What Are The HIPAA Rules And How To Ensure HIPAA Compliance?

Medical information is predominantly exchanged over the electronic mode nowadays, thus increasing accessibility and convenience but also simultaneously raising concerns over the privacy of critical protected health information (PHI).

Many countries have designed their own rules and regulations aiming to address this issue. In addition, some private entities have also framed their own standards to remove any loopholes in government-designed rules.

Background of HIPAA:

HIPAA Compliance is a must for digital healthcare solutions. Before HIPAA was enacted into the law, healthcare organizations were following different standards to safeguard the privacy and security of protected health information (PHI), but the lack of industry-wide agreed standards was a big hindrance in maintaining the confidentiality and security of sensitive patient information.

The Health Insurance Portability and Accountability Act (HIPAA) was signed into law on 21st August 1996 to regulate the handling or transmission of healthcare information. It gives control to patients over their health information and stipulates penalties in case of violation of these rules.

Basically, the HIPAA Suit consists of three main sets of rules. 1) Privacy Rule, 2) Security Rule, and 3) Breach Notification Rule.

  1. The Privacy Rule aims to protect the privacy of individually identifiable health information by restricting access to only required entities.
  2. The Security Rule sets forth certain technical procedures to ensure the confidentiality, integrity, and availability of data.
  3. Breach Notification Rule stipulates organizations to provide notification following a breach of PHI.

We will talk more about the HIPAA rules in detail later on. Let us first know what PHI is and why it is critical to secure it.

What constitutes PHI?

The critical health data is categorized as protected health information (PHI) by HIPAA. That includes the details related to the patient’s past and present physical or mental health condition, payment details of the patient, components of a patient’s medical record. In addition, PHI also includes many standard identifiers, such as name, address, birth date, insurance information, patient contact details, medical test results, social security number, and biometric identifiers of the patient (e.g., retina scan, fingerprint, or voice recording). Sometimes, this also includes data collected from medical equipment also.

Why is healthcare data critical?

In most cases, the healthcare data is permanent and can not be changed easily. Biometric details especially are more vulnerable as they can not be altered at all. So if that data is compromised in a data breach, it is compromised forever. And because it contains unique identifying information that is permanent in nature, it has higher implications when it gets compromised as it can be used to forge identities.

What are the best data handling practices as per HIPAA?

As healthcare data consists of sensitive personal data, robust security measures must be implemented to secure it. To protect patients’ data while complying with the HIPAA rules, the following steps are suggested:

  1. Secure Data Collection: Only authorized persons should be able to collect, use, or access the data and whoever collects data should also be made responsible for its security. The admin should frequently monitor which users are accessing what data and from what devices.
  2. Locate the health data storage: The health data can be stored over many electronic devices, so these devices must be secured with strong and unique passwords. Also, use two-factor authentication whenever possible. Also, do not forget to log off or lock the systems when not in use.
  3. Encrypt data: Healthcare data must be encrypted with the highest security standards during the storage and transmission of information. When the data is encrypted, getting access to it won’t be enough to read it, as it will need a key to decrypt and decipher the data. That’s why HIPAA rules strongly recommend data encryption.
  4. Always Use Latest Technologies: Obsolete or older versions have higher chances of data leakage. That is why it is cardinal to utilize the latest technologies to handle, store, and access EHR data.
  5. Educate the staff about HIPAA guidelines: At the end of the day, your staff must understand HIPAA rules to implement them properly. So, train them properly and make sure your staff is not the weak link in the chain.
  6. Conduct regular data security audits: To identify weak links and vulnerabilities in your security infrastructure, HIPAA recommends regularly conduct data security audits.
  7. Secure Data Backup Facilities: The data backup facility or data center of a healthcare institute where all the sensitive information is stored should have robust security. CCTV cameras should be installed at the premises, and access should be restricted, and biometric or other means of rigorous authentication must be implemented.

How to ensure HIPAA-Compliance Platform?

We have seen that building HIPAA-compliant software from scratch is a complex process consuming significant time and resources. To rid yourself of all these complexities and procedural headaches, you can instead choose a readymade HIPAA-compliant platform and start your telehealth business with it.

But you might be wondering how to choose the best HIPAA-compliant software? So, here are our tips to ensure you choose the best HIPAA-compliant platform vendor:

  1. Verify end-to-end encryption.
  2. Check the encryption standard.
  3. Inquire whether they conduct security audits or not.
  4. Find out where the information is stored.
  5. Sign an agreement of undertaking.
  6. Verify the security of servers.
  7. Search about the company and read reviews of their users.

HIPAA Act of 1996:

HIPAA was passed in 1966 to ensure that the advances in electronic technology do not erode health information privacy. In addition, it aimed to simplify administration processes of dealing with electronic health care transactions, unique health identifiers, and security. This act sets conditions and limits the disclosure of such information.

HIPAA Privacy Rule:

This rule was published in December 2000 and was later modified in August 2002. This rule sets standards for protecting identifiable health information of health plans, healthcare providers, and health care clearinghouses who conduct the standard health care transactions electronically. Compliance with the Privacy Rule was mandated on 14th April 2003.

Highlights of this rule are as follows:

  1. It defines how a patient’s data can be used and disclosed.
  2. PHI can be disclosed to a third party with the patient’s discretion, and even then, the information shared must be minimum necessary to perform the task.
  3. Patients can inspect and obtain a copy of their records and request a correction to them.
  4. The healthcare organization must inform their clients about their business practices and entertain complaints from the patients if it fails to adhere to HIPAA rules.

HIPAA Security Rule:

This rule was published in February 2003. It sets national standards for protecting the confidentiality, integrity, and availability of electronically protected health information. Compliance with the Security Rule was mandated on 20th April 2005.

Highlights of this rule are as follows:

  1. Confidentiality: Secure information from unauthorized access.
  2. Integrity: Ensure data integrity by securing the data.
  3. Availability: Make sure that the data is available for the authorized personnel at all times.
  4. Frequent internal audits of ongoing operations must be conducted.
  5. Role-based access to patient data must be implemented.
  6. PHI should be transmitted through encrypted channels.

HIPAA Breach Notification Rule:

The HIPAA Breach Notification Rule mandated that the covered entities should notify affected individuals. It allows patients to examine and obtain a copy of their health records and ask for corrections.

Highlights of this rule are as follows:

  1. In case of a data breach, the organization must inform all the stakeholders involved. Breaches affecting more than 500 patients must also be reported to the media and HHS. Such breaches must be reported within 60 days of discovery.
  2. Penalties for failing to comply with HIPAA rules.

The state of HIPAA rules today:

Since its enactment in 1966, HIPAA rules have witnessed many additions and revisions in their original form. The big modifications in the original HIPAA rules are only three. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 promoted EHR and encouraged data interoperability. It expanded the HIPAA rule scope by increasing potential legal liabilities for non-compliance and more stringent enforcement. The latest modification was the HIPAA omnibus final rule passed in 2013 that implemented HITECH rules more strictly and introduced advanced measures to strengthen the privacy and security protections for health information established under HIPAA. HIPAA is still considered the benchmark for patient data handling practices.

Do you want a comprehensive IT solution for the healthcare sector that is fully compliant with HIPAA rules? Contact [email protected] for more.

While I have tried to cover the most important HIPAA rules based on research, feel free to add more in the comment section to make it insightful for the readers.