Ensuring HIPAA compliance in custom healthcare software development

Introduction

HIPAA is a comprehensive law that affects every aspect of your business and how you operate it. The Health Insurance Portability and Accountability Act (HIPAA) is a significant piece of legislation in healthcare that protects patient privacy and security. It was enacted in 1996 to create national standards to protect sensitive personal health information. At its core, HIPAA includes various rules, including the Privacy and Security Rule, to ensure standards are met for handling protected health information (PHI) and that electronic PHI (ePHI) is protected. HIPAA applies to anyone with access to PHI and ePHI, so everyone must be HIPAA compliant out of respect for the program, patient safety, and rights.
Since developers provide custom software development services for healthcare, ensuring their solutions comply with HIPAA is essential. Developers must design frameworks and systems with HIPAA in mind and integrate security features such as data encryption and access controls. Furthermore, they have to assess the HIPAA-related risks and monitor their implementation. By doing so, developers supply software that meets HIPAA’s requirements, safeguards health information, and provides healthcare companies with peace of mind by reducing the risk of potential data violation cases and helping them avoid legal consequences.

Understanding HIPAA compliance

The Health Insurance Portability and Accountability Act (HIPAA), a key legislation, was enacted in 1996 to protect the privacy and security of health information. HIPAA defines national standards to ensure the confidentiality of health data. HIPAA determines that all personal and medical information regarding a patient be stored and transferred within the health system with utmost privacy, thereby protecting the patient’s information. It has become crucial when considering the future of personal health records that information is kept private. After the attacks on the World Trade Center in New York in September 2001, many Americans became worried that the government would abuse their electronic health records. In response to the fear of the government using medical records as a form of punishment, the administration worked quickly to improve the rules regarding patients' medical information. As HIPAA was being developed and implemented, the vast commercial exchange of health information became paramount. In 1995, the Senate passed an essential part of the Balanced Budget Act, making it possible for health groups and businesses to exchange information efficiently and reliably.
HIPAA has four key rules: the Privacy Rule, the Security Rule, the Breach Notification Rule, and the Enforcement Rule (known earlier as the Standard for Privacy of Individually Identifiable Health Information). The Privacy Rule is the most well-known. It pertains to the list of permitted uses and disclosures for protected health information (PHI). The rule governs whether and how your personal health information is disclosed. The terms of the rule, for the most part, ensure that you have control over your health data and that healthcare providers and organizations gain your consent before releasing your PHI. The Security Rule, which goes hand in hand with the Privacy Rule, pertains solely to protecting your electronic protected health information (ePHI). It outlines the standards for administrative, physical, and technical safeguards that protect your data from unauthorized access or manipulation. The Breach Notification Rule, the final leg of this tripod, is arguably just as important and more likely to make the headlines. It mandates that certain covered entities must notify you and the Department of Health and Human Services (HHS) of a data breach involving your unsecured PHI (ie, unsecured electronic records containing your health data), and may be required to notify the media as well.

Importance of HIPAA compliance in custom software

Protecting patient information

In custom software development, HIPAA compliance is achieved to protect the integrity of patient information, which patients trust and rely on to manage care. The confidentiality and privacy of the patient's health information is important, and the additional development of custom software should be rigorous to ensure that these values are upheld. This mitigates the compromise of the data by ensuring they are secured against threats of unauthorized access to or storage of health information. With the implementation of these requirements, from the onset, confidentiality of patient data is maintained and patient health information becomes secure.

Avoiding legal and financial penalties

HIPAA compliance also helps organizations avoid legal and financial penalties. HIPAA violations can result in monetary fines and potential legal action, depending on the severity of the breach. According to HIPAA Journal, ‘HIPAA penalties can range from $100 per violation (up to $50,000 per year per violation) to $50,000, and for repeat violations, up to $1.5 million.’ Financially, organizations may face monetary penalties and lawsuits, but more than that, HIPAA compliance can also bring scrutiny from regulators. By ensuring that custom software is HIPAA compliant, organizations reduce risks and ensure that they can meet legal requirements, avoiding potential financial and legal consequences.

Maintaining trust and reputation

Maintaining trust and reputation often go hand in hand with HIPAA compliance. Patients share private information with their healthcare providers because they believe the amount of personal trust they put in this relationship warrants this exchange of information. When an organization is noncompliant with HIPAA regulations, this trust is quickly lost, and reputation can plummet rapidly. Following HIPAA regulations shows that the organization prioritizes patients’ personal information and builds trust among the patients and the larger healthcare community. If a healthcare organization is non-compliant, it will not provide customers with the same level of trust and support that they expect from a healthcare organization, and that’s why HIPAA compliance is very important for the healthcare industry. In conclusion, HIPAA compliance can protect the reputation and build strong relationships with patients and the whole healthcare community.

