Organizations that handle health information or provide services to entities in the healthcare sector are required to comply with regulations such as HIPAA, HITECH, and SP 800-53 Rev. 5.
These regulations are designed to protect healthcare data and systems from a range of risks and threats and preserve the privacy of this data. Complying with these regulations is an ongoing process that requires regular assessments and improvements.
Here is a look at how organizations can ensure optimal compliance.
HIPAA Regulations
The Health Insurance Portability and Accountability Act is a federal law that covers two main aspects of health information protection: privacy and security.
The privacy rule outlines when and how healthcare information can be used and shared, while the security rule ensures the availability, confidentiality, and integrity of electronically protected health information.
HITECH Regulations
The Health Information Technology for Economic and Clinical Health Act governs the use and adoption of health information technology and supports enforcing HIPAA regulations.
It extends the scope of HIPAA to include business associates such as contractors, vendors, and third-party service providers with access to protected health information on behalf of covered entities.
The act also provides incentives for organizations to adopt electronic health records. In addition, it establishes requirements for notifying affected parties of breaches, as well as business associate agreements and disclosures.
SP-800-53 Rev. 5
The Security and Privacy Controls for Information Systems and Organizations is a publication by the National Institute of Standards and Technology detailing the privacy and security controls that information systems and organizations must employ.
It aims to protect individuals, organizations, operations, and the country from various risks and threats. These include foreign intelligence surveillance, structural failures, hostile attacks, natural disasters, privacy risks, and human errors.
Its catalog of security and privacy controls is divided into 20 families, each addressing a specific aspect of privacy or security.
Steps For Assessing & Improving Organizational Compliance
Here is a look at how organizations can assess and improve their compliance.
Set Up a Compliance Team
Compliance requires a multifaceted approach, so organizations should begin by setting up a compliance team with representatives from the organization’s various levels and divisions, including the legal department, security, information technology, and management.
This team will oversee the organization’s compliance program, report on its progress, and resolve any issues that arise.
Outline The Scope Of Compliance Requirements
The teams should determine which regulations apply to their organization and its operations. This entails a thorough inventory of the types of data the organization regularly handles and the systems and processes it uses for accessing, processing, and storing data.
Carry Out a Risk Assessment
A thorough risk assessment must be conducted to identify the risks that the organization’s health information systems and data could face. A good assessment will calculate the likelihood of a range of potential threat scenarios and the impact they could have on the organization.
Some types of threats that should be included are theft, data loss, accidental deletion, unauthorized access, modification, and disclosure of data.
Risks should be prioritized according to their severity. This assessment should also take into account the various regulations that fall under HIPAA, HITECH, and SP-800-53 Rev. 5.
Implement Privacy & Security Controls
Once the risks the organization is most likely to face have been identified, it is time to choose appropriate security and privacy controls that suit its resources, objectives, and context.
These controls should be guided by SP-800-53 Rev 5. Organizations should also document why these controls were selected and how they were implemented.
Train Staff
Organizations should train their staff so they understand their obligations when it comes to compliance and the protection of private health information.
They should learn how to recognize covered information, report incidents, and avoid risks such as lost devices or phishing scams. Every staff member with access to protected information, including volunteers, should undergo this training.
Monitor The Effectiveness Of These Controls
Privacy and security controls must be monitored on an ongoing basis, including measuring the performance of the controls, detecting deviations, reporting breaches, and reviewing any feedback received.
Review & Update The Program
Finally, organizations must review and update their compliance program at predefined periods, such as yearly or when the business makes significant changes to its organizational environment.
The compliance program must also be reassessed as new regulations are passed or the company’s risk profile changes. Any components of the compliance program that are no longer adequate or relevant must be revised accordingly.
Schedule a Consultation With Advantage Technology
Organizational compliance with HIPAA, HITECH, and SP-800-53 Rev. 5 is important for avoiding penalties and fines and for a strong compliance effort to demonstrate the organization’s commitment to protecting the data of its clients, employees, and partners, improving its reputation, and fostering confidence among the public.
At Advantage Tech, we offer comprehensive IT consulting services for healthcare organizations, ensuring proper compliance across the board while finding new efficiencies. Contact us today to schedule a consultation.