Health Insurance Portability Accountability Act
The Health Insurance Portability Accountability Act (HIPAA) was enacted to prevent the misuse of health information to protect patients’ privacy and maintain confidentiality within healthcare systems. Any violation or noncompliance with the statutes’ regulations can lead to severe complex legalities, including civil suits and financial penalties (Edemekong & Haydel, 2). Thus, all healthcare organizations must align their data practices per HIPAA regulations to avoid the pitfalls mentioned above. This report will analyze a court case where HIPAA regulations were violated and its implication for the hospital. It will also provide recommendations on how the hospital can prevent other violations. Integrating the hospital’s electronic health records (EHR) systems with cloud technology will help the organization comply with HIPAA regulations.
Court Case
In 2016, Athens Orthopedic Clinic was involved in a civil lawsuit where a client claimed that her medical records were being used to blackmail her. The client claimed that someone had shared the medical records from one of her visits to the hospital and threatened to leak them if she did not pay. The hospital could not provide the court with the client’s records when asked to do so. An internal investigation revealed that an encrypted hard drive with several patient information was missing. Missing or losing protected health information is a HIPAA violation. The client was awarded $300,000 in damages, and the hospital was instructed to take corrective action.
The hospital’s failure to provide the court with clients’ information proved beyond reasonable doubt that its data protection practices posed a significant risk to patients’ data privacy. The missing flash drive could have been stolen from the hospital, and its content used to extort, coerce, or threaten victims. Additionally, criminals can use the data to fake false claims in patients’ names, leading to severe fraud cases. A criminal can access enough information to create an individual’s profile from the medical records and use that information to scam companies.
Analysis of Violated Law
Title II of the HIPAA law initiated five rules to prevent healthcare fraud and abuse: privacy rule, security rule, transactions, and code set regulation, enforcement, and unique identifiers rule. The privacy rule covers data-sharing practices, the security rule covers data storage and electronic health records, and the transactions rule covers billing and transaction costs. This healthcare setting violated the security rule, which outlines administrative, physical, and technical data safeguards. The administrative safeguards require the hospital to have policies and procedures to help the facility comply with HIPAA. HIPAA administrative safeguards demand that covered entities have guidelines on access authorization, information backup, and recovery plans. The hospital would still have the client’s records with a backup and recovery plan even after the flash drive was lost. The fact that the flash drive was the hospital’s backup system underscores the importance of an automated backup system.
HIPAA physical safeguard regulations require all covered entities to control any physical access to patient information. The hospital violated several of these HIPAA physical safeguard regulations. Another guideline demands hospitals to control any hardware and software handling from the hospital’s data system and ensure no information is lost in the process. However, the flash drive’s handling led to the loss of thousands of patient records, meaning that the hospital has no clear regulations on hardware handling. HIPAA also requires all workstations and data storage devices to be properly used and kept out of the public’s view. The law also requires access to any equipment containing patient information to be restricted to only authorized personnel. Assuming that the flash drive was stolen, the hospital failed to keep the device out of view/reach of unauthorized persons. Consequently, the hospital also violated the first provision of the HIPAA physical safeguard provision, which requires covered entities to control the physical access to patient information or restrict it to only authorized personnel.
Implications of HIPAA Regulations on the Health Care System
HIPAA regulations have significantly influenced the functioning and operations of the healthcare system. The law puts a high value on protecting patients’ privacy and information confidentiality and security. HIPAA’s commitment to data privacy and confidentially upholds several ethical principles, including trust, fidelity, autonomy, fiduciary responsibility, and beneficence (Majumder & Guerrini, 3). The American Medical Association Code of Ethics states “that patients will make a full disclosure of information in the knowledge that the physician will respect the confidential nature of the communication” (Majumder & Guerrini, 3). This statement underscores the importance of trust in the healthcare system. HIPAA’s regulation that patients should have access to their information at any time promotes autonomy. The law prohibiting unauthorized disclosure protects patients’ right to privacy, enhancing the beneficence principle. Another facet relates to HIPAA mandating disclosure of information about suspected abuse protects patients from harm, further upholding the beneficence and maleficence principle.
