboarding and offboarding.
• Granular role-based access controls to tightly govern who can view, send, or archive PHI in chat and other communication channels.
• Configurable MFA requirements—such as SMS codes, push notifications, or hardware tokens—for all users, not just administrators.
• Real-time audit trails that log every access attempt, successful login, and permission change, making eDiscovery and compliance audits far more straightforward.
• Automated deprovisioning to rapidly revoke access for departing employees or third parties covered under your BAA.

Don’t forget: Identity management and MFA are not “set and forget” tools. We recommend reviewing user permissions regularly and testing your MFA process so that every layer of protection works when it’s needed most. This proactive approach, combined with encryption, archiving, and retention policy controls, helps create a robust, HIPAA-compliant messaging environment where PHI is always safeguarded.

Retention and archiving policies

Retention and archiving policies are at the heart of HIPAA-compliant messaging. When you’re dealing with PHI in chat, telehealth messaging, or digital file exchange, it’s not just about securing the data in the moment—it’s about ensuring it’s available, traceable, and protected for as long as regulations require. Let’s break down what you need to know to get this right.

Why do retention and archiving matter? HIPAA mandates that covered entities and business associates maintain certain records—often for at least six years from the date of creation or last use. This goes beyond basic backups. It means healthcare organizations must be able to retrieve past messages, audit communications, and demonstrate compliance if asked. If a message containing PHI is deleted prematurely, or if the audit trail is incomplete, it poses significant legal and operational risks.

Key requirements for HIPAA-compliant retention and archiving:

• Retention policy configuration: Platforms should allow you to set custom retention periods that align with your organization’s policies and HIPAA rules. This ensures PHI in chat and telehealth messaging is neither deleted too early nor held unnecessarily long.
• End-to-end archiving: All communications—messages, attachments, audit trail logs—must be archived in a way that maintains their integrity and accessibility. This supports eDiscovery and compliance audits.
• Searchability and eDiscovery support: Effective archiving means you can quickly locate specific messages or records when needed, whether for legal discovery, internal investigation, or patient requests.
• Strong encryption at rest and in transit: Archived messages should always be protected using robust encryption. This prevents unauthorized access, even as data ages in storage.
• Immutable audit trail: The platform must preserve an unalterable record of message activity—who sent what and when, edits, deletions, and access events. This audit trail is crucial for demonstrating compliance and investigating incidents.
• Business Associate Agreement (BAA): Your platform provider must sign a BAA, affirming their commitment to maintain, retain, and protect PHI in line with HIPAA standards—including how archived data is handled.
• Secure deletion processes: When the retention period ends, platforms should use secure, auditable deletion methods to ensure PHI is disposed of properly and irretrievably.

Practical tips for healthcare teams:

• Regularly review your retention policy and adjust as regulations or organizational needs evolve.
• Test your archiving and eDiscovery features before you need them in a real-world scenario.
• Train staff on what types of PHI can legally be stored or discussed in chat and telehealth messaging tools.
• Check that multifactor authentication (MFA) is enforced not just for live chats, but also for accessing archived records.

By implementing rigorous retention and archiving policies—and choosing platforms that support them—you’re not only meeting HIPAA’s requirements, but also building a foundation of trust with your patients and partners. Smart archiving is protection, preparedness, and peace of mind rolled into one.

Audit logging and eDiscovery

Audit logging and eDiscovery are foundational elements of any HIPAA-compliant messaging platform. These features not only support regulatory requirements but also empower organizations to detect, investigate, and resolve incidents involving protected health information (PHI) in chat and telehealth messaging environments.

Audit trails create a detailed and tamper-evident record of user activity. This includes who accessed PHI, what actions were taken (viewed, edited, deleted), and when these actions occurred. A robust audit trail allows compliance teams to reconstruct events, answer questions from regulators, and reassure patients about the safety of their data. Any platform you consider must provide comprehensive logging across all channels—messaging, file sharing, and even video communications.

eDiscovery is the process of identifying, preserving, searching, and retrieving electronic information for legal or compliance reasons. In the healthcare context, this often means quickly finding specific chat messages, files, or telehealth session records that contain PHI. Effective eDiscovery tools streamline legal holds, internal investigations, and responses to audits, reducing the risk of HIPAA violations and costly penalties.

