Virtual care delivery is a great way to make clinical services more accessible, convenient, and safe, especially during the COVID-19 pandemic and similar health crises. However, the more a medical treatment process is digitalized, the higher is the risk of unauthorized access to protected health information (PHI). To avoid data breaches associated with telehealth services, all telemedicine software platforms must meet HIPAA standards. This article explains what HIPAA is, why it’s important, and how to develop a HIPAA-compliant telehealth solution.
What is HIPAA?
The abbreviation “HIPAA” stands for “The Health Insurance Portability and Accountability Act”. Simply put, it’s the US federal law that creates a foundation for ensuring the adequate level of protection of patient health information. One of the aspects covered by HIPAA provisions is related to the processing of healthcare transactions in an electronic form. In particular, it requires the US Department of Health and Human Services (HHS) to create national standards for the secure processing of electronic data.
To implement these requirements in practice, the HHS issued the following regulations:
- HIPAA Privacy Rule. It’s a general document that establishes safeguards for the protection of patient privacy and PHI in all forms.
- HIPAA Security Rule. It’s a set of provisions that provide specific rules for the secure processing of protected health information in an electronic form (ePHI).
Medical software is HIPAA-compliant if it’s built and functions in conformity with these two acts. For the sake of this article, we’ll use the term “HIPAA” for both documents. Besides, the HHS has issued multiple other HIPAA rules, for example, Omnibus Rule, Enforcement Rule, and Breach Notification Rule. But they regulate other aspects of healthcare data protection, so we won’t cover them today.
HIPAA technical requirements: general principles
If you want to create healthcare software of any kind, including a HIPAA-compliant telehealth platform, you need to consider the main security guidelines established by this regulation. Let’s briefly outline each of them.
Data encryption is one of the most effective measures preventing unlawful disclosure of protected information. When data is reliably encrypted, it cannot be exploited by third parties even if they’ve somehow received unauthorized access to it. To make HIPAA-compliant telemedicine software, you have to ensure that encryption is implemented for both data in transit and data at rest. Some people believe that such measures might be harmful to the system’s performance and, ultimately, affect user experience. But if the software is properly built, the difference is so insignificant that users cannot notice it.
To make telehealth platforms HIPAA-compliant, developers must pay much attention to access control. In particular, users must obtain access only to the minimum necessary amount of PHI that is required to perform their job responsibilities. In other words, a system should allow a medical organization to assign different user roles to the workforce. For example, physicians should be authorized to view a broader scope of medical information than hospital administrative staff. Also, some measures should be taken to prevent unauthorized access to PHI caused by a mistake or oversight.
Keeping telehealth HIPAA-compliant requires not only specific software capabilities but also continuous monitoring of user activity. It helps medical organizations prevent data leakages and investigate breaches if an incident took place. That’s why a telemedicine platform should allow for different kinds of audits and vulnerability assessments. If a system is monitored, many violations can be identified and eliminated before any harm is done.
How to create HIPAA-compliant software for telehealth
Building a HIPAA-compliant telemedicine platform is a complex process that has to be completed by programmers with specific expertise in healthcare software development. A team should possess a superb combination of technical skills and industry knowledge to properly implement the principles mentioned above. Besides, all custom HIPAA-compliant platforms for telehealth are unique, so the coding part must always be accompanied by thorough research.
However, if you need some general guidelines, here are some fundamental technical safeguards that most HIPAA-approved telehealth platforms contain:
- Authorization. Any HIPAA-compliant telehealth solution must be password-protected. Admins should have the right to monitor all authorizations.
- User roles. A telemedicine platform must allow a medical organization to assign different user roles with different permission rights to medical staff.
- Editing capabilities. Telehealth software should allow no unsanctioned changes to ePHI.
- Automatic log-off. This function is needed to prevent unauthorized access to PHI when a device used by medical staff is left unattended.
- Web application protection. Programmers should implement the Web Application Firewall (WAF) to enable the blocking of unlawful intrusions into the telemedicine system.
- Deletion policies. When a telemedicine app is deleted from a device, all its data must be permanently deleted, too.
- Data backup. All ePHI must be backed up to ensure its retrieval in case of accidental or malicious loss.
- Storage and communication encryption. As mentioned, patient information in storage and in transit (e.g., video call, messaging) must be encrypted.
- Emergency mode. Medical staff should be able to turn on an emergency mode on a HIPAA-compliant telehealth platform in case of a disaster or force majeure.
The above list comprises the most basic security measures of a HIPAA-compliant telemedicine platform. But it’s not exhaustive. If you plan to build a custom telehealth solution that meets HIPAA standards, you should also think about additional methods to provide data protection and security.
Why is it important for a telehealth platform to be HIPAA-compliant?
Developing a HIPAA-compliant telemedicine platform requires additional effort from a medical organization and development team. So, let’s discuss the main reasons why HIPAA compliance is worth these investments.
HIPAA establishes mandatory standards for all covered entities (i.e., basically, any entity that manages PHI). It means that organizations can be charged with fines if they don’t adhere to these rules. In general, HIPAA violations may cost a hospital or clinic up to $1.5 million.
Due to the coronavirus outbreak, the HHS issued the Notification of Enforcement Discretion that canceled HIPAA penalties for non-compliance if a telehealth solution was used in good faith. But it will remain in effect only until the current health emergency situation is over. So, the new temporary rules don’t eliminate the requirement to ensure the HIPAA compliance of the telemedicine software.
Medical information almost always has a sensitive nature, no matter whether it’s simple malnutrition, or some virus, or a mental issue. Using a telehealth platform that doesn’t meet HIPAA standards places patient privacy at risk. If the data isn’t protected, PHI might be accessed by third parties, for example, hackers and cyber thieves. So, ensuring the HIPAA compliance of telemedicine software is an essential aspect of caring for patients and building trustworthy relationships with them.
The consequences of maliciously disclosed PHI might be disastrous not only for a person but also for a healthcare organization. Chances are that its reputation will remain ruined for a long time. For a private clinic, it may even lead to the entire termination of business. That’s why negligence of HIPAA standards is never a good idea.
Putting it all together
Remote healthcare delivery is an effective solution not only for the pandemic period but also for providing clinical services in normal times. But to be safe for all sides, telemedicine platforms must be HIPAA-compliant. It means that they should ensure proper data encryption, access control, and activity monitoring. If you want to build a HIPAA-compliant telehealth platform, find a development team with expertise in medical software development that knows how to implement numerous HIPAA security requirements in practice.
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