For those who work in the healthcare industry, the terms ‘HIPAA’ and ‘compliance’ may be a part of your daily vocabulary. You’ll hear these words thrown around in the context of patient records, paperwork, and everything in between.
But, what does it even mean?
Short for Health Insurance Portability and Accountability Act, HIPAA is all about protecting the privacy of patients.
At its core, HIPAA is a regulatory structure that would secure the handling, storage, and transfer of protected health information (PHI). In addition, HIPAA helps empower patients by providing them greater control of their health data and medical records, allowing them to request such records.
HIPAA has emerged into prominence in the past years due to the numerous health data leaks and breaches caused by ransomware and cyberattacks on health providers and insurers.
What Are The Entities Covered By HIPAA?
HIPAA only applies to the covered entities and the business associates. Entities covered by HIPAA are any corporation or organization that directly handles PHI or personal health records (PHRs).
In general, entities that should adhere to HIPAA compliance fall into three categories:
- Healthcare Providers: Doctors, dentists, clinics, pharmacies, nursing homes, psychologists, chiropractors, etc.
- Health Plan: Health insurance companies, government healthcare programs and company health plans, health maintenance organizations (HMOs), military healthcare programs
- Healthcare Clearinghouse: This refers to entities that process the non-standard health information they get from another entity into standard formats, or vice versa. These may include community healthcare systems for health data management and billing services.
Information And Data Protected by HIPAA
The HIPAA legislation protects all personally identifiable health data obtained, held, and/or transmitted by a covered entity or its BA. This data can be held in any form— paper, oral, or digital.
- The patient’s name, birthdate, address, biometric identifiers, Social Security number, and/or other personally identifiable information
- Any care provided to the patient
- The patient’s past, present, and/or future mental or physical health condition
- The past, present, and/or future payment information for the care provided to the patient or any data for which there’s a reasonable basis to use it to identify the patient. For example, laboratory reports, medical records and/or hospital bills contain identifying information associated with health data and is protected by HIPAA.
Meanwhile, PHI doesn’t include:
- De-identified data are data that don’t provide information or can identify an individual
- Employment and education records and other records defined in or subject to the Family Educational Rights and Privacy Act (FERPA). For example, heart rate or blood pressure data collected by a smartwatch aren’t covered since they’re not shared with a covered entity.
The Benefits Of Being HIPAA-Compliant
Now that you have a clearer understanding of HIPAA, below, walk through some of the few benefits of being compliant and implementing a strong HIPAA training program.
- Safeguard Against PHI Loss
Perhaps, the most important benefit of being HIPAA-compliant is being protected against PHI loss. Losing PHI is a serious offense, and when a healthcare provider or an organization suffers from it, they’re putting their patients and their sensitive personal data at risk. Healthcare providers and staff often interact with PHI countless times. And, every time they handle PHI, they’re faced with the risk of either exposing or losing patient information.
With HIPAA, you’re provided with a safeguarding methodology and process for ensuring that every member of your organization understands how to keep and manage patients’ PHI securely and safely.
- Increased Patient Trust
Healthcare organizations, particularly private ones, can thrive by providing a high level of satisfaction to their patients and family members. When a patient or a family member becomes unhappy with the organization, the likelihood of them continuing to use your healthcare services is very small.
Perhaps, one of the fastest ways to lose your patients’ trust or foster reputational damage towards your company is through security breaches. Large-scale data breaches have continued at an alarming rate in all industries, and the healthcare sector isn’t invincible. Data breaches can lead to substantial reputational harm and lasting damage.
Maintaining patient trust means maintaining HIPAA compliance, as well as a robust data security infrastructure with a strong focus on protecting patient information. One of the top benefits of being HIPAA-compliant is also the ability to reduce the risk of a data breach.
And, even in the event of a breach, being HIPAA-compliant can guarantee fewer damages. This is because part of a HIPAA compliance plan is to create a comprehensive data protection plan in place so that external intrusions are more likely to be noticed quickly, minimizing the scope of data breach and limiting its impact on your organization and reputation.