• Retention policy enforcement: The right platform lets you define how long messages and files are stored, automatically archiving or purging data as required by your compliance plan. This ensures you keep information only as long as necessary, reducing exposure and meeting HIPAA’s minimum necessary standard.
• Access controls: Audit logs should be protected with strict access controls and encryption, ensuring that only authorized personnel can review sensitive activity data.
• Immutable logs: The audit trail must be tamper-resistant. Look for solutions that guarantee logs can’t be altered or deleted without detection—this is critical if you’re ever required to prove the integrity of your records during eDiscovery or an audit.
• Granular search capabilities: eDiscovery tools should allow you to search by user, date, keyword, or type of PHI, making it fast and easy to locate relevant data across your telehealth messaging system.

To achieve true HIPAA-compliant messaging, ensure your communication platform is willing to sign a Business Associate Agreement (BAA) that explicitly covers audit logging, data retention, and eDiscovery functions. Combined with strong encryption, multi-factor authentication (MFA), and archiving, these features provide the transparency and control required to protect PHI in today’s digital healthcare landscape.

Proactive management of audit trails and eDiscovery isn’t just about compliance—it’s about building trust with your patients and demonstrating your commitment to safeguarding their most sensitive information.

PHI handling in telehealth

PHI handling in telehealth demands a higher standard of security and attention than ever before. As telehealth messaging becomes a cornerstone of patient care, we must ensure every interaction involving protected health information (PHI) is airtight in both compliance and privacy. Here’s what every healthcare provider and administrator should know—and put into practice—when handling PHI on communication platforms:

• Only use HIPAA-compliant messaging solutions. Not all chat or video tools are created equal. The solution must explicitly support HIPAA-compliant messaging and be willing to sign a Business Associate Agreement (BAA). This contract is non-negotiable—it formalizes the vendor’s responsibility to safeguard PHI.
• End-to-end encryption is essential. All telehealth messaging, whether in chat, video, or file sharing, must use strong encryption. This protects PHI from interception both in transit and at rest. Look for platforms that default to high-level encryption, and confirm their certification.
• Multi-factor authentication (MFA) adds a vital security layer. Enabling MFA for both patients and providers helps prevent unauthorized access, even if passwords are compromised. This is a simple but powerful step to combat common threats.
• Keep a complete audit trail of all interactions involving PHI. A robust audit trail logs who accessed what, when, and how. This becomes invaluable in monitoring security, supporting eDiscovery, and responding to potential incidents.
• Implement message archiving and eDiscovery capabilities. Telehealth platforms should allow for secure message archiving that meets HIPAA’s requirements. This supports both legal compliance and clinical continuity, making it easier to retrieve data for audits or investigations.
• Clearly define and enforce a retention policy. Decide how long you’ll keep PHI in chat or telehealth sessions, and ensure your platform automatically adheres to this schedule. Deleting data too soon—or keeping it too long—can both put you at risk.
• Train all users on PHI handling in telehealth messaging. Even the best technology won’t prevent a breach if users aren’t careful. Regularly educate staff on how to identify PHI, what’s appropriate to share in chat, and the steps to take if something goes wrong.

By integrating these practices, we create an environment where telehealth messaging is not only convenient, but also fully aligned with HIPAA’s strict requirements. Every message, file, or chat containing PHI must be treated with the highest level of security and accountability. Choosing a platform with the right safeguards, supported by clear policies and continual user training, keeps patient trust—and your organization’s reputation—intact.

Top Platforms

When evaluating communication platforms for HIPAA compliance, it’s not enough to look at brand reputation or user-friendly features. We must dig into how each platform addresses the specific requirements for handling protected health information (PHI). Below, we’ll break down the leading options and what sets them apart for healthcare organizations.

• Microsoft Teams

Microsoft Teams is a robust solution for organizations that need integrated chat, voice, video, and file-sharing. Its HIPAA-compliant messaging capabilities hinge on Microsoft’s willingness to sign a Business Associate Agreement (BAA), a critical requirement for any vendor handling PHI. Teams leverages end-to-end encryption, supports multi-factor authentication (MFA), and offers comprehensive archiving and eDiscovery tools for monitoring and retrieving PHI in chat. Detailed audit trails bolster accountability, and customizable retention policies ensure that sensitive data is preserved or deleted in line with legal mandates. For telehealth messaging, Teams integrates with scheduling and clinical tools, providing a seamless workflow for providers and patients.

