HIPAA Compliant Software Development – A Guide For Healthcare Industry


April 1, 2020


April 27th, 2023


The healthcare industry is one happening and challenging industry – in terms of criticality and popularity. Healthcare IT solutions and services are almost mandatory to be implemented now, for streamlining processes and making the most of the data that is being generated.

These healthcare systems need to be focused on what the patients, doctors, administrators, clinicians, insurance providers etc. need. The web and the mobile are now becoming attached arms to healthcare stakeholders.

Some of the prime reasons why IT solutions are a must in healthcare are a growing demand to reduce costs and integrating systems, maximizing RoI, aging populations and the want for a computerized process entry.

With increased use of technology, the task of connecting reality with technology-based solutions is getting tougher and maintaining security is becoming an issue.

What is most important is that the software development that is meant for healthcare industry needs to follow strict rules and regulations that are created by the medical companies and the state officials.

At such times, an act that emphasizes on the security aspect of the healthcare industry comes into picture – THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA). Healthcare IT solutions are supposed to comply with the regulations proposed by HIPAA and hence it forms an integral and highly important part of the entire fraternity, when it comes to integrating medical institutes.

Here is a snapshot that tells us why strict monitoring by a centralized set of rules like HIPAA is a must:

Image Source: hipaajournal.com

Between 2009 and 2019 there have been 3,054 healthcare data breaches involving more than 500 records. Those breaches have resulted in the loss, theft, exposure, or impermissible disclosure of 230,954,151 healthcare records. That equates to more than 69.78% of the population of the United States. In 2019, healthcare data breaches were reported at a rate of 1.4 per day.

HIPAA – An Introduction

“HIPAA was created primarily to modernize the flow of healthcare information, stipulate how Personally Identifiable Information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and address limitations on healthcare insurance coverage.” – Wikipedia

Enacted by 104th US Congress, signed in 1996 by President Bill Clinton, also known as Kennedy-Kassebaum Act, the HIPAA aims at the simplification of administration, privacy of health information, security of electronic record and portability of insurance.

It empowers users to seamlessly, sincerely, securely and satisfactorily leverage the healthcare IT solutions, without any compromise to privacy and with fully secured information.

For any healthcare software to be HIPAA compliant, there must be a framework to offer guidance to the concerned to ensure completion of the entire process of compliance as per HIPAA rules and regulations. This software assists the compliance-in-charge to run through the HIPAA norms and ensures that all regulations are being followed.

And, this is what happens if you don’t obey HIPAA norms or there is a data breach or there is a cyber-attack or a leak of privacy information: You can get fined heavily ranging from around 100 $ to 50,000$ per user per violation. And, there are a greater number of users, it is unimaginable how much fine would it cost?

PHI and Key Identifiers Considered PHI Under HIPAA

Protected Health Information (PHI) is a very important aspect of HIPAA. PHI talks about the secure information about the healthcare of patients that can be leveraged to offer medical services or treatment or diagnosis.

It can comprise of healthcare medical records of interaction between patients and doctors, billing data and insurance data of patients stored in different ways.

Under HIPAA rules, PHI talks about not only past and present information, it also talks about future medical records and data. It includes medical data in any form – physical, electronic or voice enabled. PHI could be in form of health records, lab results, medical files, health histories, medical bills etc.

PHI talks about any health information record associated to an individual, that includes one or more of the 18 identifiers. If these identifiers don’t exist or are tampered, the information lot does not validate to be a part of the HIPAA rule format.

Following Key Identifiers Are PHI While Implementing HIPAA:

  • Full or last name
  • Dates other than the year
  • Phone numbers
  • Geographical identifiers
  • Fax numbers
  • Social Security numbers
  • Email addresses
  • Account numbers
  • Web URLs
  • Medical record numbers
  • Certificate numbers / license details
  • Vehicle identifiers, serial numbers, license plates
  • Health insurance beneficiary numbers
  • Device identifiers and serial numbers
  • IP address
  • Full face photographs
  • Biometric identifiers – retina scan, fingerprints
  • Any unique identifying characteristic, number or code

Key Features Of HIPAA Compliant Software Development

For any healthcare IT solution / apps to be HIPAA compliant, here are certain key features / steps that need to be ensured / followed:

  • Discarding Of PHI Information

Once the PHI data is utilized, it is necessary to discard that so that it may not be misused in the future by anyone with malicious intent. Keeping such critical information intact may lead to a disaster.

  • Security Of Networks / Devices And Encryption

Since it includes a lot of data transfer across a variety of networks, there must be tight encryption rules embedded with SSL / TLS technologies to ensure total privacy of information. Even security of devices being used is equally important. Features like encrypting full devices must be implemented to the healthcare apps. Portable devices must be monitored strictly since they could lead to a data leak.

  • Thorough Audit Control Mechanism

Simply maintaining PHI data properly doesn’t suffice. What is needed is a proper audit control mechanism that can keep observing and managing where this data is being used, what is the status. This is important to find out possible chances of data threats or breach of data privacy. It can be done by having log files that maintain all the data of PHI data.

