Seven Tips for Protecting Your HIPAA Database

Richard Bailey
Author: Richard Bailey, Linux, Cloud and Lead IT Consultant
Date Published: 6 October 2021

Protecting confidential data is a top priority for every industry, but when it comes to the healthcare industry, the regulations and compliance requirements that are in place require stringent data protection measures. 

Whether you are a healthcare provider or a healthcare developer, if your organization in the US deals with the collection, storage, and/or transmission of protected health information (PHI), then your database needs to stay compliant with the US Health Insurance Portability and Accountability Act (HIPAA). 

2020 saw a steep rise in cyberattacks on healthcare data and was the third-worst year in terms of the number of breached healthcare records, with 29,298,012 records reported as having been exposed or impermissibly disclosed. According to Emsisoft, 560 healthcare facilities in the US were affected by ransomware attacks in 2020, across 80 separate incidents. 

Protecting Your HIPAA Database 
The HIPAA Security Rule requires three kinds of safeguards: administrative, physical and technical. 

Modern applications and storage formats are primarily database-driven. With the PHI getting stored primarily in database tables, having a HIPAA compliant database and ramping up the safety and security of PHI needs to be at the top of the agenda for healthcare organizations and the entities they have signed business associate agreements (BAA) with. 

A cyberattack on your healthcare database can not only lead to significant loss of revenue and the tarnishing of their reputation, but it also attracts hefty fines if non-compliance with HIPAA regulations was the reason for the breach.

Here is what you need to know to best protect your HIPAA database:

  1. Conduct risk assessments
    Regular risk assessments can help identify vulnerabilities in your organization’s data security, gaps in employee education, lapses and possible pitfalls in the security coverage of vendors and business associates, and other areas of concern.

    Internal risk assessments conducted periodically can help you figure out possible shortcomings that may lead to the database and the PHI it contains being exposed. Proactively identifying and mitigating possible vulnerabilities identified through risk assessments can help you avoid the detrimental impact of data breaches and keep your HIPAA database secure going forward. 
  1. Train your staff
    As the cybersecurity threat landscape continues to evolve, staff training needs to keep up to avoid inadvertent data breaches due to human error. Security awareness training equips your staff with the knowledge they need when handling sensitive HIPAA databases.

    As hackers continue to evolve their techniques, your staff needs to be able to identify possible phishing attacks and follow security best practices to keep up with current threats to HIPAA databases. Training would also empower your staff to exercise caution when handling patient data. 
  1. Ensure encryption of data
    Whether in the database or in transit, complete encryption of PHI is a must to ensure data safety so that malicious forces cannot bypass the database controls and access information directly. Even in case of a breach, database encryption ensures that the PHI remains unintelligible.
  1. Set up data controls
    Data controls ensure that any malicious activity that threatens the safety of the healthcare database can be flagged and blocked in real-time. Data controls include access controls, audit logging, authentication and authorization.

    The more people who have access to the data, the more at risk you are for a breach. Access controls involve setting up user authentication. Audit logging refers to keeping track of the user logins, reads, writes and edits in a separate log to comply with the HIPAA regulations. Authentication and authorization deal with defining who will have access to the database and assigning appropriate roles and privileges to the users. 
  1. Enforce BAAs
    Just ensuring in-house compliance to HIPAA norms is not enough. To protect your HIPAA database, you need to carefully evaluate HIPAA Compliance of business associates as well and ensure that you sign Business Associate Agreements (BAAs) with all the vendors who are involved in the collection, transmission, or storage of healthcare data.

    BAAs are a type of legal contract that must be in place between parties that use, transmit, receive, or exchange PHI. They need to be in place between parties that share PHI before any PHI is received or shared.
  1. Have a data recovery plan
    HIPAA requires that organizations implement backup and disaster recovery procedures in case of a service outage. Cyberattacks and other disasters can hamper the availability of data, which is why backups are a necessity per the HIPAA guidelines. However, steps need to be taken to protect the data backup as well.

    The backup data also needs to be fully encrypted to comply with HIPAA norms. All backups must be checked and tested regularly. The backups need to be verified, and the testing and verification must be logged. Utilizing Off-Site Data Backup is an integral part of disaster recovery as well. 
  1. Plan for data disposal
    The longer you must keep the protected data in your system, the tighter the regulations become. In the US, there are more than 150 state and federal laws that impact the retention of data. The regulations and duration for which you need to retain healthcare data vary depending on the type of data you are storing.

    Once the stipulated period of data storage is over, you need to put mechanisms in place to securely wipe off your database and dispose of data and media securely when no longer needed. High-security file wiping, according to current NIST standards, is a must when formulating a plan for data disposal.

A proactive plan is needed
As the healthcare landscape continues to evolve, the threats to healthcare data will continue to rise. A proactive rather than a reactive approach is required when formulating and implementing a data protection plan. 

As the regulatory requirements for ensuring the protection of HIPAA databases evolve, healthcare organizations that take a proactive approach to implement best practices for healthcare security would be best equipped for ensuring compliance and at a lower risk of suffering costly data breaches.