Zoom for Healthcare

Zoom’s specialized healthcare platform is designed with compliance at its core. By executing a BAA with Zoom, organizations unlock features like encrypted video and chat, secure file transfer, and strong MFA options. The platform supports telehealth messaging with real-time chat and video, and all interactions are logged for archiving and eDiscovery. Zoom’s audit trail functionality allows administrators to review every interaction involving PHI, while customizable retention policies help manage data lifecycle according to HIPAA standards.

Google Meet (Google Workspace)

For organizations operating in Google’s ecosystem, Google Meet—when used with Google Workspace—can be a secure choice. Google provides a BAA for Workspace users, activating encryption for data in transit and at rest, and enabling MFA for user access. Archiving and eDiscovery are handled through Google Vault, while every message containing PHI in chat is traceable via a robust audit trail. With clear retention policies, organizations gain granular control over how long data is stored. For telehealth messaging, Meet’s secure video and chat features help maintain privacy and compliance.

Slack Enterprise Grid

While standard Slack isn’t HIPAA compliant, the Enterprise Grid version can be configured for compliance. Slack will sign a BAA for Enterprise Grid customers, activating necessary encryption, MFA, and advanced archiving features. eDiscovery and audit trail tools allow organizations to track and retrieve any PHI in chat, while custom retention policies help ensure messages and files follow compliance rules. Slack can also be used for telehealth messaging with additional integrations, provided usage policies strictly prevent the sharing of PHI outside approved channels.

Doxy.me

Doxy.me is purpose-built for healthcare and telehealth messaging. The platform signs a BAA with all providers, supports end-to-end encryption for calls and messages, and employs MFA to secure user accounts. Every session is logged, creating a transparent audit trail, and the platform offers tailored archiving and retention policy settings to meet HIPAA requirements. Its simple interface makes it easy for patients and providers alike to securely exchange PHI in chat or video.

Each of these platforms takes a slightly different approach to HIPAA-compliant messaging, but all address the core requirements: signed BAAs, strong encryption, MFA, archiving, eDiscovery, audit trails, and data retention controls.

Choosing the right communication platform can make or break your HIPAA compliance. With sensitive data traveling across chat, video, and file-sharing systems, healthcare organizations must be vigilant. The rules for HIPAA-compliant messaging aren’t just about choosing a popular tool—they’re about meeting strict legal and technical standards that protect patient privacy at every step.

Understanding what makes a platform truly secure for protected health information (PHI) is essential. Look for solutions that offer robust encryption, enforce multi-factor authentication (MFA), and clearly provide a Business Associate Agreement (BAA). Without a signed BAA, even the most feature-rich platform simply isn’t safe for PHI in chat or telehealth messaging.

Don’t overlook the importance of compliance features like archiving, eDiscovery, and audit trails. These features ensure every message, file, and conversation is properly tracked, logged, and retrievable—meeting both legal requirements and operational needs. Setting a strong retention policy not only supports compliance but also streamlines data management for your team.

Ultimately, HIPAA compliance is about more than checking boxes; it’s about building trust. By prioritizing secure messaging and telehealth platforms that meet all regulatory standards, we protect our patients and our organizations. If you’re evaluating your current tools, start by asking: Does this solution keep PHI safe at every touchpoint? If the answer isn’t a clear yes, it’s time to consider your options.

FAQs

Can WhatsApp/Slack/Teams be HIPAA-compliant?

WhatsApp, Slack, and Microsoft Teams can potentially be used in a HIPAA-compliant way, but important conditions apply for each platform.

WhatsApp is generally not considered HIPAA-compliant. The platform does offer end-to-end encryption, but it lacks essential compliance features, such as Business Associate Agreements (BAA), audit trails, and approved data archiving. Because WhatsApp won’t sign a BAA and doesn’t provide controls like retention policies or eDiscovery, sharing PHI in chat on WhatsApp is not allowed under HIPAA.

