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To Improve Health Data Security, Get Your Staff On Board

Posted on February 2, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As most readers know, last year was a pretty lousy one for healthcare data security. For one thing, there was the spectacular attack on health insurer Anthem Inc., which exposed personal information on nearly 80 million people. But that was just the headline event. During 2015, the HHS Office for Civil Rights logged more than 100 breaches affecting 500 or more individuals, including four of the five largest breaches in its database.

But will this year be better? Sadly, as things currently stand, I think the best guess is “no.” When you combine the increased awareness among hackers of health data’s value with the modest amounts many healthcare organizations spend on security, it seems like the problem will actually get worse.

Of course, HIT leaders aren’t just sitting on their hands. According to a HIMSS estimate, hospitals and medical practices will spend about $1 billion on cybersecurity this year. And recent HIMSS survey of healthcare executives found that information security had become a top business priority for 90% of respondents.

But it will take more than a round of new technical investments to truly shore up healthcare security. I’d argue that until the culture around healthcare security changes — and executives outside of the IT department take these threats seriously — it’ll be tough for the industry to make any real security progress.

In my opinion, the changes should include following:

  • Boost security education:  While your staff may have had the best HIPAA training possible, that doesn’t mean they’re prepared for growing threat cyber-strikes pose. They need to know that these days, the data they’re protecting might as well be money itself, and they the bankers who must keep an eye on the vault. Health leaders must make them understand the threat on a visceral level.
  • Make it easy to report security threats: While readers of this publication may be highly IT-savvy, most workers aren’t. If you haven’t done so already, create a hotline to report security concerns (anonymously if callers wish), staffed by someone who will listen patiently to non-techies struggling to explain their misgivings. If you wait for people who are threatened by Windows to call the scary IT department, you’ll miss many legit security questions, especially if the staffer isn’t confident that anything is wrong.
  • Reward non-IT staffers for showing security awareness: Not only should organizations encourage staffers to report possible security issues — even if it’s a matter of something “just not feeling right” — they should acknowledge it when staffers make a good catch, perhaps with a gift card or maybe just a certificate. It’s pretty straightforward: reward behavior and you’ll get more of it.
  • Use security reports to refine staff training: Certainly, the HIT department may benefit from alerts passed on by the rest of the staff. But the feedback this process produces can be put to broader use.  Once a quarter or so, if not more often, analyze the security issues staffers are bringing to light. Then, have brown bag lunches or other types of training meetings in which you educate staffers on issues that have turned up regularly in their reports. This benefits everyone involved.

Of course, I’m not suggesting that security awareness among non-techies is sufficient to prevent data breaches. But I do believe that healthcare organizations could prevent many a breach by taking advantage of their staff’s instincts and observational skills.

Medical Device and Healthcare IT Security

Posted on December 21, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you haven’t noticed, we’ve been starting to do a whole series of Healthcare Scene interviews on a new video platform called Blab. We also archive those videos to the Healthcare Scene YouTube channel. It’s been exciting to talk with so many smart people. I’m hoping in 2016 to average 1 interview a week with the top leaders in healthcare IT. Yes, 52 interviews in a year. It’s ambitious, but exciting.

My most recent interview was with Tony Giandomenico, a security expert at Fortinet, where we talked about healthcare IT security and medical device security. In this interview we cover a lot of ground with Tony around healthcare IT security and medical device security. We had a really broad ranging conversation talking about the various breaches in healthcare, why people want healthcare data, the value of healthcare data, and also some practical recommendations for organizations that want to do better at privacy and security in their organization. Check out the full interview below:

After every interview we do, we hold a Q&A after party where we open up the floor to questions from the live audience. We even allow those watching live to hop on camera and ask questions and talk with our experts. This can be unpredictable, but can also be a lot of fun. In this after party we were lucky enough to have Tony’s colleague Aamir join us and extend the conversation. We also talked about the impact of a national patient identifier from a security and privacy perspective. Finally, we had a patient advocate join us and remind us all of the patient perspective when it comes to the loss of trust that happens when a healthcare organization doesn’t take privacy and security seriously. Enjoy the video below:

Doing a Proper HIPAA Risk Assessment with Mike Semel

Posted on November 19, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HIPAA Risk Assessments have become a standard in healthcare. However, not everyone is doing a proper HIPAA Risk Assessment that would hold up to a HIPAA audit. In this video, we sits down with HIPAA Expert Mike Semel to discuss the HIPAA Risk Assessment and what a health care organization can do to make sure they’ve done a proper HIPAA Risk Assessment.

