Health Insurance Portability and Accountability Act (HIPAA) — depending on your occupation this name can ring a bell for you. And, if your work responsibilities included the development of telemedicine software for the US market the ring of this bell can be a little anxious-inducing. Developing a HIPAA-compliant telemedicine platform is a painstaking, business analysis-heavy process, which is absolutely required to protect the sensitive data HealthCare apps deal with and avoid outrageously high fines and reputation damage. We’ve had our fair share of experience creating HIPAA-compliant telemedicine apps, and we want to share the essentials to help you better understand this complex regulatory environment and create well-protected apps.
Thus, this article will examine the HIPAA compliance in telemedicine, the essential of ensuring compliance, and some practices of secure data management and transmission.
HIPAA Compliance on Telemedicine
In 1996, the US President Bill Clinton signed a HIPAA, a series of rules and regulations intended to outline the protection and processing of sensitive medical data (known as protected health information). It was an important step on the path of ensuring the security of online data processing and a major point of concern for software development companies.
Protected Health Information (PHI) that falls under the authority of the HIPAA is any information that can be used to identify patients or clients of the HealthCare establishment. The most apparent examples of PHI are name, phone number, address, photos, insurance information, medical records, and results of medical tests and examinations, etc.
When the deal gets to telemedicine and HIPAA compliance, three major rules should be adhered to:
1) Only authorized users should have access to ePHI.
2) A system of secure communication should be implemented to protect the integrity of ePHI.
3) A system of monitoring communications containing ePHI should be implemented to prevent accidental or malicious breaches.
The most common HIPAA violations can be divided into three categories:
- Stolen laptop
- Stolen phone
- Stolen USB device
- Office break-in
- Sending PHI to the wrong patient/contact
- Discussing PHI outside of the office
- Social media posts
- Malware incident
- Ransomware attack
- EHR breach
The social and physical security aspects are the issue that we have no sufficient expertise to discuss. However, when it comes to software security and robustness of the system, we’re well-equipped to give some valuable advice.
Steps to Develop a HIPAA-Compliant Telemedicine Software
Developing a HIPAA-compliant software is a nuanced process, which requires thorough research and business analysis expertise. Though the approaches to ensuring the compliance may differ depending on the specifics of the particular software that is being developed, some tips for HIPAA compliance are universal and essential to any HealthCare application.
The very first step of developing a HIPAA-Compliant telemedicine solution is implementing reliable data encryption, both
-When data is transmitted
-When data is stored
Data encryption is the first, the last, and the most important resort of information protection. Even if a third party gets hold of your information, if the reliable data encryption is implemented, they wouldn’t be able to exploit the information. Considering that modern telemedicine platforms implement video and audio conferencing, it’s important to ensure that this data is encrypted when transmitted as well. It’s easy to neglect this aspect because of the thoughts that audio or video are difficult to intercept or worry that encryption may affect the software’s performance. However, leakage of audio or video data can be extremely harmful to both patients and the company. Besides, properly implemented encryption wouldn’t affect the app’s performance in a significant way for users to notice.
Often, the answer to the question “is telemedicine HIPAA compliant?” is whether the solid encryption of sensitive data exists.
Encryption is important but isn’t sufficient in protecting the data. A secure connection is another super important aspect of telemedicine and HIPAA relationships.
Thus, the patient-physician communication should be performed using secure in-app connection; skype, email, SMS, or some other third-party providers (unless they grant the levels of security required for HIPAA), isn’t an option. Some companies may offer special agreements that will provide a necessary level of security and legal responsibility needed for HIPAA-compliant data transmission. For instance, Microsoft can offer physicians BAA (business associate agreement). However, such a deal will result in additional monthly costs. Besides, being dependent on a third-party service isn’t the most comfortable option for plenty of entrepreneurs.
As follows, it’s a common practice for telemedicine platforms to implement secure in-app messaging solutions. Besides the advantage of having complete control over in-app connection, such a solution decreases costs in the long run compared to the third-party services.
Storing Data Properly
First of all, as the rule of the thumb — don’t store data you don’t have to store. There will be temporary information a healthcare provider won't need in the future. For instance, the results of some tests the relevance of which diminishes after a certain period, or information about patients who passed away or don’t longer use your services. Deleting such information as soon as it becomes obsolete is a useful habit, which will save you space on servers and make databases easier to manage and maintain. In addition, you should monitor databases for any duplications of data that may have occurred due to bugs in the system, poor management, lacking Back End architecture, or simply human error. Unnecessary copies of the information in a system not only clutter the servers but also make it easier to exploit and find ways to access the data that shouldn’t be accessible. Building a reliable software architecture and intuitive and smooth user flows can significantly minimize the possibility of any data duplications.
Also, another important point of data storage is building a flexible and reliable system of user roles, so only employees who should have access to certain data have the said access. It’s a universal rule of storing sensitive personal information. However, in the HealthCare industry, a system of user roles requires extra attention because of the complexity of patient-physician relations, ethics, and the necessity to manage information efficiently.
Some General Tips
As we mentioned in our articles on security standards in FinTech, there are approaches to coding and user-flow construction that are the must for any application regardless of the industry it belongs to. Those approaches include
1) Implementing secure coding practices, which help to avoid prevalent defects, bugs, and logic flaws within the code. Also, it is important to learn what patterns that may compromise security to avoid.
2) Including input validation to check any data received from other sources to prevent the injection of malicious code into a project.
3) Not writing unnecessarily complicated algorithms as they may lead to gaps in a project’s protection, which are difficult to notice, and increase the possibility of bugs.
4) Ensuring that a project sends the minimum of required data to external sources to prevent leaking of sensitive information.
5) Including multi-factor authentication. A single password is not enough to provide access to core functions of an app, additional authentication via email or phone is required as well.
6) Motivating users to create complex passwords.
At the end of the day, your system is as secure as your least experienced employee is educated about the nuances of working with the app and aware of the responsibility of data protection. When a new worker becomes a part of your company, he or she needs some time of adaptation and education under the guidance of an attentive mentor to better feel and understand the sensitivities and dangers of working in digital HealthCare. A week or two of thorough education and mentoring goes a long way and is a significant investment in the future. Besides, different telemedicine platforms have different unique features, and it’s important to ensure that new employees know how to use them properly.
If all of the above-mentioned tips are implemented the possibilities of Malware incidents, Ransomware attacks, Hacking incidents, and EHR breaches are significantly decreased.
The set of tips on telemedicine and HIPAA that we provided is simply scratching the surface of the matter because to build a truly secure app, each case should be researched and analyzed. Laying the foundation of the compliant HealthCare app starts with the initial stage of the development planning when a team consisting of business analysts, software developers, and QA professionals craft a blueprint of the future system. Afterward, it’s all about experience and dedication.
Building a HIPAA-compliant telemedicine solution is a painstaking process. However, with each new telemedicine or other HealthCare application developed, the process of creating regulations-loyal apps becomes a more straightforward experience. We know it from our own experience developing HealthCare solutions for markets of different countries. The accumulated business analysis and product management/development expertise allow us to quickly figure out the specifics of different regulatory environments and create a reliable app that fits those environments.
If you want our experience in creating HIPAA-compliant HealthCare solutions to become your asset, contact us, we can help.