Maintaining HIPAA Compliance in a Telehealth Multi-Platform Environment

THE COMING HIPAA CRISIS FOR HEALTHCARE PROVIDERS:

2020 saw dramatic changes in the operations of healthcare organizations due to the COVID-19 pandemic but the most profound operational impact is the forced shift to widespread telehealth operations. Government regulations, as well as internal patient and staff safety, demanded day-to-day operations and activities transition from in-person visits, diagnostics and treatments to remote connection with patients. The industry has, in fact, enjoyed widespread success with the transition although it involved redesigning business processes at almost every level. The rapid adoption of cloud computing technologies facilitated the change; the speed and effectiveness were admirable.

However, the focus on speedy transformation created potential liability. The Health Insurance Portability and Accountability Act, enacted in 1996, as well as a privacy provision enacted in 2003 radically altered requirements for protecting patient data and the processes by which that data is accessed. While healthcare providers refined compliance over the past two decades for their standard operations, many (and perhaps a majority) in an effort to meet the needs of a remote healthcare paradigm have failed to ensure new operations comply with HIPAA regulations. Although the government recognized the need for rapid transformation, and eased regulations during the process, regulation will not only return but will likely include more restrictive demands.

Although the pandemic will end, it is highly likely this restructuring in healthcare will remain in effect, with some providers maintaining a primary remote patient interaction and others blending remote and in person to varying degrees. The need to ensure the new technology and data architecture achieves HIPAA compliance is immediate. This whitepaper will examine methods by which healthcare organizations of every size can meet and exceed HIPAA guidelines quickly and effectively without devoting excessive internal resources to do so.

The Coming HIPAA Enforcement for Telehealth Operating Environments

While the requirement for HIPAA compliance was established some time ago and nearly all health care organizations achieved HIPAA-compliant operations, prior compliance is, to a great extent, irrelevant in the new telehealth environment. Compliance designed for in-person care occurring primarily on premises under the complete control of the health care organization in no way ensures compliance in this new environment. Successfully transitioning to distance diagnosis and treatment meant processes already HIPAA-compliant were exchanged for non-compliant processes for obtaining patient data, storing and disseminating patient data to relevant healthcare personnel. Existing IT infrastructure, compliant infrastructure, was abandoned as the organizations’ new technologies and processes designed for provision of care at a distance replaced compliant systems. While the organizations did an admirable job of transitioning from a business standpoint, compliance was by no means a priority. Recognizing the time pressure involved, the U.S. Federal Government relaxed HIPAA enforcement from the very beginning of the pandemic. This reprieve allowed for a remarkably fast transition to remote care but relying on continued loose enforcement is unwise. There is little doubt the government will return to standard or even stricter enforcement, meaning healthcare organizations must ensure their architecture, software, hardware and processes for telehealth provisioning achieve compliance with HIPAA requirements.

Achieving HIPAA Compliance without Localized Operating Environments

Any organization with operations that involve handling Patient Health Information (PHI) must take seriously the need to accomplish and maintain HIPAA compliance in a telehealth paradigm, which forces complexity in operating environments to achieve remote patient care. This list is not all-inclusive but provides examples of organizations affected.

Health Care Providers

The health care industry is wide-ranging and providers include health care specialties, facilities, and more. Any company or individual providing health care services or provides or receives provision that includes any health information transmitted digitally either falls under the HIPAA guidelines now (the vast majority) or is very likely to fall under HIPAA guidelines soon. The Health and Human Services (HHS) department has adopted standards for the majority of these providers including (but not limited to) hospitals, clinics, nursing home, medical offices, doctors, nurse practitioners, nurses, chiropractors, dentists, psychologists and pharmacies.

Public or Private Medical Billing or Processing Entities

Any organization who receives patient data electronically or changes non-electronic data into a digital format or receives another entity's health care transactions in order to facilitate other formats of delivery or for any other reason are subject to HIPAA rules and guidelines. A partial list of such entities includes billing services, repricing companies, community health management organizations, and value-added networks.

Health Insurance and Heal Care Plan Providers

The regular receipt and transmission of patient data requires an individual or group plan providing or paying the costs of health care take very seriously the HIPAA mandates and guidelines. The organizations include but are not limited to health insurance companies, Medicare, Medicaid, military health care programs, veterans, health maintenance organizations (HMOs) and other health care programs. These organizations face a great many “moving parts” when it comes to data as a great many individuals and systems access and modify the data as part of daily operations.

Non-Medical Associates to Health Industry Organizations

This list is immense because anyone not specifically employed by a covered entity that provides services or performs functions that involve access to patient health information will still be subject to the same data security requirements of covered entities. Such organizations and any subcontractors providing, creating, maintaining or receiving PHI for the associate organization or any organization must ensure compliance. Among the services or functions a non-medical associate organization or individual might provide are billing, claims processing, accreditation, data analysis, financial services, legal services, management administration, training, utilization review and consulting.

