In the last week of March 2020, the healthcare industry experienced a 154% rise in the number of telehealth appointments compared to March 2019. So far, experts have witnessed a significant growth of the telemedicine industry, which is projected to grow even further at a CAGR of 18.2% from 2021 to 2027.
Telemedicine solutions have numerous benefits for both healthcare providers and patients. However, they also pose a significant risk to information security due to the fact that they access tons of sensitive patient data. As such, it can be difficult to ensure that these apps comply with all legal data protection requirements.
In this article, we dive deeper into the HIPAA health platform at large, and how to make telemedicine apps HIPAA compliant.
What is Telemedicine and How Does It Work?
In its raw definition, telemedicine refers to the provision of healthcare services remotely. This means that doctor and patient consultations take place away from the healthcare facility, usually on a telecommunication app.
Telemedicine uses email, text messages, voice & video chats, and phone calls in the delivery of healthcare services. With these communication tools, patients can schedule appointments, consult with their doctors, receive prescriptions, talk about their health insurance coverage, and discuss other payment options for healthcare services.
Features of a Telemedicine Software Solution
Patients and doctors must stay connected before the successful delivery of telemedicine services can be achieved. Telemedicine solutions have separate interfaces for patients and doctors and an administrator panel. There exist 2 main approaches to enforce a successful interaction between these three elements is successful:
- Creating a single application with 3 different profiles
- Creating separate patient- and doctor-facing apps with a single backend
The fact that patients and doctors use telemedicine apps for varying purposes means that the interfaces for all these users would need to have different features.
Features of a Patient-Facing App
Patients can use a telemedicine app to create their profiles, browse available doctors, review the physicians’ qualifications, schedule appointments, enter a virtual consultation, and pay for the services received.
Here are some of the features in most patient-facing apps:
Patient’s profile creation:
- Search and filters
- Appointment scheduling and calendar
- Real-time video visits
- Chat with the doctor
- Insurance plan integration
- Ratings and feedback
Features of a Doctor-Facing App
Doctors can use a telemedicine app to accept or decline appointment requests, browse information about the patient, review the results of previous examinations, host a video or voice call with the patients, send prescriptions, leave notes, and schedule future visits.
To maintain a flawless user experience for doctors, the app should include the following features:
- Doctor’s profile creation
- Appointment scheduling and calendar
- Push notifications
- Real-time video visits
- Session recording
- EMR/EHR integration
Both the patient-facing and doctor-facing apps deal with highly sensitive information such as health-related data, insurance plans, and payment details. With that in mind, we can conclude that the need for compliance with HIPAA requirements is inevitable in the prevention of data breaches, financial losses, and reputational damage.
HIPAA Compliance Requirements for a Telemedicine Platform
The Health Insurance Portability and Accountability Act was introduced back in 1996 and signed by President Bill Clinton. It was introduced to protect sensitive patient data from illegal disclosure without the patient’s consent. Today, this act is more important now than ever as cybercrime and black data markets continue to thrive.
When developing a HIPAA compliant telemedicine platform, it is important to follow this list of HIPAA rules:
The HIPAA Privacy Rule
The HIPAA Privacy Rule was made to limit the use of personal health information; it mainly restricts the disclosure of PHI (Protected Health Information). Patients can grant or deny practitioners the permission to obtain and share information, change and update the given data, or request a copy of it.
The HIPAA Security Rule
The HIPAA Security Rule makes it obligatory to store and share information securely. It also provides three grounds upon which to provide security to user data, i.e., on technical, physical, and administrative rounds. For electronic Protected Health Information (ePHI), the healthcare entity should set up several layers of technical security including firewalls, antimalware, anti-ransomware, user authorization, etc.
Physical protection means that paper forms should be accessed only by people who need them and have permission to view the files. The administrative part is all about having Privacy and Security Officers in the entity take responsibility for risk assessment and security measures.
The HIPAA Enforcement Rule
The Enforcement Rule stresses that all privacy and security measures are obligatory, and non-compliance will have consequences in the form of penalties. An avoidable breach would cost a healthcare institution up to $1.5 million if all violations of the rule were made at once. These violations include ignorance of HIPAA rules, insufficient vigilance, or willful neglect.
Some serious violations may also turn into criminal charges.
The Breach Notification Rule
The rule states that a healthcare institution should notify the occurrence of a breach immediately. If the medical data of less than 500 people was leaked, the notification must be submitted to the Secretary of breaches of unsecured protected health information. The media should be notified as well.
In the report, medical organizations should state what kind of information was breached, who is responsible for the breach, whether the information was viewed as well as acquired, and whether the damage and risks were mitigated.
Healthcare institutions have 60 days to give notice and inform the patients whose PHI was leaked and inform them on what steps they should take next.
The Omnibus Rule
The Omnibus Rule was developed in order to cover all that was not mentioned before or specify some definitions and procedures. For example, it explains who BA or Business Associates are, includes a final amendment, and the statement that should never be used for marketing purposes.
Common HIPAA Violations in Telemedicine Platforms
It seems like building a HIPAA compliant telemedicine software is less expensive than handling PHI responsibly. Before we learn how to prevent the violation, let’s take a look at more “practical” violations in telemedicine.
