HIPAA Compliant EHR

Why Having HIPAA Compliant EHR Software Matters So Much More Than You Realize 

According to one recent study, the average cost of a single consolidated cyberattack resulted in losses that hit an enormous $4.45 million in 2023. If you needed a single statistic to help highlight why it’s so important to take cybersecurity seriously, let it be that one. 

But if yours is an organization operating in the healthcare field in particular, the situation is actually even worse than you might expect. Another study indicated that there were 725 reported data breaches over the course of the year. In that time, about 133 million records were compromised. Not only was this the most reported data breaches ever, but it was the highest number of breached records, too. 

A data breach in the healthcare sector can happen for an unfortunately large list of reasons. Sometimes, a provider is the victim of a phishing or malware attack that steals their credentials without them realizing it. Perhaps there was an insider who either intentionally or (more likely) accidentally disclosed patient information. Regardless, the impact can be catastrophic – and the financial burden alone is often too much for smaller organizations to handle. 

But at the same time, none of this should dissuade you from embracing the innovation that only digitization brings with it – particularly when it comes to EHR solutions. You’d still be hard-pressed to find a better way to optimize workflows, reduce overhead, increase revenue, and improve the patient experience – all at once. 

All this is to say that you can’t just choose any EHR to meet your needs. You need to select the right HIPAA-compliant EHR software for a wide range of different reasons, all of which are worth a closer look. 

What is HIPAA Compliance?
Breaking Things Down

To get an understanding of why having a HIPAA-compliant EHR is so essential to your success, you must first understand exactly what HIPAA is to begin with. 

Short for the Health Insurance Portability and Accountability Act, HIPAA itself was signed into law by Bill Clinton in 1996. It is designed to safeguard protected health information, otherwise known as PHI. This is the type of sensitive medical record or designated record data that can be used to A) identify an individual, and B) that was created during the course of healthcare. 

The classic example of all this would be if you were recently diagnosed with some type of disease that you didn’t want people knowing about. If records pertaining to your diagnosis or treatment plan were to fall into the wrong hands, people would know that you were battling a health condition and would know exactly what it was. HIPAA compliance is designed, in part, to help prevent something like that from happening. 

HIPAA security

To properly comply with HIPAA, any organization dealing with PHI needs to have physical, network, and process-based  security measures in place. This means that any organization that provides treatment, payment services, or operations in the world of healthcare must take steps to become compliant. 

However, a private practice is far from the only entity that needs to concern themselves with this. Coverage requirements also extend to: 

  • Any business associate that has access to PHI at any time. An example of this might be an IT company doing work on the physical computers where electronic health records are being locally stored. 
  • Organizations that support the aforementioned treatment, payment, or operations services. 
  • Subcontractors. Examples of that would include people and places like emergency facilities, specialists, labs, medical imaging providers, and more. 

When HIPAA was first published in 1996, it required the Department of Health and Human Services to put together a series of regulations that were designed to protect both the privacy and the security of health-related information for patients everywhere. Not long thereafter, the Privacy Rule and the Security Rule were published. 

The “Standards for Privacy of Individually Identifiable Health Information,” also called simply the Privacy Rule for short, sets limits on how this type of sensitive health information can be created, how it can be used, and what disclosures can be made without requiring a person’s authorization. 

Most notably, the Privacy Rule gave people more control over their protected health information than ever. Today, if you want to obtain a copy of all your health records, you can do so fairly easily. You have HIPAA and the Privacy Rule to thank for that. You can also direct a covered entity to send an electronic copy of your health records to any third party you might be working with, you can request corrections to the information contained in those records, and more. 

With all that in mind, the HIPAA Security Rule  essentially takes what is dictated by the Privacy Rule and puts it into practice. Here, we’re more focused on the technical and non-technical protections that covered entities must have in place to keep electronic PHI in particular safe from prying eyes. 

It’s one thing to say that it’s important to keep records pertaining to someone’s diagnosis (or any other treatment, for that matter) away from prying eyes. It’s another thing to actually do something about it. That’s why compliance with the Security Rule begins by requiring an organization to assess the security risks they face, all so they can put in place the administrative, physical, and technical safeguards required to mitigate that risk as much as possible. 

