Is Cloud Hosting HIPAA Compliant?

2021 was the second-worst in terms of the number of patient record breaches across healthcare service providers. Some estimates rank the largest of the nearly 45 million breaches of patient records in 2021 as some of the worst in history.

Given the constant threats patient records face, the healthcare industry is duty-bound to explore compliance to augment its security perimeter while protecting sensitive data.

Data sanctity and security are of paramount importance in the healthcare industry, which is entrusted with sensitive patient information, such as social security numbers, insurance details, names, addresses, current health conditions, prescribed medications, and hospitals visited.

This data in the hands of cybercriminals can open the floodgates for social engineering attacks on patients. The sensitivity of personal information enables medical records to be sold at exorbitant prices on the dark web, as close to $1,000 per record; approximately over ten times more than the average breached credit card records.

What is HIPAA Compliance?

The Health Insurance Portability and Accountability Act (HIPAA) defines a certain set of standards for keeping sensitive patient data secure. Organizations and covered entities (anyone who has access to patient information and provides support for treatment, payment, or operations) that handle Protected Health Information (PHI) must adhere to physical, network, and process security measures for HIPAA Compliance.

PHI encompasses everything from patients’ medical records and social security numbers to financial information to addresses, phone numbers, and photos. The wording of the Act mandates that other entities, such as subcontractors or related business associates, must also comply with HIPAA.

The Importance of HIPAA Compliance

By embracing technology, the healthcare industry provides better and faster access to patient healthcare information. However, the same technological advancement turns into a thorn in the flesh when, owing to inadequate compliance, the healthcare industry leaves such sensitive data susceptible to external threats.

The HIPAA Act lays down the guidelines for safekeeping patient medical records. Any failure to stick to the norms can invite hefty penalties from the Office for Civil Rights (OCR). The penalties can run up to $50,000 for every violation and a maximum of $1.5 million for repeat violations per year.

HIPAA attempts to strike a balance between privacy and accessibility of high-value patient records, such that the best care is offered to the patients but not at the expense of their security.

While safeguards regulating the use of PHI – stored, transmitted, and accessed electronically (ePHI) – already exist, the HIPAA Security Rule came as an addendum to the HIPAA to account for the technological advances in healthcare.

Let’s dive deeper into the HIPAA Security Rule and HIPAA compliant solutions, which are relevant for patient privacy protection:

  • Healthcare providers must implement policies and procedures that limit the use and disclosure of PHI to the minimum.

  • Restricted access to employees with specific authorization.

  • Patients are in complete control over who accesses their PHI. HIPAA-covered entities deploy adequate controls to protect any PHI created, stored, maintained, or transmitted by them.

  • Compliance ensures that the covered entities employ adequate administrative, physical, and technical safeguards for prohibiting cybercriminals from gaining access to patients’ health information.

  • Healthcare providers must notify patients of any medical data breach within 60 days.

  • Patients affected by a data breach can pursue action against violators to protect their identities and avert the risks of victimization by identity theft.

  • Patients can designate individuals to obtain their health data on their behalf.

  • Patients have the right to obtain copies of their PHI from healthcare providers. Access to copies of health information allows patients to verify errors or omissions.

  • Patients can seek alternative healthcare providers with the complete transference of their records.

  • Time and effort-intensive activities for detection of threats in systems are minimized through constant server scans by professionals.

Many of the conventions covered under HIPAA are similar to that of zero-trust security with strict reporting requirements. Adhering to the HIPAA norms involve a great deal of difficulty, owing to which businesses are increasingly seeking solutions from specialists.

HIPAA Compliance for Cloud Hosting

According to a study, the global Healthcare Cloud Computing market may grow at a Compound Annual Growth Rate (CAGR) of 14% between 2019 and 2026 and reach an estimated market value of around $40 billion by 2026.

In terms of industry outlook, the global Cloud computing market would expand substantially because of favorable regulations, elevated healthcare investments, increased public awareness, and a ‘never-seen-before’ demand for regulatory adherence and patient-care data privacy implementation concerns.

The limiting factors for the global healthcare industry are the increasing number of Cloud data violations and data portability complications. Given that data protection is a key component of HIPAA regulations, responsible health organizations are cognizant of the business opportunities in the Cloud healthcare domain. Though the Cloud offers a more secure, innovative platform for businesses for hosting some of their IT infrastructures as opposed to on-premises solutions, the core issue of being HIPAA compliant with public Cloud provider services remains.

Host cloud providers, such as Azure, AWS and GCP  cannot claim to be HIPAA Certified hosting providers today due to no federal standard. Instead, these providers standards are more aligned with security programs, such as the Federal Risk and Management Program (FedRAMP) and supported by Business Associate Agreements (BAA) with customers who need to maintain HPIAA compliance.

