How to ensure patient privacy in the cloud

Marty Puranik: ©Atlantic.Net

Cloud services that adhere to HIPAA have seen a significant increase in adoption within the health care sector in recent years. This trend continues to accelerate, and cloud computing is now deeply embedded within the U.S. health care system. The industry is experiencing cloud computing’s tangible benefits of efficiency, scalability, and cost-effectiveness firsthand.

As any health care professional can testify, safeguarding sensitive patient data is the number one requirement in a health care cloud environment. As more health care services become cloud-enabled, data protection and integrity become critical responsibilities entrusted to health care organizations.

The importance of patient privacy in the cloud

Protecting sensitive patient data is a fundamental responsibility under HIPAA.

Protected Health Information (PHI) includes a wide range of personal and medical data, from identifiers like names and Social Security numbers to sensitive medical histories, diagnoses, and treatment plans. The unauthorized disclosure of PHI can lead to severe repercussions, such as:

• Identity theft, discrimination, and emotional distress: A data breach exposes patients to identity theft, fraudulent medical claims, and potential discrimination, leading to financial harm and emotional distress.
• Loss of trust: Data breach incidents damage the reputation of healthcare providers and their business associates, potentially eroding patient trust in them.

Building a HIPAA-compliant cloud infrastructure

A robust, HIPAA-compliant cloud infrastructure is built from the ground up to protect patient data. HIPAA sets the standards for protecting patient privacy by enforcing administrative, technical, and physical safeguards. There are hundreds of rules to adhere to that vary in complexity, making it extremely challenging for health care organizations to implement. Here are some best practices for achieving and maintaining HIPAA compliance in the cloud:

• Comprehensive Security Framework: Implement a complete security solution that includes tailored policies, comprehensive procedures, ongoing staff training, and proactive risk assessments. This ensures that every aspect of your cloud environment—from data centers to management systems—meets and exceeds HIPAA regulations. Regularly review and update these policies to adapt to evolving threats and compliance requirements.
• Engage With Your Workforce: Your staff plays a crucial role in HIPAA compliance. Simplify security protocols and implement regular training programs to foster a culture of awareness and responsibility among employees regarding data privacy and security.
• Control Access to Everything: Implement multi-layered access controls to ensure that only authorized personnel can access sensitive patient data based on the "need-to-know" principle. This includes strong authentication methods, role-based access control, and regular review of access privileges.
• Watertight Data Protection: Safeguard patient information throughout its lifecycle with state-of-the-art encryption at rest and in transit. Employ robust integrity controls, such as hashing and digital signatures, to prevent unauthorized data alteration and ensure data accuracy.
• Be Vigilant, Always!: Security requires continuous monitoring and auditing of access attempts, system logs, and network traffic. Implement advanced threat detection systems and establish incident response plans to identify and swiftly address any potential threats or breaches. Regularly conduct vulnerability assessments and penetration testing.

The future of health care privacy: Potential impact of federal legislation

Since its introduction in 1996, HIPAA has continuously evolved to address emerging technologies and protect patient data. As technology advances, further compliance adjustments are inevitable. Additionally, the health care industry must stay vigilant for potential federal privacy legislation that could further shape data protection practices.

In recent years, we've already seen notable HIPAA developments:

• 2023-2024: Updates have focused on strengthening reproductive health care privacy, with a final rule published in April 2024. These changes define "reproductive health care" and restrict the uses and disclosures of related PHI, especially in response to interstate data requests following the overturning of Roe v. Wade.
• 2025 and beyond: There's an increased focus on cybersecurity in the health care sector, with potential modifications to the Security Rule expected in 2025. This includes potential mandates for stronger cybersecurity practices and reporting requirements. Additionally, proposed modifications from 2021 regarding disclosures of PHI for substance use disorder, serious mental illness, and emergencies are still under consideration and may be finalized.
• Emerging Technologies: The rise of Artificial Intelligence and Machine Learning in health care presents new privacy challenges. Future legislation and guidance are likely to address how PHI is used, processed, and secured within AI-driven systems, including concerns around algorithmic bias and data anonymization.

While specifics are still under discussion, we expect future developments to focus on:

• Expanding Patient Rights: Patients are likely to gain more control over their data, including the right to access, amend, and delete data on demand, and potentially more granular control over data sharing permissions.
• Increased Enforcement: Regulatory bodies may be granted more authority to investigate and penalize HIPAA violations. Bigger fines for non-compliance are almost guaranteed, reflecting the increasing value and sensitivity of health data.
• Greater Data Security Standards: Legislation could mandate stricter data security requirements for healthcare organizations, moving towards more prescriptive cybersecurity frameworks and best practices. This might include requirements for specific technologies or security certifications.

Conclusion

Prioritizing patient privacy in a cloud environment is not just a regulatory requirement but an ethical imperative. By embracing best practices for HIPAA compliance and staying informed about potential federal regulations, health care organizations can leverage the power of the cloud while safeguarding sensitive patient data. Choosing a cloud provider with a strong commitment to compliance and expertise in healthcare data security is crucial for building a secure, reliable, and compliant cloud environment for a brighter future in health care.

Marty Puranik is the founder, president, and CEO of Atlantic.Net, a global leader in cloud hosting and managed services headquartered in Orlando, Florida. Puranik co-founded Atlantic.Net in 1994; his early vision and technical acumen helped transform the company from one of Florida’s first commercial ISPs into a recognized innovator in cloud computing, with a presence in eight data centers across four countries and customers in more than 100 nations.