What is ePHI ? Challenges, Best practices, and Strategies

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Electronic Protected Health Information (ePHI) refers to PHI that is created, stored, or transmitted electronically. It is a subset of PHI, Protected Health Information which is regulated in the United States by the Health Insurance Portability and Accountability Act of 1996, known as HIPAA.

ePHI is extremely sensitive information and a recurrent target for bad actors. Federal records show that healthcare breaches exposed 385 million patient records from 2010 to 2022.

We don’t want you to become this statistic.

That’s why we’ve updated this guide. We’ll cover what ePHI is and what it isn't, what you need to know about HIPAA and ePHI compliance, and we’ll share the best practices for ePHI protection, along with some challenges you may encounter in your safeguarding path.

✨What is ePHI?

Electronic Protected Health Information (ePHI) refers to all Protected Health Information (PHI) that is created, stored, transmitted, or received electronically. Under HIPAA, any information that can identify a patient is considered PHI—so ePHI is simply PHI in digital form. This includes:

• Patient identifiers: Information such as name, address, phone number, Social Security number, email address, and other data that can identify an individual.
• Medical records: Details of a patient’s health history, including diagnoses, treatments, prescriptions, lab results, and imaging.
• Billing details: Insurance, billing, and payment information linked to patient care.
• Clinical notes: Documentation by healthcare professionals describing observations, interactions, and patient treatment.

HIPAA defines 18 specific identifiers that qualify as ePHI when linked to health data. These include common ones like name, email, and SSN—as well as less obvious examples like IP addresses, biometric data, and vehicle IDs.

The main takeaway is that if it can identify a patient, it’s ePHI.

What is not ePHI?

To help clarify what qualifies as ePHI, the table below provides practical examples. If unsure, consult the 18 HIPAA identifiers—any of which, when linked to health data and stored or transmitted electronically, constitute ePHI.

What Is ePHI? (protected under HIPAA) ✅What is NOT ePHI? ( not protected under HIPAA) ❌A medical record number stored in an electronic health system like EPIC or Cerner.Information in personal apps or wearables only accessible by the userAn email containing a patient’s diagnosis and full name.An anonymous blog post discussing general symptoms with no identifiers.A cloud-stored lab result linked to a patient's name and DOB.A de-identified lab result with all 18 identifiers removed.A billing record with SSN and insurance info in a patient portal.A training dataset containing only synthetic patient data.An IP address logged by a telehealth platform during a session.A physician’s personal notes stored offline with no patient identifiers.

How Does ePHI Differ From Other Types of Data?

ePHI is distinct from other types of electronic data in four key ways:

• Sensitive: ePHI contains private health details. Breaches can cause personal, financial, and reputational harm.
• Regulated: HIPAA sets strict rules for how ePHI is stored, transmitted, accessed, and secured. These regulations specify how ePHI must be stored, transmitted, accessed and protected.
• Valuable: ePHI is a top target for cybercriminals, often fetching high black-market prices.
• Interdependent: It's shared among many parties—providers, insurers, vendors—making access control tricky.

We’ve established what ePHI is (and isn’t), and why it’s so critical. Before exploring how to protect ePHI and best  practices, let’s look at how HIPAA regulates ePHI and what compliance requires.

✨Components of ePHI

Here is the list of all the components of ePHI as defined by the U.S. Department of Health & Human Services (HHS) under the HIPAA Privacy Rule

HIPAA Compliance Explained: The 3 Rules That Govern ePHI Security and Privacy

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) directed the U.S. Department of Health and Human Services (HHS) to create regulations protecting the privacy and security of health information. HHS established three key rules that apply to ePHI:

1. The HIPAA Privacy Rule

(Standards for Privacy of Individually Identifiable Health Information)

This rule sets national standards to protect individuals’ medical records and other personal health information. It applies to all forms of PHI—whether electronic, paper, or oral—and governs how covered entities may use and disclose this data.

2. The HIPAA Security Rule

(Security Standards for the Protection of Electronic Protected Health Information)

This rule provides a framework for safeguarding ePHI when it is stored, accessed, or transmitted electronically. It outlines three categories of security safeguards: administrative, physical, and technical.

3. The HIPAA Breach Notification Rule

This rule requires covered entities and business associates to notify affected individuals, HHS, and—in some cases—the media when unsecured ePHI is breached. Notification must occur without unreasonable delay and within 60 days of discovery.

A breach of ePHI often leads to a HIPAA violation. Not all violations are equal, however. Our HIPAA compliance guide explains the four tiers of HIPAA violations based on the level of culpability—from unintentional lapses to willful neglect. Spoiler alert: Tier 4 violations carry the most severe civil penalties. In extreme cases, separate criminal penalties may also apply.

✨HIPAA Compliance Checklist for ePHI Protection

To comply with HIPAA’s Security Rule, healthcare entities must implement safeguards that ensure the confidentiality, integrity, and availability of ePHI—known as the CIA triad.

Below are eight core components to review for HIPAA Security Rule compliance. Our PEC framework—Plan, Enable, Control—provides a structured approach to managing these responsibilities:

🧭 Plan - Develop a proactive security strategy for your ePHI.

• Risk Assessment: Regularly identify vulnerabilities and threats to ePHI—this foundational step drives all other safeguards.
• Policies and Procedures: Document how ePHI is created, handled, stored, and disposed of. These policies guide staff and ensure regulatory compliance.
• Contingency Plan: Prepare for disruptions with data backups, emergency operations, and disaster recovery protocols.

