Protecting Sensitive Personal Information: Steps to Ensure Data Privacy in Healthcare
Healthcare and health insurance organizations must remain compliant with multiple privacy regulations as they regularly collect and handle sensitive patient data. Data privacy and protection laws focus largely on sensitive personal information (SPI), which represents a greater risk to individuals if compromised.
The Health Insurance Portability and Accountability Act (HIPAA) is the primary regulation protecting medical information in the United States, requiring strict controls and safeguards for patient data. Additionally, healthcare organizations must adhere to other regulations such as the California Consumer Privacy Act (CCPA) and the General Data Protection Regulation (GDPR) if they have customers in California or the EU.
In 2023, several key regulatory updates significantly impacted healthcare and insurance organizations. The U.S. Department of Health and Human Services (HHS) proposed critical modifications to the HIPAA Privacy Rule to enhance patients’ rights over their health information and streamline data sharing for care coordination. The enforcement of the HITECH Act also became more stringent, emphasizing the critical need for robust data protection measures. Furthermore, new state-specific privacy laws went into effect in California, Colorado, Connecticut, Utah, and Virginia, adding layers of complexity to the compliance landscape.
The fines resulting from ineffective data privacy can be devastating. HIPAA compliance fines vary based on the level of negligence and final resolution, with one recent case incurring $4.75 million in penalties. Healthcare and health insurance organizations must protect sensitive data to avoid fines, penalties, reputational damage, and putting their patients at risk.
Keep reading as we explore what defines sensitive personal information and how to ensure data privacy at every level.
What is Sensitive Personal Information in Healthcare?
Sensitive personal information includes specific data points related to a customer, client, or employee. SPI is a distinct data category that differs from general personal information and requires stronger protections.
Some types of sensitive personal information are:
- Social security numbers
- Financial records
- Precise location data
- Medical information
- Ethnic origin
- Sexual orientation
- Citizenship or immigration status
- Genetic or biometric data
Healthcare organizations must also take special precautions when protecting medical information. Protected health information (PHI), as defined by the CDC, encompasses healthcare claims, benefit inquiries, referral authorizations, claims processing data, data analysis, billing records, and other transactions containing patient information.
Protected health information (PHI) includes:
- Health insurance claims
- Prescription records
- Medical diagnoses and treatment histories
- Benefit inquiries
- Referral authorization
- Claims processing
- Data analysis
- Billing
- Other transactions containing patient information
Healthcare and health insurance organizations must understand how specific regulations define SPI, as there can be some differences between requirements. Information falling into these categories must be protected with a high degree of security.
What is Not Considered Sensitive Personal Information?
It’s helpful to distinguish between sensitive and non-sensitive data categories, so let’s briefly touch on other types of data that are still associated with customers and employees:
- Educational data
- Non-personal data
- Anonymized data
- Publicly available information
Importance of Data Privacy for Customers and Patients
Why is data privacy for personal information so important? If sensitive data is breached, end users can become victims of several possible crimes:
- Financial fraud
- Other forms of identity theft
- Reputational damage
- Discrimination or harassment
Each of these possible outcomes can be devastating for your customers or patients. Implementing data protection measures isn’t just about protecting your company; it’s about preventing the potential harm caused by a breach.
As for your organization, you may incur public fines and penalties if regulatory violations are found. We’ll explore these elements in greater detail later.
Cybersecurity Challenges in Healthcare
The healthcare sector faces a heightened level of data security threats compared to many other industries. Recent years have seen a disturbing uptick in cyber incidents, with U.S. Health and Human Services (HHS) data revealing a 93% increase in large data breaches from 2018 to 2022. Even more alarming is the 278% surge in ransomware-related breaches within the same timeframe.
The impact of such breaches is profound, leading to extensive care disruptions, compromised patient safety, and strained healthcare provisioning. Significant cyber incidents have resulted in multi-week outages, rerouting of patients, and postponement of critical medical procedures, emphasizing the dire need for resilient cybersecurity measures.
Key cybersecurity challenges in healthcare include data breaches, ransomware and sophisticated cyberattacks, insider threats and human error, and third-party and cloud security risks.
Essential Steps to Ensure Sensitive Data Protection
How are organizations expected to manage sensitive data related to customers or clients? Specific regulations may provide requirements or guidance for protecting SPI, so let’s explore an overall approach.
Healthcare and health insurance organizations must take appropriate considerations when handling sensitive patient information to stay compliant and protect their patients. Key aspects of identifying and protecting sensitive data include:
Accurate Data Discovery and Classification
Before you can protect personal sensitive data, you need to know about it. Sensitive data is captured by a wide range of sources, such as billing departments, new client onboarding, or doctors’ patient notes.
Using a solution like 1touch’s Inventa for sensitive data discovery is a potent first line of defense in protecting sensitive data. Inventa discovers and classifies all personally identifiable information and PHI according to your policies, allowing you to protect it while in motion, in use, and at rest.
