The following is a guest post by James Hinton
In 1854 John Snow had a moment. At the time it hadn’t seemed like that significant an event, but Dr. Snow’s use of collected data and maps to pinpoint the source of a cholera outbreak in London started something. Though it started small, Big Data and Geographic Information Systems (GIS) today provide a one-two punch that is helping push modern healthcare into new realms of possibility.
Unfortunately, Big Data and GIS come with certain risks that are directly related to HIPAA compliance. In order to get the full value of these tools significant amounts of medical data need to be brought together, standardized, and made accessible to the specialists using these tools. Any time you do this you run the risk of data breaches on a massive scale.
In August, hackers managed to access the records of 4.5 million patients in the Community Health Systems database. While they did not obtain actual health data, the scope of the breach and the potential to go the next step both drew attention to the scope of the potential damage that could be done. The most recent breach to impact more than 500 patients reported by the U.S. Health & Human Services took place in Michigan last December, as the result of an unauthorized e-mail containing data.
Given the possibility of losses of Personally Identifiable Information (PII) highlighted by these incidents and the American Care Act’s requirements for the digitization of patient records it becomes important to ensure all information used by Big Data and GIS projects be HIPAA compliant. The crux of this lies on the shoulders of Health IT professionals in the healthcare industry. Here’s what a few of these HIT professionals are doing to combat the risk of online data HIPAA violations.
Keeping security patches up to date.
Every stage of data handling for the health informatics professional involves software. Whether it’s at the data entry stage, data base storage, or transition, all e-health records involve programs working to encode and transmit this information in a secure environment. A well set up system is written in a way that all of this software is designed to meet HIPAA standards by complying with the HITECH Act (Title XIII of the American Recovery and Reinvestment Act of 2009).
Unfortunately, software is static. While criminals seeking to steal health records continually work to find new ways to gain access, the software itself remains as written. To combat this, the authors of software being used for secure record handling have to make adjustments to the software to remain one step ahead. These adjustments, or patches as they are called, have to be added to the software by the Health IT professionals in charge of maintaining the system.
The August data breach of the Community Health Systems database was eventually traced to a device that had not been patched to prevent hackers using the “Heartbleed” vulnerability to gain admittance. The seriousness of the need to remain current with all patches was high enough to prompt the HIPAA Journal to dedicate an entire article just to patching alone.
Developing and enforcing device and app policy
Every unique device or piece of software that connects to the record keeping system represents an opportunity to improve access for both authorized users and opportunist crooks. Every computer or server has weaknesses that could potentially be exploited, and every piece of software has vulnerabilities that can be taken advantage of. The wider the variability in hardware and software that is accessing the data is, the more danger points are introduced to the system.
In order to limit these danger points, Health IT professionals are having to actively engage in pruning the hardware and software networks being used. A 2012 Aruba Networks survey revealed that, at the time, 85% of all hospitals in the U.S. permitted employees to use personal devices such as laptops and cell phones to the network. However, this move to a Bring Your Own Device (BYOD) solution presents a substantial risk that a breach might occur.
Every different BYOD device added into the network of machines substantially complicates the effort to keep PII secure. Health IT pros attempting to keep the network secure have to ensure that any device being connected is compatible with the security software of the network, and ensure that the privately owned device is being properly patched. Further, any software on the device also has to be designed to comply with security requirements.
Given that Trend Micro, a major provider of both security software and BYOD networking solutions found that there were 890,482 fake apps in April 2014 alone, many Health IT professionals have simply opted to adopt a “there’s no such thing as a HIPAA compliant app” stance. Proactive HIT staff have been rigorously removing all but a very narrow set of devices and software from the allowed list and started aggressively monitoring for any unauthorized devices being added by authorized but unaware employees.
Educating health care personnel on HIPAA compliance as it effects their use of IT
That final point in the previous paragraph leads us directly into the third thing Health IT professionals are doing to help protect data from being stolen or abused: education. While the HIT staff can be diligent with their patching software as well as developing and enforcing stringent device and app policies, all of that can be completely circumvented by one employee using an authorized device with allowed software if that employee is unaware of the risks. HIT professionals are actively engaging in training employees on approved and unapproved uses as a mitigating factor to help tackle one of the largest sources of HIPAA breaches currently experienced.
One stereotypical example of the problem would be a physician conducting an exam on a patient. Hoping for a quick consult from a colleague, the physician uses an authorized and hospital issued Blackberry to text the colleague with information pertaining to the reason for the visit along with a photograph. The colleague receives this on and responds with another Blackberry.
Even these two devices are both hospital equipment and use only authorized software that has been properly patched, a HIPAA violation just occurred. PII has just been passed via text, which means that it has gone through an unsecure third party, the phone service provider, totally bypassing every step the Health IT pro put in place to prevent a breach.
To prevent this, proactive HIT professionals are engaged in ensuring employees are educated on how to gain the benefits of electronic patient data without risking that data. Some provide the training personally, while others hire organizations such as HIPAA Secure Now to do the job. Some even engage in advanced coursework specifically dealing with IT security. Either way, these IT types are engaging the personal side of Big Data.
Big Data and GIS have been a boon to healthcare starting all the way back in 1854. With current usage projects as simple as telling us which states are healthiest or as complex as providing patients real time data on healthcare access, the benefits are widespread and very much an important part of managed care. However, they do also represent risks. A proactive Health Information Technologies professional engages in several practices that can ensure these risks are mitigated and both patients and providers can rest assured all data is HIPAA compliant.
James Hinton is an Idaho writer with a bad habit of putting his two cents in on everything. He can be found writing on a number of topics at jamiemhinton.wordpress.com