Although the above entity types represent those most likely to require HIPAA compliance, it is impossible to create an all-inclusive list because the business and non-business reality of today’s world is hyper-connectivity and constant reliance of virtual environments. Nearly every public and private industry segment has organizations that handle personal health information at some point or have an association with an organization that does. Thus, HIPAA is quickly becoming a business standard for handling data rather than a standard associated with any particular segment.

Challenges Faced by Organizations with HIPAA Compliance in Remote Operating Environments

Breaches or violations of HIPAA Compliance can occur if any healthcare organization or other organization:

• Lacks sufficient safeguards to protect Personal Health Information (PHI) whether those safeguards be administrative, technical or physical.
• Uses PHI in a manner not consistent with current law.
• Discloses PHI in a manner not consistent with current law.
• Uses more than the minimum necessary PHI.
• Discloses more than the minimum necessary PHI.
• Fails to provide an individual access to that individual's PHI.

Preventing these breaches is a challenging process even with localized non-remote environments. The process is particularly difficult in an environment demanding remote, cloud-based operations. Thus, the telehealth context to business operations creates systems which:

• Create far more variables with additional users and endpoints. This makes it far more difficult to track PHI dataflow and determine where PHI data might be stored within the remote environment.
• Create not only a higher volume of PHI data than in-person (on-premises) care but also create additional points at which the data is stored. This is because there are more patient interactions that occur virtually (digitally) and therefore more PHI data is collected, stored and transmitted.
• Create far greater system vulnerability by giving cybercriminals access to larger and more diverse environments. They allow these criminals to exploit the vulnerabilities at more points of entry and to move within the environment more surreptitiously and ultimately require new tools to detect and respond to threats.
• Require completely new processes for governance and protection. Remote environments do not operate in the same way as on-premise operating environments and communication is all delivered in a way that creates data.
• Deny businesses end-to-end visibility because of the number of systems, users and endpoints involved. This makes detection of breaches and incidents of non-compliance more difficult to detect. When detected, the scope of the event is more difficult to determine, making it more difficult to address and disclose in a timely manner.

Perhaps the most challenging aspect of HIPAA compliance needs in a telehealth operating paradigm is that the need for change comes while healthcare organizations face unprecedented resource (both financial and human) burdens for pandemic-related testing and care. This makes the very basic resources of time and necessary attention very scarce indeed.

The Telehealth HIPAA Compliance Solution

Securus360 provides a set of solutions to address HIPAA compliance in an effective, immediately actionable way. These solutions are designed for rapid and efficient implementation, implementation that will not require significant internal effort from the healthcare organization but will nonetheless address all core elements of HIPAA compliance. Securus360 has real world solutions and they have been proven in the real world. They are updated regularly, making them uniquely effective in handling the data security requirements of today’s telehealth operating environments.

Securus360 HIPPA compliance solutions include:

Ensure Proper Internal Privacy Rules for PHI

• HIPAA Privacy Rule Compliance
  Compliance in this area is complex because of broad regulations and includes any individual health data in any medium if said data is individually identifiable. Securus360s suite of data privacy compliance services not only achieves HIPAA compliance but also compliance with CCPA, ISO 27701 and GDPR.
• HIPAA Security Rules Compliance
  HIPAA's Security Rules mandate both technical and nontechnical safeguards that covered organizations and entities must implement to secure PHI. Securus360 offers solutions for implementing these safeguards as well as a suite of security testing services to identify weaknesses in current processes and to continually analyze implemented processes to secure PHI data.
• HIPAA Breach Notification Rule Compliance
  Entities subject to HIPAA’s Breach Notification Rule must notify patients when their PHI is used or disclosed without permission or when the data environment is breached, compromising the privacy and/or security of the PHI. Securus360 provides services that greatly expand an organization’s capabilities to not only detect breaches and collect data necessary for sufficient disclosure but also allows the breaches to be detected faster and investigated more thoroughly and effectively. Most importantly, Securus360’s MXDR service allows for faster response including analyzing the event, responding to and remediating the event.

The Benefits of Acting Now to Achieve HIPAA Compliance in a Telehealth Environment

The political, social and business impacts have been profound but now that the pandemic is manageable and its impacts on day-to-day life are diminishing, the days of HIPAA enforcement laxity are numbered.

With the right partner and quick action, healthcare organizations will be able to make their operating environment(s) and the PHI inside it private and secure at all times. This can be accomplished in a HIPAA compliant manner even if internal resources are unavailable. With the right partner, ongoing advances in technology and access to additional services will ensure up to date compliance even as new regulations or enforcement protocols are enacted.

Entities that wait will find themselves scrambling to achieve and maintain HIPAA compliance. Those entities that get ahead of the process will not only decrease liabilities associated with non-compliance but also enjoy a competitive advantage over organizations that do not act.

Learn How AI-Driven MXDR Can Empower and Protect Your Healthcare Institution

Contact Us