Electronic Health Record (EHR) Breach
If a telemedicine platform works with EHR but lacks the software tools to prevent unauthorized users from accessing the EHR, it will be a problem. Hackers prefer to steal from the EHR because the data obtained here is arguably more expensive on the market than SSN or card information: it contains all identifiers, family information, location, SSN, card info and payments, and a list of treatments and diseases that may harm someone’s reputation.
EHR breaches may be caused by hacking, disclosure to the wrong contact, malware or ransomware attacks, etc.
Encryption turns readable information into a mix of symbols. Any person or any machine will not be able to decipher it unless they have an encryption key. This makes encrypted data more protected since while a hacker can steal it, they will not be able to use it.
Data encryption is no easy task. It may require development teams and sophisticated tools, which translate into a hefty expense. Many institutions end up avoiding the upfront cost of the investment and land into trouble later.
Unattended, Lost, and Unsecured Devices
Medical workers often forget to log out. Many don’t save their passwords on their devices and desktops in hospitals. However, telemedicine apps are often used on personal mobile phones, and users can be careless with their personal items.
An attack on a mobile phone is much easier in the sense that users often don’t have to log out. Their passwords are still in place. To make the matter worse, many people visit sketchy websites and follow random links without knowing it.
Access by Unauthorized Users
Sometimes, doctors reveal crucial information about their patients in their social life. Although this might be unintentional, they could discuss the patients’ conditions with unauthorized guests or other employees at the workplace.
Either way, only authorized people should access the information for treatment (and other authorized purposes). In all the other cases, it will be a violation.
Improper Disposal of PHI
Disposing of personal health information presents yet another overlooked cause of the breach. It is not enough to just hit the “delete” button. The information will still be accessible from the trash can or other kinds of archives for 30 days or longer. When disposing of PHI, the person responsible should completely wipe it off from hard drives and backups.
How to Develop a HIPAA Compliant Telemedicine Software
Here is a list of things you should take care of if you want to avoid penalties imposed by HIPAA and remain relevant for healthcare institutions and patients across the US.
How can I make a HIPAA compliant telemedicine software? A secure connection is one of the most basic requirements when building a compliant software solution. By secure connection, we refer to the connection between a physician and a patient – from messaging, voice, or video chat.
It would be best if you did not rely on third parties for such a task. Zoom, Skype, and e-mail apps are not HIPAA-compliant. If something goes wrong on their side, the effects will extend to your doorstep. Therefore, it would be better to develop your own communication system.
Proper Data Storage
There are three main points to consider when it comes to data storage. First, do not store unnecessary information, such as test results or the information of a deceased person. If useless information is discarded, it will both increase accessible storage space and reduce the amount of information that could be stolen.
Secondly, watch out for duplicate information. Duplicates in the system often mean bugs in the system that hackers can use to get in. They also mean more information to steal. Thirdly, create a heavily regulated access system and only give access to authorized users for that particular patient.
As mentioned earlier, encryption is a near-perfect way to share and store data and make a telemedicine platform HIPAA compliant.
One of the main rules of HIPAA is to give access to PHI only to those who need it. Do not provide personal health information to a physician who has nothing to do with the patient’s treatment. Also, do not hand the information to the whole billing team if only one person is responsible for processing the patient’s treatment payment.
It is important to monitor when and where the information was accessed. Doing this makes it easier to identify who breaches the data. Every employee in a healthcare entity also has behavioral patterns that will be picked up by the system. The next time they log in at a time they don’t usually login or perform some suspicious activity, admins can get notified early enough to prevent a possible breach.
Employees often forget to log off their desktops and leave their computers unattended. The risk is even higher when the facility sees a long day with many patients and tons of work. While human error is inevitable at some point, an automatic log-off wouldn’t hurt.
Automatically logging off users after a period of inactivity enhances data security by preventing unauthorized access long after the employee left their computer unattended.
Appointing a HIPAA Compliance, Privacy, and Security Officer
Having a committed compliance, privacy, and security officer streamlines the process. He/she should have expertise in IT since their monitoring will be much more productive and useful. The administration already has enough responsibilities and may not be able to create strategies for security and perform assessments.
Employee Training on Basic Data Security Measures
Around 53% of all healthcare cybersecurity incidents happen because of unintentional personnel actions. Some basic training (in the video, audio, or written format) should educate employees not to open sketchy links on email or messages on the platform, not to leave their devices unattended, and use strong passwords to secure the information.
It is also important for telemedicine users to learn how to protect their personal devices that they may use for work.
HIPAA compliance in telemedicine applications is of paramount importance in health-related technology. But, like many other tech products, telemedicine solutions often suffer from EHR breaches, lack of encryption, and employees neglect. That is why developers have to think about security measures such as a secure connection, proper storage, automatic logs-off, authorization, and other things whilst creating a HIPAA compliant telemedicine app.
If you’re looking for a reliable vendor to develop a telemedicine platform HIPAA compliant solution, you’ve come to the right place. Langate is a HIPAA-compliant development center with over 17 years of experience in the creation of health tech solutions. Our security officers will put up all levels of data protection needed for a HIPAA-compliant solution, guaranteeing a successful, legal, and risk-free solution that would best suit you.