- Proactive Data Protection
Complying with HIPAA standards means implementing a comprehensive security risk management strategy of patient data. This allows your healthcare organization to protect sensitive data and systems against current risk.
In addition, a smart data protection plan can also allow your organization to promptly adapt to any new, emerging threat.
With the advancement and arrival of new technologies, it can be daunting to safeguard not only today’s threats, but tomorrow’s as well. You don’t have to worry much about that if you’re complying with HIPAA standards.
The first step in harnessing protection against future cyber threats is to implement a robust data protection plan. It lays the groundwork for protecting your organization and systems against future threats by ensuring that everyone in your organization is data-security-minded, as well as ensuring that you have tight access controls and active threat measures in place.
This should help you quickly incorporate new, innovative strategies for defending against threats in the future, instead of being caught off guard by the active and ever-changing threats. Such heightened cybersecurity posture, which comes with HIPAA compliance, ensures that you can defend your organization against tomorrow’s threat.
- Prevent Lawsuits And Establish Differentiation
Did you know that HIPAA compliance isn’t mandatory? Technically, HIPAA training is required by federal law. However, your organization doesn’t need to be fully HIPAA-compliant to operate legally. This only means that most healthcare providers tend to forgo HIPAA compliance in order to cut corners and save money. When you do, you open yourself up to the risk of damaging your reputation, as well as lawsuits and hefty fines.
In addition, being able to confidently tell your patients you’re fully HIPAA-compliant can help set you apart from competitors, building loyalty and giving you an edge. HIPAA compliance can be your low-cost way to secure hospital’s reputation, as well as to stand out from other healthcare facilities and organizations.
- Save On Unnecessary Expenses
Obtaining and maintaining HIPAA compliance is knowing that you won’t be subjected to corrective actions over non-compliance. And, that alone can save you significant unnecessary expenses and costs.
Corrective action can take several forms. However, each can have significant monetary costs associated with them. Sure, voluntary compliance efforts will result in high expenses—from training your staff to changing your processes or systems in order to be compliant.
However, your expenses and costs will be a lot more expensive if you don’t follow the standards. Corrective action has associated costs than just losing business from a bad reputation. Extensive re-training and training will be needed for your staff. Non-compliance can also mean that your security measures, data storage, and processes will need a system-wide overhaul in order to bring you to compliance.
In addition, non-compliance can have a negative impact on your revenues. Data breaches and other security issues—regardless of how big or small— where multiple violations occur can lead to significant monetary penalties. Not to mention patients filing lawsuits and compensation claims for damages caused by your noncompliance.
So, by maintaining HIPAA compliance, you’re essentially ensuring that your organization can prevent unnecessary costs and expenses, as well as ensure ongoing profitability.
How To Be HIPAA-Compliant?
The Department of Health and Human Services created seven elements for an effective HIPAA compliance program. This provides guidance for organizations in creating their own compliance programs or vetting for compliance solutions.
Take note that these are the bare minimum requirements that any effective compliance program should address:
- Implement written procedures, policies, and standards of conduct
- Conduct effective compliance education and training
- Designate a compliance committee and officers
- Conduct internal auditing and monitoring
- Develop effective communication
- Enforce standards via well-publicized disciplinary guidelines
- Prompt response to detected issues and carrying out corrective actions
During a HIPAA investigation in response to a possible violation, the federal auditors of HIPAA will compare your compliance program against these seven elements to judge its effectiveness.
With the digitization of the modern world, cybersecurity and customer privacy have become a critical priority for most industries, and even more so with the healthcare industry. Thanks to HIPAA legislation, health information and data are highly protected.
Complying with HIPAA standards is tedious. But, at the end of the day, those who practice proper security hygiene and are HIPAA-compliant protect not only their patients and clients, but also themselves.