  • Examples of administrative safeguards would be those actions, policies, and procedures that a healthcare organization would follow to maintain compliance. Examples of this would include everything from making sure that only certain employees have access to an EHR system, to choosing an EHR solution like PrognoCIS that is HIPAA-compliant in the first place. 
  • Physical safeguards would be those that help protect both electronic PHI, along with the computers used to access that information, from unauthorized access. So if copies of all patient records are stored on-site on a server, for example, there must be physical safeguards in place to prevent unauthorized access to the room where that server equipment is housed in. 
  • Technical safeguards would be the types of technology that is used to protect and control access to electronic patient health information. A VPN that prevents unauthorized access to your private practice’s network where electronic PHI is accessed would be just one example of such a technical safeguard. 

How is HIPAA Applied to Electronic Health Records (EHR)?

When HIPAA was first signed into law, electronic health record (EHR) platforms like the ones we have today didn’t really exist yet – at least not to the extent of something like PrognoCIS. At the time, the possibilities were essentially limited to digital versions of files and other documents that previously only existed on paper. People weren’t quite thinking about the type of platform built on the foundation of EHR as a concept that can help bring medical billing, telemedicine, custom mobile apps, and more together under one roof. 

Because of that, the answers to questions like “what are the security standards for EHR?” or “how does HIPAA impact electronic health records?” aren’t necessarily difficult, but they are a lot more involved than many people realize. 

Take telemedicine, for example. As per the Department of Health and Human Services, all covered healthcare providers and health plans need to use technology from vendors that comply with HIPAA – end of story. If a private practice wants to offer telemedicine to patients, they need to enter into a HIPAA business associate agreement that oversees not just the video conferencing platform used to facilitate that virtual appointment, but also any other remote communication technologies as well. 

In a broad sense, this means that if your private practice wants to offer telehealth appointments to patients, you can’t do so over a more traditional platform like Zoom. If you do use a HIPAA-compliant platform and want to follow up with the patient in writing so they can have a summary of what you talked about, whatever platform you’re using to send that message on needs to be compliant, too. 

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HIPAA Compliance Checklist 2024: What You Need to Know

From a purely logistical point-of-view, HIPAA is actually very clear as to which measures need to be in place to remain compliant with regard to electronic health records. These include taking steps like: 

  • Access control – Techniques like passwords, PINs, and more should be used to make sure that only the people who are authorized to have access to patient electronic records have it. 
  • The use of encryption – When electronic health records are being transmitted or stored, they must be properly encrypted – meaning the only people who can “understand” that information are those who can adequately decrypt it using an associated key. 
  • There must be an audit trail – At any given moment, you should be able to see who has accessed a record, what changes were made, when that access occurred, and more. 

Technology security concept safety digital protection system Despite all these provisions, it’s also important to acknowledge that no system is perfect – meaning that sometimes a breach unfortunately can and will occur. This is especially true in an environment like healthcare, where the potential value of the information that can be compromised is so high. 

Under HIPAA, if a doctor, hospital, or other provider does suffer a breach, the Secretary of Health and Human Services must be notified. If more than 500 people in a particular state or jurisdiction have been affected, the media must be notified as well. 

This is all in service of one of the things that HIPAA was built to accomplish in the first place: giving people as much visibility as possible into their sensitive medical information. 

