Glossary
Protected Health Information (PHI)
Any health information that can be tied to a person and is held by a HIPAA covered entity or business associate. In chat, PHI is what a patient or clinician types, attaches or is identified by.
General definition
Protected Health Information (PHI) is the term the US Health Insurance Portability and Accountability Act (HIPAA) uses for health information that identifies, or could reasonably be used to identify, an individual. The definition sits in 45 CFR 160.103 and covers information about a person’s past, present or future physical or mental health, the care they receive, and payment for that care, whether it is spoken, written on paper or stored electronically (where it is often called ePHI).
Information becomes PHI when two things are true: it relates to health, care or payment, and it is held by a covered entity (health plans, healthcare clearinghouses and providers that bill electronically) or by a business associate that handles it on their behalf. A chat vendor hosting patient conversations for a clinic is a business associate.
HIPAA’s Safe Harbor rule lists 18 identifiers that must be removed before data counts as de-identified. They fall into a few groups:
- Direct identifiers: names, Social Security numbers, medical record numbers, health plan and account numbers, licence and vehicle numbers
- Contact and location data: street addresses and small geographic units, phone and fax numbers, email addresses, URLs and IP addresses
- Dates: birth, admission, discharge and death dates, and any age over 89
- Biometric and visual data: fingerprints, voice prints, full-face photographs and comparable images
- Anything else unique: device serial numbers and any other code or characteristic that could single a person out
In a messaging product PHI is rarely a neat database field. It is a patient describing symptoms, a clinician attaching a scan, a support agent quoting a policy number. That is why the HIPAA Security Rule’s technical safeguards (access control, audit controls, integrity and transmission security, 45 CFR 164.312) apply to the chat layer itself, not only to the electronic health record behind it.
In the Ethora ecosystem
Ethora is built for teams that need chat inside healthcare products without moving PHI into a consumer messenger. The healthcare chat SDK and the HIPAA-compliant chat API run on a server you control (a dedicated cloud account or self-hosted), with TLS in transit, encryption at rest, role-based access controls and a compliance audit trail with immutable log export. Ethora signs a Business Associate Agreement on Enterprise and dedicated plans and provides the technical safeguards; your organisation remains responsible for its own HIPAA programme.
Two controls matter most for PHI in live conversations. The Trust & Safety system can match patterns that look like PHI shared in the wrong place and remove the message immediately or after a configurable delay, so it is not retained in the archive or the logs. Configurable retention and per-user erasure let you keep records for as long as your policy requires and no longer.
