Clinicians seek quick, efficient, and convenient methods to communicate with colleagues. However, using text messaging without a secure text messaging system (STMS) is considered a HIPAA violation. This systematic review aims to investigate why clinicians are not utilizing secure text messaging systems (STMS) when sharing protected health information (PHI) with their peers. Additionally, the research will explore whether these clinicians are consciously disregarding federal guidelines concerning the texting of PHI. Such deliberate noncompliance could be classified as a form of deviant behavior within the workplace. We conducted a PRISMA-guided systematic literature review across four databases, examining ten empirical studies and two conceptual studies from the United States published in English between January 2017 and August 2024. We identified deviant behaviors associated with the unsecured text messaging of PHI through a deductive approach. These behaviors were subsequently classified based on Lawrence and Robinson’s (2007) workplace deviance framework, which includes the need for autonomy, social identity, and perceived justice. Additionally, we recognized behaviors that were categorized inductively, which included training needs, increased workloads, and workarounds.