Advantages of partnering with a FedRAMP-authorized Cloud Service Provider (CSP)

FedRAMP is a cybersecurity risk management program for the purchase and use of Cloud products and services used by US federal agencies. Only Cloud service providers (CSP) with FedRAMP approval may work with government agencies.

The Office of Management and Budget (OMB) launched the program in response to the 2011 Cloud-First Policy by the US government.

A FedRAMP-Authorized CSP framework not only helps evaluate your organizational compliance requirements but also offers a host of security benefits and efficiencies:

  • Delivers significant cost and time savings compared to independent and redundant assessments.

  • Enables uniform evaluation and authorization of Cloud information security functions and controls.

  • Provides valuable insights into Cloud security controls.

  • Provides a faster Cloud adoption roadmap.

How do you ensure that your Cloud Hosting solution is HIPAA compliant?

While the Cloud is a viable alternative for many businesses trying to achieve HIPAA compliance, not all Cloud systems conform to the HIPAA Privacy and Security Rule’s guidelines.

Some of the core server functionalities that are needed to deliver effective HIPAA-compliant Cloud hosting services are:

  • A highly available infrastructure with an Uptime Service Level Agreement (SLA) to ensure backup in case of a system outage. SLAs help avert complications concerning system downtime. A fully managed security firewall blocks unwarranted access to PHIs and is a key component for safeguarding data privacy and security.

  • Mandating the use of encrypted and robust Virtual Private Networks (VPNs) for effective data encryption during transmission. Secure Sockets Layer (SSL) certifications ensure extended security for all servers, domains, and sub-domains that include ePHI in your systems. Anti-malware protection helps maintain a virus-free ecosystem and is crucial for providing PHIs with a high level of data security.

  • Multi-Factor Authentication for preventing unauthorized access to protected systems because of multiple sign-ins, sign-outs, and weak passwords.

  • Data segregation for separating your HIPAA compliant environment from your Cloud hosting provider’s shared data from other businesses. A secure environment ensures protection for PHIs while complying with HIPAA regulations.

  • Offshore data backups for helping secure electronic health records and guaranteeing ePHI-generating systems can be restored with minimal data loss after a failure. Backups, when encrypted, help prevent unauthorized users from accessing PHIs stored on backups.

  • Business Associate Agreement (BAA) for outlining the responsibilities of your partners in safeguarding your PHI. This agreement helps chart the roles that each business plays in the instance of a data breach.

HIPAA Compliance Guidelines for Small and Medium Healthcare Businesses

HIPAA seeks to protect sensitive patient data and lay down the guidelines for data handling. However, the challenges of hefty penalties for non-compliance are a concern for small businesses operating on a budget.

The solution for implementing PHI and ePHI security and safeguards, therefore, begins by answering the fundamental question ‘What is HIPAA compliance?’.

For small and medium-sized businesses, the three types of safeguards that are an elementary component of HIPAA compliance are:

  • Physical safeguards: entailing limited access to data, including security.

  • Technical safeguards: encompasses network security, data encryption, and monitoring technology to track how the data was accessed and transmitted.

  • Administrative safeguards: includes organization-wide strategies for securing PHIs, managing data access among employees, and defining standards for executing business with external parties.

Mitigation of risks to ePHIs can be outsourced to a reliable and compliant Cloud service provider and web hosting company, which offers cutting-edge methodologies for maintaining compliance through restricted access, malware protection, and more.

Checklist for HIPAA Compliance

HIPAA compliance is more than a simple set of regulations that businesses must adhere to as they foster trust between healthcare providers and patients. Staying within the norms of HIPAA compliance is a prerequisite for healthcare businesses seeking to ensure patient satisfaction and tackle cybercrime.

The most optimal method to secure data is by drafting a HIPAA compliance checklist and aligning it with the established regulations, and more importantly, with your business strategy:

  • Limiting access to HIPAA data through the creation of privilege models for determining access permissions.

  • Creating a Data Map for understanding where all the HIPAA-regulated files are stored – both locally and on the Cloud.

  • Using physical and technical enforcement for protecting and securing data, enabling locking of files, and two-factor authentication as the key components of cybersecurity measures.

  • Regular monitoring of all access to PHI and ePHI by setting up real-time alerts when healthcare information is requested.

Conclusion

The healthcare industry must balance data security and the growing need for easy access to healthcare providers, insurers, partners, and other affiliate entities. Though Cloud adoption aims to offer a more secure and HIPAA compliant environment for generating PHIs, only a competent hosting service may meet the stringent requirements through an array of cybersecurity tools and resources. The checklist, along with other compliance documents, when validated with the service provider, underscores the importance of the security of sensitive patient data. Every patient has the right to privacy, and the onus of abiding by these rights largely lies with healthcare organizations.

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