Mobile technology has become commonplace in the healthcare industry. Numerous apps are available to assist clinical practitioners with a wide array of tasks, such as record management, patient monitoring, report generation, and many more. However, because of red tape, health-related apps have to strictly comply with HIPAA regulations pertaining to patient security and privacy of ePHI (Protected Health Information).
This article lists some proven ways and tips to ensure that the healthcare app you are developing, complies with HIPAA.
Before we start, let’s first discuss the rules around HIPAA and where those rules apply.
What is HIPPA?
HIPAA stands for the Health Insurance Portability and Accountability Act. This act sets safety and privacy standards for sensitive patient data. Organizations that access protected health information (PHI) must follow robust physical and security measures to ensure HIPAA Compliance.
Another important thing you must understand when developing a HIPAA application is the type of information you store and transfer via the app. There are two kinds of information:
- PHI (protected health information): This category includes emails, bills from doctors, blood test reports, MRI scans, and any other medical data.
- CHI (consumer health information): This refers to the information you receive from fitness trackers, like heart rate readings and the number of walking steps.
In the United States if your application accesses – processes, transfers, or stores PHI, it must be compliant with HIPAA standards. Even if you are developing an application for other countries, you have to meet similar requirements established within those jurisdictions.
As the healthcare sector is fast embracing computerized operations and mobile technology, HIPAA compliance has become even more important than ever. While electronic methods increase efficiency and mobility, they also pose severe security risks to healthcare data.
The following HIPAA rules protect patient data while allowing the industry to adopt new technologies to improve the quality of patient care.
- Privacy Rule:
This rule sets limits and conditions on access to patient data. It also gives patients rights to examine or obtain a copy of their health records and to request changes.
- Security Rules:
This rule requires appropriate physical, technical, and administrative safeguards to ensure the integrity, security, and confidentiality of ePHI (electronic protected health information).
- Enforcement Rules:
The HIPAA Enforcement Rule describes how the HIPAA law is enforced and when necessary corrective actions will be taken.
- Breach Notification Rules:
This rule describes when HIPAA covered entities and their business associates should notify certain organizations or individuals of a breach of unsecured PHI.
HIPAA rules are flexible enough to allow organizations to implement policies and technologies that suit their structure, size, and potential risks to patients’ and consumers’ e-PHI.
Tips and Tricks When Writing HIPAA Compliant Applications
So when you are developing an eHealth app, make sure you follow these tips to make sure that all HIPAA standards are met:
Ensure Access control
The HIPAA Privacy Rule states that nobody should be able to view or modify more patient records than required. This also specifies the patient’s right to limit access to their records.
You can accomplish this by:
- Assigning and tracking a unique identification to each user: By doing this, you will be able to identify and track all activities on your system.
- Assigning each user an individual list of privileges: Allow users to view and change particular information. You can also control the access database entities and URLs.
After assigning privileges, your system should be able to verify that the person trying to access PHI is the one he/she claims to be. The law offers several general ways in which you can implement this safeguard:
- Physical identification using a key, token or a card
- Personal Identification Number
Though password is the easiest authentication method, it’s also the easiest method for hackers to crack. A recent report revealed that 81% of total data breaches occur due to stolen or weak passwords. A secure password should have between 8-12 characters, and this excludes common combinations such as “123456,” “search123”, etc. Ideally, consider a two-factor authentication and pair the password with a second verification method.
Protect the PHI over networks using HTTPS. This secure communication protocol encrypts all your data into a string of characters with SSL/TLS. The encrypted information is useless without the key that comes enclosed with the SSL certificate.
To secure your healthcare app with HTTPS, you have to get an SSL certification from a trusted provider and install it. Avoid the regular FTP and use a secure FTPS or SSH protocol to transfer files containing PHI.
And, when it comes to transferring information via email, remember that even popular email services like Gmail don’t provide PHI protection. Instead, you should use HIPAA compliant email services like MailHippo, VM Racks, etc.
A recent study revealed that hospitals are disposing of PHI in an improper and insecure manner. This leads to hefty penalties to hospitals as well as massive data breaches.
Thus, it is important to ensure that all ePHI on the devices must be disposed of securely. According to HIPAA Rules, these include laptops, smartphones, tablets, servers, portable hard drives, and electronic storage devices, including CDs, backup tapes, and all devices capable of storing PHI.
You should erase and destroy the media that contains PHI before you throw them away. Depending on the type of device and the situation, you can erase the data magnetically, overwrite using specialized tools, or even destroy the device physically.
Regular data destruction programs don’t work for flash-based memory drives. However, you can use advanced tools like Samsung Magician software to dispose of your flash drives.
In addition to this, everyone within the health organization should be aware of their responsibilities when handling devices containing ePHI.
Embrace Standards-based Coding Practices
A standard coding practice is vital to make apps and devices interact securely and efficiently. Standard-based coding such as ICD-10, HL7, SNOMED, and DICOM makes secure and efficient communication a reality.
Similarly, Workgroup for Electronic Data Interchange (WEDI) and Integrating the Healthcare Enterprise (IHE) coding practices help ascertain that your data is encrypted for privacy purposes. These leading authorities provide guidelines that developers must follow when developing an app for a healthcare organization. They focus on the best practices to ensure HIPAA compliance. They provide
Further, keep the app user-centric and user-friendly, which may require repeated testing in a controlled environment. This will not only influence the success of the app but will also help ensure its privacy and security.
Data Backup And Storage
Problems like database corruption, server crash, and natural disasters like fire and earthquake can occur inevitably. These can damage your PHI. Therefore, backups are crucial to ensure data integrity.
You must store the copies of your PHI on several different storage media. Outline a PHI backup plan with the probability of data compromise in mind. Backup all your high- and medium-risk data daily in a secure location.
You are advised to sign a HIPAA-compliant Business Associate Agreement (BAA) with your backup provider. A data backup is useless if you are unable to restore it. In August 2016, ransomware attacked Martin Medical Practice Concepts in California. Backup failure caused the local hospitals lost valuable data on nearly 5,000 patients.
So it is important to check your system regularly to avoid backup failures. Log the system’s downtime and failures to back up the PHI. And keep in mind, the backups should also comply with HIPAA security standards.
Overlooking audit controls often lead to hefty penalties. So you should keep track of operations performed on the PHI stored in your system.
- Record each user log in and out
- Monitor who, where, and when someone accesses, updates, or deletes the data on your system.
You can monitor these activities via specialized hardware or software. Alternatively, you can use a table in a database of log files to record all activities performed on PHI.
This table should have the following columns:
- user_id: The unique identifier for users accessing PHI
- entity_name: The entity that the user has accessed
- record_id: Identifier of the entity
- action_type: Type of access: create, read, update, or delete
- action_time: Time of interaction
You have to periodically audit your activity logs so that you can identify any unauthorized access to PHI timely and respond proactively.
Enable Automatic logoff
With automatic logoff, any inactive session automatically expires after a particular period, and users have to re-enter their login credentials to access it. This protects PHI when a user loses his/her device while logged into the app.
The period of inactivity depends on your system’s specifics. Ideally, this should be between 2-3 minutes, and it should not exceed 10 minutes for web-based apps.
HIPAA is highly important for everyone – healthcare organizations, patients, developers, business associates, and other covered entities. Making your app HIPAA compliant is also important for the success of the app.
Undoubtedly, integrating a mobile app into a HIPAA compliant framework can be non-trivial; it’s necessary as penalties for violating these standards are massive.
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