Key compliance considerations for custom software

Data encryption and security measures

Encrypted data at rest and in transit is key in protecting sensitive health information from unauthorized access. Only data in transit – in motion from one system (server or device) or user to another – may safely be sent unencrypted. However, data at rest, stored in systems, on file in databases, etc., must also be encrypted to ensure additional security, even in case of compromising physical security. Strong encryption standards such as AES (Advanced Encryption Standard) must be used. This high-quality encryption standard is adequate for the confidentiality and data integrity expected from HIPAA.

Access controls and authentication

By building strong access controls into your custom software system, you can ensure that only those with permission can access your health information. In this part of the framework, you would be Layering Security by setting up user roles and permissions based on job function or task and instituting multi-factor authentication (MFA) methods to secure logins. These methods require the user to use more than one form of proof when attempting to log in. For example, the individual entering the system to get an electronic patient record would need to enter a password and use a fingerprint reader or a one-time code sent to a mobile phone for verification. Putting these systems in place would minimize any risk of improper access and data breaches.

Audit trails and monitoring

Audit trails and monitoring are vital for HIPAA compliance because they track all access and changes to unique data. This is important because compliant custom software should include event-logging capabilities that track which users performed the action, what was done, and when it happened. By regularly reviewing these audit trails, it is possible to identify suspicious activity or potential security breaches. This allows organizations to react quickly and prevent such risks, thus ensuring that organizations and their protected patients' data remain as secure as possible. Ongoing monitoring and auditing allow for deviations in security measures to be dealt with immediately, ultimately keeping data and compliance at the highest success.

Data backup and recovery

Data backup and recovery are vital in ensuring data integrity and availability in case of a disaster or system failure. Every custom healthcare software solution must have built-in processes for regularly creating secure copies of data at predefined intervals. These copies are stored in a secure location separate from the server or main database to ensure that all the collected data can be retrieved, even if there is a hardware glitch, cyberattack, or any other catastrophic event. Furthermore, it is essential to prepare a well-thought-out data recovery plan. Most healthcare data backup solutions take weeks to recover completely, so a data recovery plan must provide a strategy for quick and error-free data recovery in case the need arises to retrieve data as soon as possible. Given the strategic and operational importance of managing sensitive patient data, proper backup and recovery mechanisms form the crux of healthcare regulatory compliance.

Steps to achieve HIPAA compliance in software development

Conducting a risk assessment

A risk assessment is the first step to designing and developing software from a fully HIPAA-compliant perspective. It systematically identifies and analyses risks and vulnerabilities that could jeopardize the security or privacy of patient data, including potential problems with data storage, transmission, and access controls. This assessment can be beneficial in identifying potential system weaknesses, and addressing them before problems emerge and become a breach or other HIPAA non-compliance issue.

Designing with compliance in mind

The key takeaway from designing with compliance in mind is that ‘HIPAA is designed to be preventative,’ according to a 2019 Office for Civil Rights study on IoT. This means the basic features of physical security, encryption, secure authentication, and access controls are designed into software before the code is written. Providers will likely successfully comply with the law over time when HIPAA compliance is built into the design, workflows, tools, and applications. This method empowers designers, developers and architects to create reliable, high-quality software that can safeguard sensitive health information and maintain regulatory compliance over the software’s lifespan.

Testing and Validation

Testing and validation are critical to confirm that all HIPAA applications are present. By excessively testing the software, you can prove that the software functions correctly and can handle HIPAA requirements based on all conditions and circumstances. Validate that all privacy controls are in operation, that encryption is applied, that user access is restricted correctly, that vulnerability assessments are used to identify any weaknesses with minimum risk, that penetration testing is deployed and performed, and that HIPAA standards are appropriately applied without any compliance issues. By validating all key functions, developers of any electronic online application can ensure the software will work properly as designed and be fit for use following all standards.

Regular Updates and Maintenance

Regular updates and maintenance are also crucial to maintaining HIPAA compliance because, as new threats and susceptibilities are recognized and as the HIPAA rules change, keeping the software current and up-to-date is essential if the software and the organization are to remain HIPAA compliant. Regular Updates should include the installation of patches and updates for various security problems and changes in rules and regulations. Regular maintenance includes identifying and eliminating potential breaches or vulnerabilities and adjusting to account for new security risks. These regular Updates and proactive maintenance will keep the software secure and up to date with current HIPAA rules and regulations.

Conclusion

To sum up, to comply with HIPAA and ensure that custom software used in healthcare is safe for patients, it is essential for the programmers and healthcare entities who use this software to focus on robust data encryption, stringent access controls, comprehensive audit trails, and a proper backup and recovery strategy. Risk assessment, design-for-compliance from the start, rigorous testing, and adequate maintenance of interconnected systems are key to ensuring that data is protected and healthcare entities comply with the letter and the spirit of these regulations. This not only allows organizations to avoid the threat of fines and litigation but will also improve the overall security of medical software, leading to better and safer patient care.