Electronic Protected Health Information or ePHI refers to individually identifiable health information stored or transmitted electronically.
ePHI includes a wide range of personal health information such as medical records, diagnostic results, treatment plans, billing details, and any identifiable health-related data like names, addresses, birthdates, and Social Security numbers.
HIPAA mandates ePHI protection, setting standards for its security.
Challenges in ePHI protection include cyber threats, unsecured devices, and employee misconduct.
Best practices for ePHI protection involve encryption, continuous monitoring, and regular audits.
Advanced strategies, such as zero-trust architecture, AI adoption, and data masking, enhance ePHI security.
Strac's DLP solution provides instant detection and redaction of sensitive ePHI to safeguard it against unauthorized access, maintaining HIPAA compliance.
Federal records show that healthcare breaches exposed 385 million patient records from 2010 to 2022. This statistic underscores the pressing need for safeguarding Electronic Protected Health Information (ePHI) in this digitized healthcare landscape. ePHI protection not only upholds HIPAA compliance but also maintains patient trust and the integrity of the entire healthcare system.
What is ePHI?
Electronic Protected Health Information or ePHI refers to all the protected health information (PHI) created, stored, transmitted, or received electronically. This includes:
Patient identifiers: This category comprises any information identifying a patient, such as a patient's name, address, phone number, Social Security number, email address, and more.
Medical records: A complete record of a patient's medical history, including diagnoses, treatments, prescriptions, lab results, x-rays, and other test findings.
Billing details: Information about a patient's insurance, billing, and payment history.
Clinical notes: Notes by doctors, nurses, therapists, and other healthcare practitioners that describe interactions, observations, and patient care.
Protecting ePHI is essential to ensuring patient privacy and security. It often involves adhering to stringent regulations and implementing robust security measures.
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:
Names: Full name, last name, first name, middle name, or initials
Geographic data: Street address, city, county, state, zip code, and other geographic information
Dates: Includes all calendar dates related to an individual like birth date, admission date, discharge date, date of death, and more
Phone numbers: Any phone number that can be used to call an individual
Fax numbers: Any fax numbers associated with the individual
Email addresses: Any email addresses that can be used to contact the individual
Social Security number: The unique number assigned to individuals for identification purposes
Medical record numbers: Unique numbers assigned to patients' medical records by healthcare providers
Health insurance beneficiary numbers: The unique number assigned by health insurers to individuals
Account numbers: The unique number assigned to the patient's account
Certificate/license numbers: Unique Numbers associated with any certificates or licenses held by the individual
Vehicle identifiers and serial numbers: Includes license plate numbers
Device identifiers and serial numbers: Identifiers for medical devices or other equipment used on or by patients
Web universal resource locators (URLs): Web addresses or other locations associated with the individual
Internet protocol (IP) addresses: Addresses assigned to devices used by or for the individual
Biometric identifiers: Fingerprints, retina, and iris patterns, voiceprints, and any other unique identifying characteristic.
Full face photos and comparable images: Any images of the individual's face
Any other unique identifying number, characteristic, or code: Any other data that can be traced back to a specific individual.
How does ePHI differ from other types of data?
ePHI is distinct from other types of electronic data in several ways:
Sensitivity: ePHI contains confidential data regarding a person's medical history and condition. Unauthorized access or disclosure can have serious personal, financial, and reputational consequences.
Regulation: In the United States, ePHI is regulated by laws and regulations, most notably the Health Insurance Portability and Accountability Act (HIPAA). These regulations specify how ePHI must be stored, transmitted, and accessed.
Value: ePHI can command greater rates on the black market than other forms of data, making it a desirable target for hackers.
Complexity: With multiple stakeholders, including doctors, hospitals, insurance companies, and third-party suppliers, controlling access can get tricky.
HIPAA's role in safeguarding ePHI: A closer look
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the U.S. Department of Health and Human Services (HHS) Secretary to create regulations ensuring the privacy and security of specific health information. To fulfill this mandate, HHS introduced what is commonly known as the HIPAA Privacy Rule and the HIPAA Security Rule.
The Privacy Rule, officially titled the Standards for Privacy of Individually Identifiable Health Information, establishes nationwide standards to protect certain health data.
On the other hand, the Security Standards for the Protection of Electronic Protected Health Information (the Security Rule) outline a comprehensive set of national security standards for safeguarding certain health information when it is stored or transmitted electronically.
The Security Rule translates the principles outlined in the Privacy Rule into practical technical and non-technical measures that organizations, known as "covered entities," must implement to secure individuals' ePHI.
The Office for Civil Rights (OCR) within HHS enforces the Privacy and Security Rules through voluntary compliance efforts and civil monetary penalties.
HIPAA compliance checklist for ePHI protection
To comply with HIPAA, healthcare entities must adhere to a comprehensive set of requirements, including:
Risk assessment: Healthcare organizations must regularly conduct assessments to identify system vulnerabilities and potential threats to ePHI.
Access control: Covered entities are responsible for establishing and implementing role-based access controls, ensuring that only authorized personnel can access ePHI.
Audit control: Organizations are required to monitor and record ePHI-related activities, allowing for the detection of any unauthorized access or breaches.
Integrity control: Maintaining ePHI integrity necessitates measures like encryption and data validation to prevent unauthorized alterations.
Transmission security: During electronic data transmission, ePHI protection is mandatory, with encryption serving as a key safeguard.
Policies and procedures: Written policies and procedures that delineate ePHI handling are essential for employee guidance and regulatory compliance.
Training and awareness: Regular education and awareness programs are crucial for reducing the risk of security breaches resulting from human error.
Contingency plan: Covered entities must have a contingency plan for emergencies, encompassing disaster recovery and data backup strategies.
Challenges in ePHI protection
With the rapid digitization of healthcare data and the increasing sophistication of cyber threats, healthcare organizations face numerous challenges in safeguarding ePHI.
1. Vulnerabilities in storing ePHI
Storing ePHI presents its own challenges, especially when leveraging cloud environments:
Lack of control: When healthcare businesses rely on third-party cloud service providers, they may not have complete control over their data storage and security standards.
Data access: Unauthorized access can occur if sufficient access controls are not in place, particularly in multi-tenant cloud systems.
Data loss: There is always the risk of data loss in cloud storage owing to technological breakdowns, so companies should be aware of various types of data loss prevention.
Compliance: Ensuring cloud storage solutions comply with HIPAA and other requirements can be complex.
Data breaches: Cloud environments can expose sensitive patient data if not adequately secured, making cloud data loss prevention a must.
The average cost of a healthcare data breach has reached an all-time high of $10.1 million—a 9.4% increase from 2021.
2. Threat landscape
The threats healthcare organizations face in safeguarding ePHI include:
Phishing attacks: Cybercriminals frequently use deceptive emails to mislead healthcare staff into disclosing critical information or passwords.
Ransomware: Malicious malware, known as ransomware, encrypts data and makes it unavailable unless a ransom is paid. The rate of ransomware attacks in healthcare has almost doubled from 34% in 2021 to 60% in 2023.
Insider threats: Data breaches can occur accidentally or purposely by employees or other reliable parties. Fraud is the most prevalent case type across all insider threat incidents within the Healthcare Sector.
Advanced persistent threats (APTs): APTs are sophisticated and well-organized cyber attacks that aim to infiltrate a network, remain undetected for an extended period, and continuously steal data or cause harm.
Unsecured devices: Unsecured devices, like laptops, smartphones, or tablets, are a leading cause of ePHI breaches. In 2019, a New York medical center faced a $3 million penalty after losing an unencrypted flash drive and laptop, potentially exposing sensitive patient data.
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