Certain pediatric tasks require fairly precise ages, for example when evaluating jaundice one must know a baby's age in hours. What precautions are required to ensure that a birthdate cannot be inferred by usage data from an app that automates some of these tasks? For example, if a nurse enters in that a baby is 8 hours old, it seems a birthdate could be identified if the time of the nurse/app interaction was known.... more »
I'm a compliance consultant for early stage startups with tight budgets. I'm not sure how to advise them regarding BAAs for third-party services such as customer support ticketing that aren't meant to collect PHI, but may incidentally. (E.g. "[Covered entity] entered my profile information wrong and I don't know how to change it. It should say...") These subcontractors meet the NIST definition of a cloud service provider,... more »
I see a great deal of variation from organization to organization on what constitutes PHI in the digital realm. I have several scenarios that I'd like your thought on: - Is public website browsing behavior considered PHI as is suggested in the current Winston Smith V. Facebook case (http://digitalcommons.law.scu.edu/cgi/viewcontent.cgi?article=2175&context=historical)? This could impact a number of common services used... more »
The scenario is this: A private health clinic (PHC) signs up online to use a web-based EHR application to create patient charts, schedule patients, provide a patient portal, etc. - classic practice management tasks. The EHR vendor has a BAA with a company which hosts its web application and the encrypted database. My question is, what happens to the PHC's electronically stored ePHI if the PHC's account is cancelled and/or... more »
Does HIPAA have any restrictions on offshore development and/or customer support functions if the parent company is based in U.S. and/or if the foreign entity is owned and/or controlled by an entity based in U.S.?
We are a small startup team that is distributed nationwide. To date everyone has used their own personal computers to login into work email, etc. Is it a requirement that we purchase and make all of our employees use only their work computers for development and access to our db? It's understood that we need a robust password policies and defined lists of who has access to any sensitive data where ever they may be.
Do entities need to run internal and external vulnerability scanning be HIPAA compliant? Do entities have to run penetration tests to ensure compliance? Reading §164.312(e)(2)(i) it seems that 'security measures' could include these tests, but does not specify a requirement for it. Additionally, a risk analysis could identify that these services would help to reduce the risk, threats and vulnerabilities in-scope systems,... more »
Data masking or controlled access provides a means for patients to control disclosure of select information within the EHR. http://www.nature.com/gim/journal/v10/n7/pdf/gim200876a.pdf Can patients request that access to sensitive data be controlled? Can patients request that only certain people can access their PHI? Can they request an audit of how their data has been shared by a covered entity? If so, do (or should)... more »
We are a small organization starting up a tele-health initiative. We would like to deliver a copy of our Notice of Privacy Practices electronically and have patients acknowledge receipt via check box prior to completing our online intake forms. This method is used for acceptance when one downloads software online. We are having a difficult time understanding the requirements for this. Can it be a check box and/or typed... more »
In order to be HIPAA compliant, should all activity that occurs with in an app be logged, or should activity that exceeds the normal threshold be logged? For instance, users that access information in the application routinely during the course of their work day will evince a regular level of activity. The activity will indicate routine access of sensitive information. Should the log contain all of the users activity,... more »
A provider or a wellness management company, which are both subject to HIPAA because they collect and house PHI. If that provider or wellness provider suggest to a patient that they use an app (the app was not developed for them and there has been no communication with the app company that the providers are going to use the app) to gather health data to share with them and the app company suffers a breach of information.... more »
From Kevin Wiggins, Saul Ewing: If a CE puts PHI on the Cloud and later terminates that Cloud as a service provider, there is inevitably some data remanence, thus leaving PHI on the Cloud. NIST Special Publication 800-80 addresses this by suggesting CEs use crypto-erase. What if the CE previously sent unencrypted PHI to the Cloud? Is it as simple as extending the protections of the contract to the information and... more »
We are not a covered entity or business associate. We are developing a direct-to-consumer app that tracks medication adherence. We want to de-identify the information the app collects to sell to third parties. Do we follow the same HIPAA de-identification processes that a covered entity or business associate would follow?
A business associate provides no medical advice, medical services, medical devices, etc. But it talks to patients of the covered entity. Those patients tell the business associate what prescriptions they have for prescription drugs and when they must be refilled. The business associate faxes the refill request to the pharmacy. Does that make the business associate a covered entity?
Remote devices may not have access to the internet at all times and therefore may be operating offline. Data must be stored on the devices until connectivity is restored. What is the protocol for PHI data storage on offline mobile devices?