Learn more about Mike Semel and his services on the Semel Consulting website.

Full Disclosure: Semel Consulting is a sponsor of Healthcare Scene.

There’s More to HIPAA Compliance Than Encryption

Posted on March 24, 2015 I Written By

The following is a guest blog post by Asaf Cidon, CEO and Co-Founder of Sookasa.
Asaf Cidon
The news that home care provider Amedisys had a HIPAA breach involving more than 100 lost laptops—even though they contained encrypted PHI—might have served as a wake-up call to many healthcare providers.  Most know by now that they need to encrypt their files to comply with HIPAA and prevent a breach. While it’s heartening to see increased focus on encryption, it’s not enough to simply encrypt data. To ensure compliance and real security, it’s critical to also manage and monitor access to protected health information.

Here’s what you should look for from any cloud-based solution to help you remain compliant.

  1. Centralized, administrative dashboard: The underlying goal of HIPAA compliance is to ensure that ­­organizations have meaningful control over their sensitive information. In that sense, a centralized dashboard is essential to provide a way for the practice to get a lens into the activities of the entire organization. HIPAA also stipulates that providers be able to get Emergency Access to necessary electronic protected health information in urgent situations, and a centralized, administrative dashboard that’s available on the web can provide just that.
  1. Audit trails: A healthcare organization should be able to track every encrypted file across the entire organization. That means logging every modification, copy, access, or share operation made to encrypted files—and associating each with a particular user.
  1. Integrity control: HIPAA rules mandate that providers be able to ensure that ePHI security hasn’t been compromised. Often, that’s an element of the audit trails. But it also means that providers should be able to preserve a complete history of confidential files to help track and recover any changes made to those files over time. This is where encryption can play a helpful role too: Encryption can render it impossible to modify files without access to the private encryption keys.
  1. Device loss / theft protection: The Amedisys situation illustrates the real risk posed by lost and stolen devices. Amedisys took the important first step of encrypting sensitive files. But it isn’t the only one to take. When a device is lost or stolen, it might seem like there’s little to be done. But steps can and should be taken to decrease the impact a breach in progress. Certain cloud security solutions provide a device block feature, which administrators can use to remotely wipe the keys associated with certain devices and users so that the sensitive information can no longer be accessed. Automatic logoff also helps, because terminating a session after a period of inactivity can help prevent unauthorized access.
  1. Employee termination help: Procedures should be implemented to prevent terminated employees from accessing ePHI. But the ability to physically block a user from accessing information takes it a step further. Technical tools such as a button that revokes or changes access permission in real-time can make a big impact.

Of course encryption is still fundamental to HIPAA compliance. In fact, it should be at the center of any sound security policy—but it’s not the only step to be taken. The right solution for your practice will integrate each of these security measures to help ensure HIPAA compliance—and overall cyber security.

About Asaf Cidon
Asaf Cidon is CEO and co-founder of cloud security company Sookasa, which encrypts, audits and controls access to files on Dropbox and connected devices, and complies with HIPAA and other regulations. Cidon holds a Ph.D. from Stanford University, where he specialized in mobile and cloud computing.

NueMD’s Startling HIPAA Compliance Survey Results

Posted on December 12, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a recent HIPAA compliance survey of 1,000 medical practices and 150 medical billing companies, NueMD found some really startling results about medical practices’ understanding and compliance with HIPAA. You can see their research methodology here and the full HIPAA Compliance survey results.