Overall, you can help make sure that your organization remains HIPAA compliant by taking the following steps: 

  • Once you’ve made an effort to understand the rules laid out in HIPAA like the Security Rule and the Privacy Rule, verify that you understand exactly which ones apply to your organizations and which ones might not. 
  • Conduct a thorough risk analysis so you know exactly what types of threats you are exposed to. If you don’t offer telehealth, for example, you naturally don’t have to worry about issues that might arise from insecure telehealth connections. 
  • Create a compliance plan. What are the actionable steps that you need to take to achieve and maintain compliance? These will vary depending on the organization. 
  • Establish accountability. HIPAA compliance is something that requires buy-in from everyone within an organization. If records get compromised due to user error from a newly hired employee who doesn’t know your protocols, it ultimately doesn’t matter – your practice isn’t compliant and this must be addressed. 
  • Make every effort to stay up-to-date on changes to HIPAA as they occur and enact change when required. 
  • Document absolutely everything. Any change you make, even if it’s something as seemingly innocent as swapping one vendor out with another, needs to be carefully documented to preserve the aforementioned audit trail. 
  • If data breaches do occur, report them to the appropriate parties immediately. 

How Does PrognoCIS Help You Become and Stay HIPAA Compliant?

 In a lot of ways, this has made robust EHR platforms like PrognoCIS even more valuable than many already assumed them to be. When you leverage one of these tools, the most immediate benefit you’re getting is one of productivity. You’re taking a lot of tasks that formerly required disparate platforms and are condensing everything down into a “single source of truth” for your organization. Things get more efficient, you start saving money, you improve patient experiences – everybody wins.  But think about how complicated HIPAA compliance becomes as it pertains to EHR if every one of these core functions still exists in its own separate silo: 

Everything from a diagnosis to a treatment plan falls under the definition of what is covered under the HIPAA Privacy and Security rules.

Submitting invoices and claims electronically is convenient, yes – but that’s also sensitive information that could be used to identify someone, so it needs to be protected.

Scheduling an appointment and sending a reminder, along with other case management duties like authorization requests or eligibility checks, certainly need to be executed with an eye towards HIPAA.

Otherwise known as eRx. This is also fundamental to the core of what is protected by HIPAA as it pertains to electronic health records.

These are just a few of many examples. PrognoCIS in particular also offers a wide range of other features like  revenue cycle management  and  medical credentialing as well. 

Attempting to remain HIPAA-compliant with even four separate solutions to handle these critical tasks quickly becomes an uphill battle. But when you bring everything together under one platform like PrognoCIS, which was built with HIPAA in mind, this all becomes one less thing that you have to worry about. It’s certainly no longer something you have to let get in the way of offering patients the critical care that they need. 

Key Takeaways

  • HIPAA was signed into law in 1996 and governs the way that patient health records are not only created and stored, but shared and accessed as well. 
  • Anyone who comes into contact with or uses electronic health records with sensitive patient data must be HIPAA-compliant. This includes not only an organization like a private practice, but any other entity helping them on the administrative side of things and subcontractors as well. 
  • This means that if the EHR vendor you’re using isn’t HIPAA-compliant, your organization isn’t compliant either. This is true even if you’ve taken every other reasonable step to maintain that compliance in-house. 

If you’d like to find out more information about what to look for in HIPAA-compliant EHR software, or if you’d just like to see how a solution like PrognoCIS can revolutionize your practice without sacrificing security to do it, please don’t delay - contact Bizmatics, Inc. today. 

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HIPAA Compliant EHR

Protection and Confidential Handling of Health Information

Protecting your patient’s data is of paramount importance.

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Hipaa Security

What Is HIPAA Compliance ?

Providers are now using electronic health records (EHR) to store patients’ electronic protected health information (ePHI). There are many advantages to this system but also vulnerabilities. The government has established strict rules for the use of EHRs designed to protect a patient’s protected health information (PHI) and to guard against cybersecurity breaches that could expose this protected information.

The rules are comprehensive and at times, difficult to understand. There are extremely high penalties for non-compliance with the governmental rules. Software programs have been created with EHR privacy and security rules in mind. Here is the least you need to know when working with your own EHR and software provider to be sure you are compliant with HIPAA’s rules. Checkout How HIPAA-Compliant PrognoFax Improves Workflow

Table of Contents

Who Must Comply with its Rules?