Title II’s enforcement rule outlines the procedures for investigating HIPAA violations and the associated financial penalties. Healthcare facilities have been forced to revamp their practices and systems and increase paperwork to avoid civil lawsuits and fines, increasing operational costs for many healthcare facilities. According to Edemekong and Haydel, healthcare providers hold onto life-saving information in a bid to avoid HIPAA violations (2). The law also has implications for the current technology trend in the healthcare system. HIPAA requires covered entities to uphold privacy and security concerns in all documentation and communication modes, including electronic health records. The law’s privacy restriction has led to a 95% and 70% reduction in follow-up surveys and patient accrual in medical research, respectively (Edemekong & Haydel, 2). These laws have reduced researchers’ ability to conduct chart-based medical retrospective research.
Recommendation
The hospital should integrate its EHR system with cloud technology to improve compliance with HIPAA regulations. A systematic review conducted by Ahmadi and Aslani revealed that integrating cloud technology with EHR significantly improves data privacy and security practices, and operational costs (1). The study endorsed cloud technology as a gold standard for improving data security and privacy practices and reducing organizational costs. As mentioned earlier, organizations spend a lot of money implementing systems that help with HIPAA compliance. However, with cloud technology, the hospital does not need such systems because the cloud service providers offer the necessary software and hardware.
Cloud technology eliminates the risk of data loss and unauthorized access because it has two-factor authentication features, digital signing, encryption, decryption features, time encryption, and a unique key that allow personalized email delivery to individuals. These features will enable the hospital to comply with HIPAA’s data privacy, security, and technical safeguards provisions. For example, time encryption is a feature that allows automatic sign-out from the system when a log-in session expires. The hospital can use encryption features as a user control system to prevent unauthorized data access, including archived data and data stored in the EHR database and external storage devices. Most cloud technologies also have an in-built firewall that can detect spyware activities and prevent intrusion, including cyber-security attacks. The hospital can create a role-based access control from the EHR system and assign it to specific employees. The role-based access control will significantly improve accountability and prevent intentional/accidental data violations by staff.
The cloud’s encryption features can change identifiable patient data into decrypted codes, allowing for the safe transmission of patient information between health providers. The digital signing and encryption features will restrict access to authorized personnel. The cloud can also act as the data recovery system, solving the missing information paradox as the data is stored offsite. This way, the hospital can always have safe access to information with or without a hard drive. Integrating cloud technology and the EHR system will significantly improve the hospital’s compliance with HIPAA data privacy and protection regulations.
Conclusion
The hospital currently does not have the necessary safeguards to protect health information. Its data storage practices are incompliant with HIPAA regulations, and corrective action is needed to prevent future HIPAA violations. The hospital should integrate its EHR system with cloud technology to prevent unauthorized data access and prevent data loss risks. The encryption and authentication features will solve the missing or stolen information issue. Outsiders cannot steal patient information since the system has digital signing, time encryption, encryption, and decryption that restrict access and allow safe data transmission between providers. Personnel cannot steal information because only authorized personnel with access control can access the data. It will be impossible for data to be lost because the data is stored in the cloud; hence, recovery is possible.
Sources
Ahmadi, M., & Aslani, N. (2018). Capabilities and advantages of cloud computing in the implementation of electronic health record. Acta Informatica Medica, 26(1), 24–28. Web.
Edemekong, P. F., & Haydel, M. J. (2019). Health Insurance Portability and Accountability Act (HIPAA). StatPearls Publishing.
Majumder, M. A., & Guerrini, C. J. (2016). Federal privacy protections: Ethical foundations, sources of confusion in clinical medicine, and controversies in biomedical research. AMA Journal of Ethics, 18(3), 288–298.Web.