This is the most in depth HIPAA survey I’ve ever seen. NueMD and their partners Porter Research and The Daniel Brown Law Group did an amazing job putting together this survey and asking some very important questions. The full results take a while to consume, but here’s some summary findings from the survey:

  • Only 32 percent of medical practices knew the HIPAA audits were taking place
  • 35 percent of respondents said their business had conducted a HIPAA risk analysis
  • 34 percent of owners, managers, and administrators reported they were “very confident” their electronic devices containing PHI were HIPAA compliant
  • 24 percent of owners, managers, and administrators at medical practices reported they’ve evaluated all of their Business Associate Agreements
  • 56 percent of office staff and non-owner care providers at practices said they have received HIPAA training within the last year

The most shocking number for me is that only 35% of respondents had conducted a HIPAA risk analysis. That means that 65% of practices are in violation of HIPAA. Yes, a HIPAA risk analysis isn’t just a requirement for meaningful use, but was and always has been a part of HIPAA as well. Putting the HIPAA risk assessment in meaningful use was just a way for HHS to try and get more medical practices to comply with HIPAA. I can’t imagine what the above number would have been before meaningful use.

These numbers explain why our post yesterday about HIPAA penalties for unpatched and unsupported software is likely just a preview of coming attractions. I wonder how many more penalties it will take for practices to finally start taking the HIPAA risk assessment seriously.

Thanks NueMD for doing this HIPAA survey. I’m sure I’ll be digging through your full survey results as part of future posts. You’ve created a real treasure trove of HIPAA compliance data.

What Do We Know About Minimum Necessary Coming to HIPAA?

Posted on November 14, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We recently sat down with Alisha R. Smith, RHIA, HIM Compliance Educator at Healthport, to talk about HIPAA Omnibus and one of the components that was left out of the HIPAA Omnibus final rule: minimum necessary. In the video below, Alisha talks about what your company can do to prepare for minimum necessary and what minimum necessary might require if it gets included in future HIPAA requirements.

What do you think about Alisha’s recommendations? Do you think that legislation will be passed to include minimum necessary as part of HIPAA?

Six Reality Checks of HIPAA Compliance

Posted on April 23, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Between Windows XP causing HIPAA compliance issues and the risk associated with the risk assessment required by meaningful use, many in healthcare are really waking up to the HIPAA compliance requirements. Certainly there’s always been an overtone of HIPAA compliance in the industry, but its one thing to think about HIPAA compliance and another to be HIPAA compliant.

This whitepaper called HIPAA Compliance: 6 Reality Checks is a great wake up call to those that feel they have nothing to worry about when it comes to HIPAA. While many are getting ready, there are still plenty that need a reality check when it comes to HIPAA compliance.

Here’s a look at why everyone could likely benefit from a HIPAA reality check:
(1) Data breaches are a constant threat
(2) OCR audits reveal health care providers are not in compliance
(3) Workforce members pose a significant risk for HIPAA liability
(4) Patients are aware of their right to file a complaint
(5) OCR is increasing its focus on HIPAA enforcement
(6) HIPAA Compliance is not an option, it’s LAW

Obviously, the whitepaper goes into a lot more detail on each of these areas. As I look through the list, what seems clear to me is that HIPAA compliance is a problem. Every organization should ask themselves the following questions:

Are we HIPAA compliant?

What are you doing to mitigate the risk of a breach or HIPAA violation?

When I look at the 6 Reality Checks details in the whitepaper, I realize that everyone could benefit from a harder look at their HIPAA compliance. A little bit of investment now, could save a lot of heartache later.

4Med Health IT Courses – HIPAA Training, ICD-10 Training, PQRS Training and More

Posted on January 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As most of you know, I’ve been sharing a number of different 4Med approved education courses on this site and throughout my various social media channels. I think 4Med’s done a pretty good job putting together training courses that matter to those of us in Healthcare IT. For example, they have HIPAA courses, EHR Courses, ICD-10 courses and they recently added a course on PQRS which I haven’t seen anywhere else. As a partner, those links and the discount code “healthcare20” will get you a 20% discount off the course price. Plus, many of the courses include CMEs for those that need them.

What’s also been amazing to me is how many people I work with sell the 4Med courses as well. Everyone from health IT service providers to EHR consulting companies are signed up as 4Med affiliates and are suggesting these courses to their clients.

It makes sense why so many people are interested in these training courses. HIPAA Omnibus has led many to take another look at their HIPAA compliance. One of those requirements is to have regular HIPAA training. ICD-10 is bearing down on us and many aren’t ready and so ICD-10 training is going to be huge over the next 6 months. PQRS penalties are coming and many have no idea how the PQRS program even works. Hopefully these training courses can be useful for many of you.

