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How to Keep Electronic Health Records HIPAA Compliant

Leah Zitter
Leah Zitter

Safeguards are in place to secure confidential patient data and protect healthcare stakeholders from fines and lawsuits.

If you’re old enough to remember the 1980s, you might recall seeing patients’ notes cataloged in files, faxed, sealed in A4 manilla envelopes, or left on desks for filing. Today, electronic health records (EHRs) must abide by Health Insurance Portability and Accountability Act (HIPAA) precautions, known as the HIPAA Security Rule, to ensure higher levels of patient confidentiality and security.

HIPAA injunctions ensure that only approved individuals can access patients’ health records. For medical practitioners and health institutions, HIPAA-compliant records protect against prohibitive fines, lawsuits, loss of jobs, or premises lockdowns. Appropriately regulated EHRs help people who come into contact with electronic protected health information (ePHI) conform to the HIPAA rules.

We’ll explore HIPAA compliance rules and best practices all healthcare organizations should implement.

What are HIPAA compliance rules?

All healthcare institutions and guardians of HIPAA-protected records are expected to follow four injunctions.

  1. HIPAA privacy: Healthcare entities must implement safeguards to protect the privacy of patients’ electronic protected health information (ePHI). This privacy rule applies to electronic information about the patient, details on their physical or mental health, conversations between a doctor and medical staff, billing information, medical charts, and prescriptions.
  2. HIPAA security: Confidential information can be shared only with authorized stakeholders directly involved with patient care.
  3. HIPAA enforcement: Every person who comes into contact with ePHI must protect this patient data. The HIPAA enforcement rule mainly deals with penalties and investigations when entities are found to be noncompliant.
  4. HIPAA breach notifications: HIPAA breach notifications provide guidelines on what you must do if a breach occurs. Breaches include unauthorized access to ePHI, inadvertent disclosures, stolen or misplaced data, and digital hacks.

How do you apply HIPAA rules to EHRs?

You’ll need to follow some best practices to keep ePHI confidential.

Best privacy practices for HIPAA compliance

  • Thoroughly shred printouts of any patient information. Paper-shredding services can make this process easier and more secure.
  • Encrypt ePHI to make it unreadable.
  • Implement an audit trail, recording whenever someone logged in to ePHI, the place and time they accessed ePHI, and any changes they made.

Best security practices for HIPAA compliance

  • Technical safeguards for securing electronic data include firewalls, antivirus software, a data backup plan and a network security program. Perform all necessary system updates and patches.
  • Administrative safeguards center on collecting, accessing, managing and auditing data. Ensure only authorized users with access controls (e.g., passwords or PINs) can access patient data.
  • Physical safeguards concern how or where you store data to protect it from accidental or deliberate intrusion and environmental or natural disasters.

Best practices to enforce HIPAA rules and prevent ePHI breaches

  • Conduct risk assessments to identify and analyze risks to patients’ information so you can implement safeguards to reduce those risks. Cybersecurity risk assessments include vulnerability scans and penetration tests that scan systems to root out network vulnerabilities.
  • Enforce rules through standardized HIPAA contracts with covered entities (CEs) and stakeholders.
  • Draft policies and procedures. When CEs draft written policies and procedures on HIPAA compliance and train their staff on how to follow these rules, they can avoid HIPAA breach notifications. Update your policies and procedures periodically and redraft written documents every six years.
Did You Know?

While HIPAA laws impact employers who are CEs, other employers have privacy and security obligations under federal laws like the Americans with Disabilities Act and the Family and Medical Leave Act (FMLA).

What is an electronic health record (EHR)?

When doctors, medical practitioners, healthcare insurers, billers, or anyone involved with patient care and payment processing document and review a patient’s case, they create and add to the patient’s medical records. An electronic health record, or EHR, is a digital version of these patient documents.

EHRs are computer logs containing sensitive patient health information (PHI), including patient-related billing, conversations, forms, charts and prescriptions – anything related to the patient’s medical treatment and mental or physical health.

Practitioners refer to the EHR to schedule or revise consultations, order prescriptions, or educate themselves on the patient’s history. Medical billing and coding departments refer to ePHIs to pay doctors and healthcare institutions.

Who must comply with HIPAA rules?