🚀 Enable - Empower people and systems to act securely.

• Transmission Security: Use end-to-end encryption and secure messaging to protect ePHI in transit.
• Training and Awareness: Provide ongoing staff education to reduce human error—still a leading cause of ePHI breaches.

🛡️ Control - Monitor and enforce access to ePHI.

• Access Control: Apply role-based restrictions so only authorized users access specific ePHI types.
• Audit Control: Track who accessed ePHI, when, and what actions they took—vital for incident response.
• Integrity Control: Use encryption, checksums, and validation to guard against unauthorized modification.

Challenges in Protecting ePHI

As healthcare becomes increasingly digital, protecting ePHI feels like hitting a bullseye on a moving target–that moves faster and faster. There are three key challenges to keep in mind when protecting ePHI:

Cloud Vulnerabilities

Healthcare organizations often rely on third-party cloud services, which can limit control over data. Risks include unauthorized access (especially in multi-tenant systems), accidental data loss, and complex HIPAA compliance. If misconfigured, cloud environments can expose sensitive data. The average cost of a healthcare data breach reached $10.1 million in 2022. This is why cloud data loss prevention is a must.

Expanding Threat Landscape

Cybercriminals use phishing to target employees, while ransomware attacks surged from 34% in 2021 to 60% in 2023. Insider threats—both accidental and malicious—remain common. In one case, a New York medical center faced a $3 million fine after losing an unencrypted laptop and flash drive. Unsecured mobile devices are frequent sources of ePHI exposure.

Stale Data and Improper Disposal

Old or unused data increases breach risk and may violate retention rules. Stale data can also undermine the accuracy of current records. Critically, deleting files doesn’t ensure secure removal—only certified wiping or destruction meets HIPAA disposal standards.

Learn more about sensitive data categories in the Strac Catalog of Sensitive Data Elements.

✨How to Protect ePHI?

It’s all about protocols. Protecting ePHI requires layered safeguards that address its full lifecycle—from creation and transmission to storage and deletion. Below are three essential focus areas for maintaining HIPAA compliance and protecting sensitive health information:

• Encryption and security
• Monitoring and management
• Compliance and auditing

1. Encryption and Security

• Use strong encryption: Implement AES-256 encryption to protect data at rest and in transit.
• Manage encryption keys: Rotate keys regularly and store them separately from encrypted data.
• Encrypt all devices: Secure laptops, mobile phones, and tablets to reduce breach risk in case of theft or loss.
• Apply end-to-end encryption: Keep data unreadable to unauthorized users—even if intercepted.

2.  Monitoring and Access Management

• Role-based access: Grant ePHI access based on job function to limit exposure.
• Real-time monitoring: Use software that detects suspicious behavior and triggers alerts immediately.
• Log management: Analyze access logs regularly to catch unauthorized attempts early.
• Multi-factor authentication: Require two or more authentication methods to enhance login security.

3. Compliance and Auditing

• Conduct regular audits: Review security protocols and systems for HIPAA alignment.
• Stay HIPAA-compliant: Ensure your organization meets both the HIPAA Privacy Rule and Security Rule.
• Employee training: Reinforce ePHI protection through recurring HIPAA education.
• Plan for incidents: Maintain a tested breach response plan for rapid mitigation and reporting.

Review our detailed DLP Security Checklist.

Advanced ePHI protection strategies: Beyond HIPAA compliance

When it comes to security and compliance, it’s always worthwhile to go the extra mile. While basic compliance with regulations like HIPAA is essential, the following advanced strategies can ensure more robust ePHI protection.

• Implement zero trust architecture: Authenticate, authorize, and encrypt every access request before approval. ‍
• Adopt advanced technologies: Employ AI to identify anomalous network patterns or behaviors that could indicate a breach.‍
• Redact sensitive data: Data masking renders it anonymous and unusable for malicious purposes, while still retaining its value for legitimate uses.

✨Redact sensitive ePHI in real-time with Strac DLP

Strac is a data loss prevention (DLP) solution, dedicated to safeguarding ePHI from unwarranted breaches and cyberattacks. Its core features include:

• Instant Detection and Redaction: Strac identifies sensitive information and automatically takes predefined actions, such as data redaction or alerting administrators, to protect ePHI.
• No-Code Integrations: Strac offers effortless integration with multiple platforms, including Zendesk, Slack, Gmail, ChatGPT, and more. This simplifies ePHI security across diverse platforms.           ‍
• Regulatory Compliance: With zero downtime and built-in compliance templates, Strac ensures that your organization consistently complies with HIPAA's stringent regulatory standards.

By now you should have a solid understanding of what ePHI is, how it is regulated by HIPAA, and the best practices to protect your ePHI and ensure HIPAA compliance. For further reference, we recommend you check out HIPAA PHI Guide, the basics of Data Loss Prevention (DLP), and how to encrypt email in Outlook.

And remember, here at Strac.io we obsess over ensuring proper data loss protection across all vectors and we are here to help, so book a demo today.

Frequently Asked Questions About ePHI

What is ePHI?

ePHI stands for Electronic Protected Health Information—any patient-identifiable health data created, stored, or transmitted electronically under HIPAA.

What are examples of ePHI?

Medical records, billing info, email addresses linked to diagnoses, and IP addresses collected during telehealth visits all qualify.

Who must comply with ePHI rules?

Covered entities and business associates, including healthcare providers, insurers, and vendors handling patient data, must follow HIPAA’s ePHI regulations.

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