5 Best HIPAA-Compliant Platforms for Therapists Abroad

Hi, I’m Dr. Annie Krajewski. I’ve been traveling the world and running my private practice full-time for 3+ years!

When I was first building my US-based private practice as a digital nomad therapist, figuring out HIPAA-compliant platforms was honestly one of the most overwhelming parts of the whole process.

I knew I wanted to see clients remotely and travel, but staying compliant with US privacy laws while working from Morocco or Bali? That felt really complicated.

The good news is that the right tools exist, and once your tech stack is set up correctly, HIPAA compliance becomes just another part of your routine. 

Here's exactly what I use in my own practice!

Can you see therapy clients while living abroad?

Yes! I've been running my US-based private practice while living and traveling abroad for over three years. It's completely possible, and I now teach others how to become a remote therapist, too.

That said, practicing from another country comes with important responsibilities.

You're still bound by US privacy laws, your clients' data still needs to be protected, and the platforms you use to communicate, document, and bill need to meet HIPAA standards, regardless of where you are.

Learn more about how to legally become a digital nomad therapist.

What does HIPAA compliance mean for digital nomad therapists?

HIPAA doesn't stop applying just because you're not in the US anymore. As long as you're serving US-based clients, you're bound by US privacy laws.

Here's what that means practically:

• Any platform that touches client data needs to meet HIPAA standards: This includes your EHR, video platform, email, phone, texting, and internet connection.

• PHI includes anything that could identify a client: For example, their name, appointment times, diagnoses, billing records, and even the fact that they are your client.

• You need a Business Associate Agreement (BAA): It's a non-negotiable for every third-party platform that handles PHI.

A BAA is a contract between you and a platform where they agree to handle your clients' data responsibly and in line with HIPAA requirements.

It puts legal accountability on the vendor and not just you. Without a signed BAA, using that platform for anything client-related puts you at risk, even if the platform seems secure.

I've spent a lot of time researching and testing platforms to find tools that are both HIPAA-compliant and reliable from anywhere in the world. 

Here are my top picks (and what I use myself):

5 best HIPAA-compliant platforms for therapists abroad

1. Jane App (EHR + payments)

Jane is my favorite EHR, and it's the first platform I recommend to any therapist who wants to work abroad!

Most EHRs are built with US compliance in mind and nothing else, but Jane goes a lot further. It complies with HIPAA, GDPR (Europe), PIPEDA (Canada), and privacy laws in Australia and New Zealand, which means that your clients' data is always protected.

Jane handles scheduling, client records, documentation, and billing all in one place.

I also process payments through Jane, and the processing fees are the lowest I've found through any EHR. This is super important because accepting payments incorrectly can actually be a HIPAA breach, so having a compliant payment system built into your EHR removes one more thing to worry about!

If you're thinking of getting Jane, use code DIGITALNOMAD1MO to get your first month free!

2. Proton VPN for business (internet security)

When you're working from another country, you're often on shared or unprotected WiFi, even if you're renting an Airbnb or staying at a hotel. 

A regular VPN encrypts your internet connection, but a regular VPN isn't enough for HIPAA compliance. You need one that will sign a BAA.

Proton VPN for Business does exactly that! It protects your connection and your clients' data at the level HIPAA requires, and it works reliably in most countries. It also doesn't slow down your connection during sessions, which is an issue I've experienced with other VPNs.

Learn more about the best countries for digital nomad therapists.

3. Google Workspace (email + document storage)

Google Workspace covers email, document storage, calendar, and a suite of other tools that are HIPAA compliant when you sign a BAA with Google. It's reliable, works everywhere internationally, and integrates easily with most other platforms you're already using.

Gmail through Google Workspace is technically HIPAA compliant for outbound emails, but it isn't end-to-end encrypted. 

To fill that gap, I use Paubox as an added layer. Paubox encrypts your emails end-to-end automatically, without requiring clients to log into a portal to read your messages.

Together, Google Workspace and Paubox give you a fully compliant email setup.

Learn if a US therapist can work in Europe (and how).

4. Spruce Health (phone + texting)

Regular calls and texts don't have end-to-end encryption, which means using your personal number for client communication is a potential HIPAA breach, even for something as simple as confirming an appointment.

Spruce Health gives you a separate, HIPAA-compliant number for all client calls and texts.

What I especially love about Spruce is the automatic responders. When you're running a solo practice across time zones, clients may reach out at times when you're sleeping or exploring.

An auto-responder lets them know when to expect a reply and can include helpful links, such as your cancellation policy, intake forms, or scheduling page.

It's a small thing that makes a big difference in how professional and responsive your practice feels, even when you're on the other side of the world!

5. Zoom for healthcare (video sessions)

There are a lot of video platforms out there, but Zoom for Healthcare is the one I keep coming back to!

The most important reason for that is that it works on low internet bandwidth better than most alternatives. When you're abroad, your connection isn't always perfect, and Zoom handles those fluctuations a lot better than other platforms in my experience.

Make sure you're using Zoom for Healthcare specifically and that you have a BAA signed. A standard Zoom account is NOT HIPAA compliant!

I've also heard great things about Google Meet from other virtual therapists. It can be HIPAA compliant through Google Workspace with a BAA, but I haven't personally used it for client sessions, so I can't speak to it from experience.

Move Your Practice Abroad in 6 Months Roadmap

Getting your HIPAA-compliant tech stack in place is a big step, but there's a lot more to building a location-independent practice as a therapist. 

If you want a clear, personalized plan for making it happen, learn more about my Move Your Practice Abroad in 6 Months Roadmap.

Move Your Practice Abroad in 6 Months Roadmap.

Here's what's included:

• A pre-call assessment to understand your specific situation

• A 90-minute 1:1 strategy session with me

• A custom Notion roadmap with your personalized step-by-step plan

• 7 days of email support after your session

• The full cost is credited if you continue working together

It's not a generic download or one-size-fits-all advice, but a custom roadmap built around your practice, goals, and timeline. Get your roadmap!

FAQs

Do I need a BAA with every platform I use?

Yes, for any platform that stores, transmits, or processes PHI. That includes your EHR, video platform, email provider, VPN, and phone and texting app. If client data moves through it in ANY way, you need a signed BAA!

Can I use free versions of these platforms?

Generally, no. Free versions of most platforms don't include the option to sign a BAA, which means they aren't HIPAA compliant for client data. The business or healthcare versions of these tools cost money, but that cost is part of running a compliant practice. Most of these fees are also tax-deductible as business expenses.

Learn more about how to file taxes as a digital nomad therapist.

What if a platform I love doesn't offer a BAA?

If a platform won't sign a BAA, you can't use it for anything involving client data. It doesn't matter how convenient or affordable it is. Using a non-compliant platform puts your clients at risk and exposes you to serious legal consequences. 

Find an alternative that will sign a BAA, and reach out to your liability insurance provider if you're unsure whether a specific tool is safe to use.

Ready to build your location-independent practice?

HIPAA compliance is one piece of the puzzle, but there's a lot more to figure out before you take your practice abroad, including licensing, insurance, visas, time zones, taxes, and more!

If you want to learn more about becoming a digital nomad therapist:

• Download my free guides to get started on the most important pieces

• Subscribe on YouTube for honest, practical videos about building a location-independent therapy practice

• Connect on Instagram to join a community of therapists on the same path

• Get in touch if you have questions or want to talk through your specific situation

The life you're imagining is possible. You just need the right information and a solid plan to get there!