HIPAA injunctions apply to all CEs who electronically transmit healthcare information:

  • Any healthcare provider or health plan that uses EHRs and technical devices to process ePHI is subject to HIPAA injunctions.
  • Healthcare clearinghouses mediate between healthcare providers and insurers. If they’re involved with billing, repricing, or overseeing community health management information services, they’re subject to HIPAA injunctions.
  • Business associates that provide services to healthcare entities – and may therefore be exposed to ePHI – are subject to HIPAA injunctions.
  • Contracted business associates or similar non-workforce members who perform tasks for healthcare entities and are exposed to ePHI are subject to HIPAA injunctions.

To use telemedicine and stay HIPAA compliant, choose a secure telehealth solution, limit access to sensitive information, and develop a cybersecurity strategy.

6 essential HIPAA practices for EHRs

Follow these best practices to ensure compliance with HIPAA EHR rules:

  1. Use safe storage. Store all electronic systems and patient-related records in a locked, monitored area.
  2. Power down devices. Turn off electronic devices when not in use, or implement a robust medical records management system with an automatic time-out setting.
  3. Use a firewall. Install firewall protection to deter hackers from accessing patient records.
  4. Have a backup system. Make backups of your ePHIs, and consider storing them with one of the best cloud storage and online backup services.
  5. Shred old records. Shred dated medical records to reduce the risk of breaches.
  6. Train your staff. Train any staff members who work with your EHRs to handle these confidential records correctly.

If you’re considering implementing a medical records management system, check out our reviews of the best medical software offering HIPAA compliance tools and strong security.

HIPAA-EHR compliance tips for remote workers

More employees are processing confidential information from their homes. To avoid HIPAA-compliant violations, remote workers should adhere to these best practices:

  1. Work in a private, secure place. Don’t work on HIPAA-sensitive projects in public. People could snoop over your shoulders and read the data. Even worse, malicious actors use wireless devices and powerful antennas to pick up unsecured wireless networks. They could hack into the confidential electronic data in your care and gain unrestricted access to private medical information.
  2. Use a VPN. Use a virtual private network (VPN), particularly if you work in a public place such as a hospital or airport. VPNs encrypt your public data, scrambling it from snooping individuals.
  3. Keep patient data off the calendar. Take care not to misuse patient data when using a digital calendar or drafting digital notes. A Google task reminder to process Jane Doe’s July appointment could land you in hot water.
  4. Take precautions when faxing. To protect private data, use a cover sheet when faxing patient information.
  5. Ensure a secure internet connection. To ensure a secure internet connection, you need the WPA3 encryption protocol with its Wi-Fi Enhanced Open Mode option for increased security on unsecured networks.
  6. Create strong passwords. Use strong passwords a crook can’t crack. Experts recommend using passwords with upper- and lower-case numbers, symbols and letters. Create different passwords for personal and business devices; if you write them down, keep them in a safe place, like your wallet.
  7. Use up-to-date antivirus software. Keep your antivirus and anti-malware software up to date. Some of the best antivirus software includes Kaspersky, Bitdefender, Avast, Norton and ESET.
  8. Use a firewall. Install firewalls on computers, devices and routers to protect your ePHI. You may also want to use software scanners, like Vistumbler or Airodump-ng, to search the airwaves of your home for foreign Wi-Fi signals that could pick up this ePHI.
  9. Think before you click. Foil phishing attempts by not clicking on suspicious email links. Double-check seemingly familiar email addresses for subtle irregularities. Steer clear of suspicious ads, websites, links and messages. Any promotion that sounds too good to be true probably is.
  10. Change or conceal your SSID (service set identifier). Your Wi-Fi network SSID is listed among other local networks on your wireless-enabled device. Either change its name to mislead would-be hackers or remove your SSID from the network list. At the very least, disable the SSID in public settings when anyone with wireless technology can pick up your signals.
Image Credit: Drazen Zigic / Getty Images
Leah Zitter
Leah Zitter
Contributing Writer
Leah Zitter PhD is a trained journalist who covers emerging technology across more than 60 industries. Her PhD is in Behavioral Neuroscience which beautifully intersects with the AI/ ML topography. Clients include Google, AWS and Microsoft.