The use of EHRs is controlled by The Health Insurance Portability and Accountability Act of 1996 (HIPAA) which required the Secretary of the U.S. Department of Health and Human Services (HHS) to establish regulations to protect the security and privacy of certain health information. In response, HHS established two basic rules: The HIPAA Privacy Rule and the HIPAA Security Rule. The HHS has published a list of who must comply with the , which is the same list of entities that must comply with the Security Rule. The two rules apply to all medical providers who use EHR. A summary of the specifically listed entities includes the following.

Health Plans. This basically includes all health plans, either individual or group no matter what entity sponsors the plan, if the plan pays the cost of medical care. This includes providers of medical, dental, and vision care, prescription drug insurers, health maintenance organizations (HMOs), Medicare, Medicare Advantage or supplement insurers, and long-term care insurers. There are more than are included and there are also some exceptions. 

Health Care Providers. Any health care provider who uses EHR for a standard medical transaction is a covered entity (CE) that must comply with the HIPAA rules. If health care providers bill for their services, they are CEs

Health Care Clearinghouses. Health care clearinghouses are entities such as billing services, repricing companies, and community health management information services, for example. The Privacy Rules apply to them when they are functioning in a way that provides them access to a patient’s PHI.

Business Associates. A business associate (BA) is a person or organization that provides services to a CE that involves the use or disclosure of a patient’s PHI.

Business Associate Contract. When a covered entity uses a contractor or other non-workforce member to perform BA services or activities, the Rule requires the CE to have a contract that specifies the expected protections for compliance with HIPAA privacy safeguards of the EHR.

Compliance with the HIPAA Privacy Rule

The HIPAA Privacy Rule “establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically.”

The purpose is to keep a patient’s protected health information (PHI) safe from discovery by those not authorized to access it. PHI is defined as “all individually identifiable health information a cover entity creates, receives, maintains or transmits in electronic form.” In general, this includes the patient’s:

  • Name, address, birthdate and Social Security Number.
  • Any information about the patient’s physical or mental health condition.
  • Any medical care or treatment provided to the patient.
  • Any information about payment for the care of the individual that identifies the individual or could lead to the ability to identify the individual.

Although patients have rights concerning the information, health care providers can disclose PHI when needed for patient care and treatment. This means health care professionals can access a patient’s EHR for a consultation, prescriptions can be sent to the pharmacy via EHRs, and for other specific purposes defined in the rule.

HIPAA Compliance With The Security Rule

The HIPAA Security Rule establishes minimum security standards for protecting all ePHI that is created, received, maintained, or transmitted by a CE or BA. If security standards are met, the National Coordinator for Health Information Technology states that “property configured and certified EHRs can provide more protection to ePHI than paper files provided.”

These safeguards are to help health care providers avoid some of the common gaps that could lead to a cyber-attack and data loss. Safeguards with which you must comply include:

Administrative safeguards. The main requirement is that you perform a security risk analysis. The purpose is to identify any risks to the ePHI. This includes risks due to the conduct of your employees. Administrative actions must be taken to prevent, detect, and correct any security violations. You are required to perform a security risk analysis that identifies and analyzes risks to the protected information and then implements measures that will reduce the identified risks.

Physical safeguards. These safeguards protect the electronic information systems as well as the actual physical structure where the electronic information is stored from:

  • Natural disasters.
  • Environmental disasters.
  • Unauthorized intrusions.

Organizational standards. The standards require written contracts between CEs and BAs. The contracts must specifically cover the need for security and the prevention of breaches.

Policies and Procedures. Every CE must adopt reasonable written policies and procedures that comply with the requirements of the Security Rule. The written documents must be maintained for six years after their creation date “or last effective date (whichever is later).” The policies and procedures must be periodically reviewed and updated.

Protection Against Breach

News reports abound about security breaches, usually related to large retail chains or banks. Health care providers often believe they are so small that criminals will stay away and not bother to cyber-attack them. This is not true. Small organizations have frequently been hit by cyber-attacks and often the breach goes undetected for a time.

