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OCR Cracking Down On Business Associate Security

Posted on May 13, 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.

For most patients, a data breach is a data breach. While it may make a big difference to a healthcare organization whether the source of a security vulnerability was outside its direct control, most consumers aren’t as picky. Once you have to disclose to them that the data has been hacked, they aren’t likely be more forgiving if one of your business associates served as the leak.

Just as importantly, federal regulators seem to be growing increasingly frustrated that healthcare organizations aren’t doing a good job of managing business associate security. It’s little wonder, given that about 20% of the 1,542 healthcare data breaches affecting 500 more individuals reported since 2009 involve business associates. (This is probably a conservative estimate, as reports to OCR by covered entities don’t always mention the involvement of a business associate.)

To this point, the HHS Office for Civil Rights has recently issued a cyber-alert stressing the urgency of addressing these issues. The alert, which was issued by OCR earlier this month, noted that a “large percentage” of covered entities assume they will not be notified of security breaches or cyberattacks experienced by the business associates. That, folks, is pretty weak sauce.

Healthcare organizations also believe that it’s difficult to manage security incidents involving business associates, and impossible to determine whether data safeguards and security policies and procedures at the business associates are adequate. Instead, it seems, many covered entities operate on the “keeping our fingers crossed” system, providing little or no business associate security oversight.

However, that is more than unwise, given that the number of major breaches have taken place because of an oversight by business associates. For example, in 2011 information on 4.9 million individuals was exposed when unencrypted backup computer tapes are stolen from the car of a Science Applications International Corp. employee, who was transporting tapes on behalf of military health program, TRICARE.

The solution to this problem is straightforward, if complex to implement, the alert suggests. “Covered entities and business associates should consider how they will confront a breach at their business associates or subcontractors,” and make detailed plans as to how they’ll address and report on security incidents among these group, OCR suggests.

Of course, in theory business associates are required to put their own policies and procedures in place to prevent, detect, contain and correct security violations under HIPAA regs. But that will be no consolation if your data is exposed because they weren’t holding their feet to the fire.

Besides, OCR isn’t just sending out vaguely threatening emails. In March, OCR began Phase 2 of its HIPAA privacy and security audits of covered entities and business associates. These audits will “review the policies and procedures adopted and employed by covered entities and their business associates to meet selected standard interpretation specifications of the Privacy, Security, and Breach Notification Rules,” OCR said at the time.

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.