Slack can be HIPAA-compliant only if you use the Enterprise Grid plan and configure all available security features. This includes enabling encryption, multi-factor authentication (MFA), archiving, and monitoring audit trails. Most importantly, Slack will only sign a BAA on specific plans, and your organization must enforce strict retention policies and control access to PHI in chat. Standard or Free Slack versions are not suitable for HIPAA-regulated environments.

Microsoft Teams is part of the Microsoft 365 suite, which does support HIPAA compliance when set up correctly. To be compliant, you need to have a signed BAA with Microsoft, use robust encryption, enable MFA, configure retention policies, and monitor audit logs. Teams can also support eDiscovery, archiving, and telehealth messaging, making it a solid choice for healthcare organizations—as long as these features are implemented and used as part of a comprehensive compliance strategy.

What must a BAA include?

A Business Associate Agreement (BAA) is a critical contract under HIPAA that outlines how a service provider (the “business associate”) will safeguard protected health information (PHI) on behalf of a covered entity. For HIPAA-compliant messaging platforms, a BAA must clearly define the permitted uses and disclosures of PHI, ensuring that PHI shared—whether in chat, telehealth messaging, or file attachments—is handled safely and only for authorized purposes.

Key elements a BAA must include are the requirement for strong encryption of PHI, implementation of multi-factor authentication (MFA), and maintaining a detailed audit trail to track all access and actions related to PHI. The agreement should also cover archiving and eDiscovery capabilities to support legal and compliance needs, as well as outline the platform’s retention policy—specifying how long PHI in chat and other communications will be stored and when it will be deleted.

Additionally, the BAA must require the business associate to promptly report any security incidents or breaches, agree to cooperate with HIPAA investigations, and ensure that any subcontractors handling PHI follow the same strict standards. By including these technical and administrative safeguards, the BAA helps organizations confidently use modern communication tools for everything from team messaging to telehealth, while meeting all HIPAA requirements.

How do we audit the platform?

Auditing a platform for HIPAA-compliant messaging starts with ensuring robust technical and administrative safeguards are in place. We need to verify that the platform provides a detailed audit trail—this means every access, edit, or transmission involving PHI in chat is logged automatically. Comprehensive audit logs allow us to track who accessed what information, when, and what actions were taken, making it easier to detect unauthorized access or suspicious activity.

Next, we should confirm the platform’s security features, like encryption for messages in transit and at rest, mandatory MFA (multi-factor authentication), and proper archiving capabilities. These features help protect sensitive information and support compliance efforts. Reviewing the signed BAA (Business Associate Agreement) is also essential, as it sets expectations for both parties regarding PHI protection and audit responsibilities.

For a thorough audit, we’ll want to review the platform’s retention policy and eDiscovery options, ensuring that messages—including telehealth messaging—are retained according to regulatory requirements and can be retrieved during audits or investigations. Regularly scheduled audits, supported by the platform’s built-in reporting tools, help us proactively identify gaps and maintain ongoing compliance.

Finally, it’s important to periodically test access controls and review user permissions. By doing so, we can be confident that only authorized team members can access PHI, further reducing the risk of data breaches and supporting a culture of continuous HIPAA compliance.

Is E2E encryption mandatory?

End-to-end (E2E) encryption is not explicitly mandated by HIPAA regulations, but encryption itself is highly recommended as an addressable safeguard. HIPAA requires covered entities and their business associates to implement reasonable and appropriate security measures to protect electronic protected health information (ePHI), especially during transmission. While the law doesn’t demand E2E encryption specifically, it does expect organizations to adopt strong encryption methods to mitigate risks—especially for HIPAA-compliant messaging and telehealth messaging platforms.

The key is to ensure that all PHI in chat, messages, or files is adequately protected from unauthorized access. Many organizations choose E2E encryption because it offers a higher level of security—ensuring only the sender and recipient can access the message content. However, HIPAA-compliant solutions may also use other secure encryption standards, as long as they are documented, effective, and part of a broader security strategy that includes requirements like MFA (multi-factor authentication), audit trail capabilities, and a signed BAA (Business Associate Agreement).

Ultimately, your encryption strategy should be documented in your HIPAA policies, and you must be prepared to justify your choices during audits or eDiscovery processes. If you’re handling sensitive PHI in chat or telehealth messaging, adopting E2E encryption is a best practice—but not an absolute legal requirement—as long as your overall safeguards meet HIPAA’s strict security standards.