"Testing a new encrypted messaging app's extraordinary claims"
"There's no longer any real distinction between cleartext and encrypted messages – nothing is meaningfully encrypted. For your security, you shouldn't use Converso to send any message that you wouldn't also publish as a tweet."
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TITLE: Confusion in Text Messaging, Encryption, and HIPAA
A therapist colleague of mine contacted Ring Central (a video and
telephone platform that provides HIPAA BAA subcontractor paperwork upon
request) with questions about their messaging capabilities and
encryption. They were looking for a compliant way to text message with
clients. The support staff directed them to this article:
At first glance, the article would seem to make messaging with clients
golden as a good level of encryption is described and the therapist has
a HIPAA BAA with Ring Central. Right?
Wrong.
A few different topics are getting confused here -- smart phone SMS text
messaging, messaging within Ring Central apps and websites, and HIPAA
BAA subcontractor agreements.
With SMS text messaging by phone it will never be HIPAA compliant (even
if the therapist sends it from within Ring Central) because the client
will get the SMS text message unencrypted on their smartphone.
Messaging within the Ring Central apps and website IS at an excellent
level of encryption -- but won't be covered by the therapist's HIPAA BAA
agreement unless the people messaged are also part of the therapist's
company account or are other therapists with their own Ring Central
accounts with HIPAA BAA subcontractor agreements. This will rarely if
ever cover therapy clients.
This gets confusing. So -- for example -- when I go into my Ring
Central account online and click on "Message" I'm invited to email a
messaging link to anyone I choose. So far so good. But when that
person (like a client for example) goes to that messaging link, Ring
Central REQUIRES them to sign up for their own FREE Ring Central
account. That FREE account WILL NOT be covered by a HIPAA BAA
agreement. So the messages sent to them (inside a Ring Central app or
website) will be encrypted but not HIPAA compliant.
Similar problem with Ring Central video conferencing. As long as the
client DOES NOT sign in with their own free account -- and instead goes
to my anonymous video link -- it will be covered under my BAA agreement
with Ring Central. However, Ring Central invites clients to sign up for
their own FREE account in order to video conference with me. If the
client makes that mistake, then its no longer a HIPAA compliant video
conference session because only one of our two Ring Central accounts is
covered by BAA.
I sometimes wonder why this all is left in such a confusing state?
Of course, I'm not a lawyer, so do your own research too.
*
Michael Reeder, LCPC
* Hygeia Counseling Services : Baltimore / Mt. Washington Village location
I've said several times that the Signal messaging app may not be HIPAA compliant.
I was likely wrong.
From another thread (thank you Siderea): "You don't need a BAA from Signal to be in compliance with HIPAA. Signal is one of the very few platforms that meets the carrier standard not to need one, because they have no access to the contents of messages sent through them."
Person Centered Tech says it best (above), but some factors include:
a) The need to keep copies of all communications in the client's chart. So you have to get messages out of Signal and into your chart. You also have to convince clients not to set their messages to self-destruct or you need to retrieve them before that happens! Signal messages (as of 2016) were not backed up automatically when your phone is backed-up. Lose your phone -- lose your messages.
b) You may need client phone numbers stored in your phone. Do you store them not under their names (initials maybe)? Do you need a BAA agreement with the vendor that backs-up your phone directory?
c) You may need to keep Signal from displaying client names on screen whenever you get a new pop-up alert of a new Signal message.
Just learned about @simplex and I must say it looks fairly promising as a future #InstantMessaging app to replace #Signal in the long run (I do like #Matrix but it's good to see an alternative and their tech looks solid).
I was not 100% sure about #SimpleX ToS, though, and couldn't find out who the company was, nor their business model (though donation is at least a part of it).