HIPAA in the cloud: Tips to maintain HIPAA compliance in a public cloud infrastructure

HIPAA in the cloud: Tips to maintain HIPAA compliance in a public cloud infrastructure

No one who works in the healthcare industry can deny the reliability and usefulness of the cloud. Public cloud solutions, in particular, offer unparalleled opportunities for healthcare organizations to store, manage, and analyze huge amounts of sensitive patient data. However, navigating the intersection of cloud computing and regulatory compliance, particularly with statutes like the Health Insurance Portability and Accountability Act (HIPAA), presents distinct challenges.

HIPAA cloud compliance challenges

HIPAA mandates concerning the security of PHI and electronic protected health information (ePHI) are comprehensive. These mandates cover the storage and transmission of personally identifiable information about a patient's current, past, or future health status, encompassing both traditional paper-based records and electronic data.

While the public cloud offers numerous benefits for healthcare organizations, ensuring HIPAA compliance in this environment presents several key challenges. Here are just some of the critical hurdles healthcare organizations need to overcome:

  • Shared responsibility model: Public cloud environments operate under a shared responsibility model. The cloud service provider (CSP) manages the security of the underlying infrastructure, but the healthcare organization (i.e., covered entity) remains ultimately responsible for HIPAA compliance. For many healthcare organizations, the challenge lies in the lack of a clear understanding of their roles and responsibilities in avoiding security gaps.
  • Business associate agreements (BAAs): HIPAA mandates that covered entities have robust BAAs with any third-party vendor handling PHI. In the cloud context, this includes the CSP. Negotiating and finalizing a comprehensive BAA can be a complex process for healthcare organizations.
  • Data encryption: HIPAA demands that PHI be encrypted both at rest (stored on servers) and in transit (being transmitted). While many cloud providers offer encryption solutions, the onus falls on the healthcare organization to ensure the chosen encryption method meets HIPAA's stringent requirements. Additionally, managing encryption keys securely becomes a critical responsibility for the organization.
  • Access controls: HIPAA mandates strict access controls to safeguard PHI. In a cloud environment, ensuring that only authorized personnel within the healthcare organization and designated personnel at the CSP have access to specific patient data can be a challenge.
  • Risk assessments: Maintaining HIPAA compliance requires ongoing vigilance. Healthcare organizations may know that they must conduct regular risk assessments to identify potential vulnerabilities within their cloud environment, but not many may be properly equipped with the know-how to handle this undertaking internally.

HIPAA cloud computing tips to keep your healthcare organization secure

While the challenges associated with HIPAA compliance in the cloud are significant, your healthcare organization can follow these tips to address the specific challenges mentioned earlier:

Embracing proactive partnership

Don't rely solely on the inherent security of the cloud platform. Carefully evaluate the CSP's security policies, procedures, and certifications relevant to HIPAA compliance. Look for certifications like HIPAA compliance audits (HITRUST CSF) or SOC 2 reports.

Additionally, you should clearly define organizational roles and responsibilities. A documented agreement outlining the specific security responsibilities of both the healthcare organization and the CSP is crucial. This agreement should detail aspects such as data security, access controls, incident response protocols, and audit trails.

Negotiate comprehensive BAAs

CSPs may offer standard BAA templates that may not be optimal for your practice. Instead of settling, engage in discussions to ensure the BAA clearly outlines the specific security measures the CSP will implement to safeguard PHI. This includes encryption standards, access controls, and breach notification procedures.

Maintain a BAA inventory

Healthcare organizations often use multiple cloud-based services. Maintain a comprehensive inventory of all BAAs with relevant CSPs, ensuring each agreement is up to date and reflects current HIPAA requirements.

Protect PHI throughout its journey

Always choose a cloud service provider that offers strong encryption options for PHI, both at rest and in transit. AES 256-bit encryption is the current industry standard for HIPAA compliance. Ensure that the CSP has in place measures regarding the secure management of encryption keys.

Keep in mind that the responsibility for safeguarding encryption keys falls on the healthcare organization. Make sure to implement secure key management practices, including key rotation protocols and access restrictions.

Grant access wisely

One of the best ways to grant access to users is to implement multifactor authentication (MFA). MFA adds an extra layer of security by requiring a second verification factor beyond just a username and password to access PHI in the cloud environment.

Moreover, you should enforce role-based access control guided by the principle of least privilege. Grant users access only to the specific PHI data sets they require for their job functions. Lastly, regularly monitor user activity logs to identify any suspicious or unauthorized access attempts to PHI within the cloud environment.

Conduct regular risk assessments

Schedule regular risk assessments to evaluate the security posture of your cloud environment. These assessments should not only analyze the CSP's security measures but also identify potential vulnerabilities within your data security practices.

Following a risk assessment, promptly address any identified vulnerabilities. This could involve implementing additional security controls, user training, or updating BAA agreements with relevant cloud service providers.

Here’s another tip: consult Healthy IT’s healthcare IT support professionals today to stay on top of HIPAA compliance regulations. We can help your organization leverage the benefits of the cloud while ensuring HIPAA compliance and safeguarding the privacy of your patients' protected health information. Call us today or leave us a message.