You may struggle to adequately comply with data privacy regulations without the right discovery and classification system. It’s possible to focus on specific types of data capture to protect, but you may still miss information that should be safeguarded using manual methods.
Consent and Notice During Collection
HIPAA and similar regulations require obtaining patient consent for data collection and sharing. Organizations must provide a clear privacy policy readily available to patients. Regulations also mandate a documented privacy policy that’s readily available to consumers and patients.
Collecting and storing consent for each individual is vital for remaining compliant. Additionally, should a breach occur, your fines may be reduced if you demonstrate specific practices were in effect.
Cybersecurity Assessments
Regular cybersecurity assessments are crucial for healthcare organizations to understand their IT assets, vulnerabilities, and implement risk mitigation controls. Employee training is also essential to protect the organization.
These assessments involve understanding an organization’s entire inventory of IT assets, the vulnerabilities facing them, and implementing risk mitigation controls. Higher-level practices are also involved, such as providing comprehensive employee training to protect the business.
While cybersecurity practices go beyond data privacy and protection, strong security is still necessary to ensure data privacy. Every organization needs to conduct regular security assessments to prevent breaches that may come from a range of possible attack vectors.
Access Control and Logging
Only authorized users or systems should access PHI. Access control should be carefully monitored and have effective credential lifecycle practices. Any IT systems that need to access SPI should follow similar procedures.
Additionally, robust logging systems should be in place to track a range of metadata to create audit trails that indicate every time PHI was accessed. Audit trails can help in root cause analysis following a breach or to demonstrate compliance during external audits.
Frequent Internal Audits
Internal audits aim to follow the same processes as an external auditor from a regulatory agency or third party. An audit helps identify any shortfalls in data protection processes in order to correct them prior to an official audit.
Internal audits are important to ensure data privacy processes are effective and compliant. The corrective actions you take after an internal audit will bolster security and data classification processes to prevent a devastating incident from occurring.
Consequences of Breached Sensitive Personal Information
Inadequate or incomplete data classification and protection may result in a breach or failure of an audit, both of which can significantly affect your organization. Let’s explore the primary ways these incidents can have far-reaching consequences.
- Consumer Harm: Ensuring data privacy is critical to protecting your business and customers. SPI includes data that may be used maliciously for identity theft and financial fraud. When location data is included, breaches can also result in harassment or physical harm. Should a breach occur, this data remains available to bad actors and can create devastating situations for customers. Recovering from a single incident of identity theft can take years.
- Legal Obligations: Companies that are non-compliant with data protection regulations, whether intentionally or otherwise, may facing steep fines, penalties, and legal proceedings. The exact financial impact varies depending on the severity and scope of specific violations. Non-compliance is often a result of having ineffective data classification and protection processes. Your organization might have some level of data protection in place but still have blind spots that enable sensitive data to fall into the wrong hands. Adopting the right tools to identify and classify SPI is critical to avoiding this mistake.
- Reputation Damage: A data breach can have disastrous results for any business’s future due to the significant harm it can cause to its reputation. Even once the fines have been paid and everything is resolved, potential customers, partners, and patients may still be aware of the incident. Rebuilding a reputation following a data breach can be challenging, and for some organizations, it may prove impossible. Implementing preventative measures now is the best way to ensure the lasting success of your business.
Risk Management Strategies for Healthcare
Effective risk management for healthcare payers involves identifying, assessing, and mitigating various risks, including cybersecurity threats, regulatory non-compliance, and operational inefficiencies.
Key risk management strategies include:
- Proactive defense and risk management
- Leveraging AI for enhanced defense
- Implementing Zero Trust architectures
- Strengthening cybersecurity governance
- Cultivating a security-conscious culture
- Regulatory vigilance and adaptation
Technology and Compliance in Healthcare
Technology plays a critical role in maintaining compliance and identifying risks in the dynamic world of healthcare and insurance. Emerging technologies such as AI, machine learning, cloud computing, biometric authentication, and blockchain offer transformative potential but must be implemented with careful consideration of privacy laws, data security implications, and alignment with healthcare-specific regulations.
Adopt Accurate Data Discovery and Classification Systems and Processes
Protecting sensitive data is mission-critical in almost every industry. Failing to safeguard SPI can have both immediate and long-term adverse consequences. Data discovery, classification, and protection are necessary to prevent breaches and maintain compliance.
1touch.io Inventa serves as a strategic data discovery and classification solution for healthcare and insurance organizations, providing AI-driven insights to tackle the complexities of compliance, data security, and strategic decision-making. The platform’s sophisticated algorithms provide total visibility across hybrid, multi-cloud, and mainframe environments with industry-leading accuracy, equipping insurers with relevant insights to inform decision-making, prioritize actions, and reduce risks.
Staying aware of every byte of data within your organization is complex, but Inventa helps simplify discovery and classification so you can adequately protect it.
Explore In-Depth Insights: Download Our White Paper on Compliance and Data Security in Health Insurance
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