Windows XP Won’t Be HIPAA Compliant April 8, 2014

Posted on December 12, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As was announced by Microsoft a long time ago, support for Windows XP is ending on April 8, 2014. For most of us, we don’t think this is a big deal and are asking, “Do people still use Windows XP?” However, IT support people in healthcare realize the answer to that question is yes, and far too much.

With Microsoft choosing to end its support for Windows XP, I wondered what the HIPAA implications were for those who aren’t able to move off Windows XP before April 8. Is using Windows XP when it’s no longer supported a HIPAA violation? I reached out to Mac McMillan, CEO & Co-Founder of CynergisTek for the answer:

Windows XP is definitely an issue. In fact, OCR has been very clear that unsupported systems are NOT compliant. They cited this routinely during the audits last year whenever identified.

Unsupported systems by definition are insecure and pose a risk not only to the data they hold, but the network they reside on as well.

Unfortunately, while the risk they pose is black and white, replacing them is not always that simple. For smaller organizations the cost of refreshing technology as often as it goes out of service can be a real challenge. And then there are those legacy applications that require an older version to operate properly.

Mac’s final comment is very interesting. In healthcare, there are still a number of software systems that only work on Windows XP. We’re not talking about the major enterprise systems in an organization. Those will be fine. The problem is the hundreds of other software a healthcare organization has to support. Some of those could be an issue for organizations.

Outside of these systems, it’s just a major undertaking to move from Windows XP to a new O/S. If you’ve been reading our blogs, Will Weider warned us of this issue back in July 2012. As Will said in that interview, “We will spend more time and money (about $5M) on this [updating Windows XP] than we spent working on Stage 1 of Meaningful Use.” I expect many organizations haven’t made this investment.

Did your HIPAA compliance officer already warn you of this? Do you even have a HIPAA compliance officer? There are a lot of online HIPAA Compliance training courses out there that more organizations should consider. For example, the designated compliance officer might want to consider the Certified HIPAA Security Professional (CHSP) course and the rest of the staff the HIPAA Workforce Certificate for Professionals (HWCP) course. There’s really not much excuse for an organization not to be HIPAA compliant. Plus, if they’re not HIPAA compliant it puts them at risk of not meeting the meaningful use security requirements. The meaningful use risk assessment should have caught this right?

I’m always amazed at the lack of understanding of HIPAA and HIPAA compliance I see in organizations. It’s often more lip service than actual action. I think that will come back to bite many in the coming years. One of those bites will likely be organizations with unsupported Windows XP machines.

HITECH Privacy Compliance Gets Trickier – Meaningful Use Monday

Posted on July 9, 2012 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

It’s been a very interesting few weeks for privacy protection under  HIPAA. Just in case you haven’t had a chance to catch up on them,  here’s what’s going on.  The OCR has announced the protocols under which it’s going to perform audits required by HITECH.

Here’s how OCR is going to check both you and business associates for compliance with the HIPAA Privacy Rule,  Security Rule and Breach Notification Rule. Here’s a summary from the Beyond Healthcare  Reform blog from lawfirm Faegre Baker Daniels:

Privacy Rule Security Rule
Notices of privacy practices Administrative Safeguards
Right to request privacy protection for PHI Physical Safeguards
Access to PHI Technical Safeguards
Administrative requirements
Uses and disclosures of PHI
Amendment of PHI
Accountings of disclosures

Meanwhile, there’s the matter of the temperature being turned up on your relationship with your business partners. As things stand, maintaining HIPAA-level control over information once it leaves your facility or office is hard enough.  Since 2009, HITECH has required covered entities and business associates to disclose if they’d used information on patients — including for treatment, payment or operations — if the access was through an EMR.

While that’s sticky to enforce, it mostly affects providers, not the business associates in most cases. But things could get a little trickier going forward.  A new proposed rule would now require a basic access report applying not just to EMRs, but also to uses and disclosures of e-PHI in a designated record set.

As the Beyond Healthcare Reform blog notes, this could mean that health plans and business associates (if they have a designated records set) would have to provide the access reports for everything, including treatment, payment and operations.

I doubt any of us are surprised to see OCR getting tougher on data sharing;  in fact, I’d argue that it’s overdue. The question is whether in the mean time, the near-daily data breaches we see (stolen laptops with unencrypted data, lost data disks) still haunt us.  Scary times.