Whether you are a sole practitioner or a large medical group or metropolitan hospital, HIPAA compliance requires you to take steps to ensure that the PHI of your patients remains secure and protected from a cybersecurity breach.

hipaa-security

Generally, software for EHRs has security features built-in or at least provided to you as part of the service you get from the software company. You are still charged with the duty of learning how these features work and making sure that you and your staff keep up to date on any upgrades.
HIPAA requires you to have strong EHR security practices whether your EHR is installed in your office or whether you use a cloud service provider that you access over the internet.

If you become aware of a breach or potential breach, you must “provide notification of the breach to affected individuals, the Secretary, and, in certain circumstances, to the media. In addition, business associates must notify covered entities if a breach occurs at or by the business associate.”

HIPAA Audit

Every CE and BA is subject to a HIPAA audit to be sure they are complying with the HIPAA Security Rule and Privacy Rule. This is conducted by the HHS Office for Civil Rights (OCR). Initially, HIPAA will send out a questionnaire asking for certain information about compliance. CEs and BAs who are selected for an audit will have 10 business days to provide the requested information to OCR through its website’s secure portal.Also Read – Audit preparation for small medical practices

The OCR will provide its results to the audited entity that can then respond. These written responses will be included in the final audit report.

HIPAA and Telehealth

Until the COVID-19 pandemic, HIPAA had no specific rules applicable to telehealth. The same requirements that applied to all other CEs and BAs for the use of EHRs applied to telehealth practitioners.

Telemedicine Software Screen

The COVID-19 environment has resulted in changes regarding telehealth and HIPAA “on almost a daily basis.” According to HIPAA, “during the COVID-19 national emergency, which also constitutes a nationwide public health emergency, covered health care providers subject to the HIPAA Rules may seek to communicate with patients, and provide telehealth services, through remote communications technologies.  Some of these technologies, and the manner in which they are used by HIPAA covered health care providers, may not fully comply with the requirements of the HIPAA Rules.” 

This allows health care providers to use almost any provision for communicating with their patients by way of any nonpublic facing remote communication product available to them. This includes “popular applications that allow video chats.” As an example, HIPAA clarifies that while Facebook Messenger can be used since it is not public facing, Facebook Live which is public facing does not meet the standard and cannot be used for telehealth.

Although the exception has been made due to the pandemic and to allow health care providers to treat specifically COVID-19 patients, it also allows doctors to treat their patients for other health problems.

How to Ensure Your Software is HIPAA Compliant

Not all software is HIPAA compliant. To be sure the software you use for your EHRs is compliant, it must meet the following criteria:

Prognocis telehealth app

  • All users must be authorized.
  • Access is controlled so that only authorized users can access the data.
  • An authorization monitoring program is in force.
  • There is a data backup plan.
  • There is a remediation plan in the event of a breach.
  • There is an emergency mode.
  • Users are automatically logged off after a certain period of time.
  • Data is encrypted.

Related Article:

 

How does PrognoCIS help you to be HIPAA Compliant?

PrognoCIS, a Meaningful-Stage 3 certified EHR provides a powerful platform for secure data storage, retrieval and transmission. 

PrognoCIS provides HIPAA compliance in the following ways: 

  1. Conduct Annual Pen Test
  2. PHI is encrypted at Rest and in Transit
  3. Annual review of documented policies and procedures
  4. Annual security risk assessment of the physical, technical, and administrative security to protect personal health  information 
  5. Designated Privacy Officer to oversee matters complying with HIPAA
  6. Annual HIPAA training for all employees 
  7. Undergo DEA 1311 Audit every 2 years (required to support EPCS).
  8. Access Control – 2FA and Fingerprint Authentication for password protection
  9. Host in Amazon AWS (SOC compliance)
  10. BAA with customers, Sub-BAA (or contracts in general) with vendors
  11. Incident Management and Anonymous reporting
  12. Business Continuity & Disaster Recovery
  13. Certified as per ONC Certification requirements for Health IT products 
  14. Use AlertLogic CloudDefender tools and services to monitor and protect our cloud Environment

Please feel free to contact us to learn more about HIPAA Compliance and measures that PrognoCIS takes to help ensure the privacy and security of your PHI.

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We look forward to exploring the potential benefits and offers prognoCIS has for you.

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