  • Proper Handling Of Documentation Is A Must

Since most healthcare software solutions deal with documents of stakeholders, mostly patients, the system must handle documentation properly in line with what is needed for HIPAA compliance. Documents need to be managed in a simple and comprehensive manner under tight security control and with utmost accuracy.

  • User Authentication And Access Control

The apps that are compliant to HIPAA need to have accurate user authentication integrating modern methods like PIN codes, cards, bio-metrics etc. Users must have relevant access control including those especially meant for admin rights, abiding by the HIPAA rules and regulations.

  • Secure Backup And Recovery Mechanisms

Wherever there is too much data, a secure and accurate backup mechanism is an essential. Especially when it is PHI data, there must be a safe way to deal with natural disasters, corrupt information, server crash and many such calamities. And, even if any such disaster occurs, there must be stringent recovery plans that must be appropriate for the mishap occurred.

  • Maintaining Relationships With Business Contacts

Any software solution that is dealing with healthcare and complying with HIPAA must encompass dealing with its business contacts. The solution must manage the business processes that are being associated with business colleagues.

Major Benefits Of HIPAA Compliance

Why is HIPAA compliance so important?

What are the benefits that healthcare units are enjoying, post implementation of these standards?

Have a look:

  • Brings in legal balance with all processes abiding by the HIPAA set of regulations
  • Lessens burden on hospital authorities to protect data, secure it and offer it the best way
  • Increases the speed at which communication happens between stakeholders in a smooth way
  • Proactively protect sensitive data including patient information
  • Earns profitability, lessens cost increase and thereby garners increased revenue earning
  • Prevents any type of discrimination withing patients
  • Brings about a sense of security amongst all involved, increasing the approaches taken to protect the private information of patients
  • Inculcates a sense of adherence to principles and adapting to the right way, for stakeholders involved
  • Increases awareness of protecting PHI amongst staff, thereby, enhancing its significance
  • Helps healthcare units get a good feedback, score while assessment and handle PHI data properly
  • Makes healthcare processes smooth, secure and helps them follow law rigidly
  • Secures user authentication, records legal information, generates a variety of reports
  • Earns patient trust in a big way, since patients are assured of a rule compliant system
  • Offers role-based security to stakeholders based on what their role is
  • Provides a strong password control through a secure system
  • Gets physical and system security closer and tighter

Common HIPAA Breaches To Prevent

Avoid these HIPAA violations, save your healthcare unit from further chaos:

  • Not safeguarding mobile devices or them getting stolen is a big risk, since maximum information lies on those, after the invent of these healthcare systems
  • Patient information must not be revealed to other patients / administrators, without following the security protocols
  • Forgetting paper-based patient records at unnecessary places can prove to be dangerous as it can be read by anybody, without any security protocol

The HIPAA Compliance Software Checklist

There are certain checklist items that better be checked for compliance, while implementing HIPAA standards in any healthcare IT solution, here are they:

Do you have an agreement / privacy policy jotted down between all necessary roles and stakeholders? check box
Have you embedded necessary security features, encryption logic in your healthcare app, compliant to HIPAA standards? check box
Have you made sure if your healthcare solution needs HIPAA compliance or not? check box
Have you extracted the key metrics that you want to measure through HIPAA compliance? check box
Is your budget for establishing the standards set? Does it align with the organisational cost lines? check box
Have you established cloud-based storage and devices for your healthcare app / software based on standards? check box
Have you joined hands with a competent IT service provider who excels in software development and healthcare industry? check box
Are your rules set to balance between user accessibility and data protection? check box
Have you established a rapport with a professional business analyst who can help you identify the importance of HIPAA for your solution? check box

Certain Limitations Associated With HIPAA

  • Implementing HIPAA increases the administrative costs and requirements associated with it
  • Violating these norms turns out quite a costly affair
  • Transparency becomes difficult in terms of revelation of data due to fine imposing
  • Because of strictness in violation rules, patients sometimes suffer waiting or not getting information
  • While abiding to HIPAA norms, the billing structure gets complicated
  • Following the rules and regulations sometimes leads to a stringent data sharing platform

How Is GDPR Comparable To HIPAA?

GDPR is a very common term today, quite popular and in demand. What is GDPR?

GDPR (General Data Protection Regulation) is data protection and privacy law that enforces organizations to protect personal data of EU (European Citizens), giving more control to individuals over their personal data.

But, does it sound synonymous to the HIPAA standards?

Since GDPR also talks about data privacy, protection and security of information, it is often confused with HIPAA norms. Here is the comparison between the two:

Both, GDPR and HIPAA are individual set of rules and regulations that looks at the security of data and retaining its privacy.

But, the main difference in both is its focus area. GDPR focuses on the European Union’s privacy data.

GDPR looks at the sensitive personal information also apart from PHI and hence has a broader perspective than HIPAA.

HIPAA focusses only on the PHI of the healthcare industry.

Both are similar but have their own set of characteristics and domain areas to work on.

On a Parting Note

This article has given an insight into all nitty-gritty of how HIPAA standards influences the healthcare industry and offers a better version, a more secure, stable, trustworthy environment. Imposing HIPAA has surely given a boost to the healthcare units and is making healthcare software solutions much easier to implement and effective to use.

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