Source: http://hipaa.technicaldr.com/p/4095965898/2018/03/24/hipaa-email
Timestamp: 2019-04-18 23:00:28
Document Index: 720976265

Matched Legal Cases: ['§ 164', '§ 164', '§ 164', '§ 164', '§ 164', '§ 164']

HIPAA & Email | HIPAA Compliance for Medica...
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From www.hipaaone.com -	March 24, 2018 12:30 AM
Is it possible to email patients in a HIPAA compliant manner? What can and cannot be included in an email to patients? What does HIPAA have to say about it? These questions have long been on the minds of providers as they attempt to navigate towards greater messaging options without opening themselves up to breaches, penalties or fines. Before determining if HIPAA and email can effectively coexist, let’s take a step back and understand what the HIPAA Privacy and Security rules allow.
Per the Office for Civil Rights (OCR) of the Department of Health and Human Services webpage, “The HIPAA Privacy Rule allows covered health care providers to communicate electronically, such as through e-mail with their patients, provided they apply reasonable safeguards when doing so. See 45 C.F.R. § 164.530(c). For example, certain precautions may need to be taken when using e-mail to avoid unintentional disclosures, such as checking the e-mail address for accuracy before sending, or sending an e-mail alert to the patient for address confirmation prior to sending the message.”
OCR then goes on to state if the patient reaches out to a healthcare provider using email, the provider can assume that email communication is acceptable. If the provider feels the patient does not understand the possible risks of using un-encrypted email, the provider should alert the patient and ensure that they want to continue with email communications.
Additionally, the Privacy Rule states that patients have the right to request a provider communicate with them by alternative means if reasonable; “For example, a health care provider should accommodate an individual’s request to receive appointment reminders via e-mail, rather than on a postcard, if e-mail is a reasonable, alternative means for that provider to communicate with the patient. By the same token, however, if the use of unencrypted e-mail is unacceptable to a patient who requests confidential communications, other means of communicating with the patient, such as by more secure electronic methods, or by mail or telephone, should be offered and accommodated.” See 45 C.F.R. § 164.522(b).
The HIPAA Security Rule does not prohibit the use of e-mail to send ePHI, however, it does outline some standards to protect and guard the integrity of unauthorized access to ePHI. Sited from the OCR website, “However, the standards for access control (45 CFR § 164.312(a)), integrity (45 CFR § 164.312(c)(1)), and transmission security (45 CFR § 164.312(e)(1)) require covered entities to implement policies and procedures to restrict access to, protect the integrity of, and guard against unauthorized access to e-PHI. The standard for transmission security (§ 164.312(e)) also includes addressable specifications for integrity controls and encryption. This means that the covered entity must assess its use of open networks, identify the available and appropriate means to protect e-PHI as it is transmitted, select a solution, and document the decision. The Security Rule allows for e-PHI to be sent over an electronic open network as long as it is adequately protected.”
Recap of the Privacy and Security Standards:
Providers may e-mail patients but they must take precautions.
Should the patient request his/her provider use e-email, the provider must take the necessary steps to ensure the ePHI is protected.
As a standard practice, providers should warn patients about the risks of e-mail communications.
Information shared over an open network increases the likelihood of unauthorized access.
Best Practices for HIPAA Compliant Email
Below is a list of some best practices to ensure compliant e-mail along with adhering to the Privacy and Security Rules:
Encrypt e-mail messages – If the provider is not using a patient portal or e-mail application, encrypt any/all sent e-mail messages and avoid sending any PHI. Additionally, any attachments (specifically those including PHI) should be encrypted as well.
Capture each patient’s consent to receive communication by email – Include a communication consent form within the patient on-boarding forms to verify communication preferences and allow patients to opt in or out of e-mail correspondence.
Utilize a secure, HIPAA compliant email application – There are many email applications and servers designed to offer providers a HIPAA compliant e-mail offering.
Message patients through an EMR portal – A secure EMR portal is the perfect place to send HIPAA compliant messages to patients. Patients may log in to view appointment reminders, test results and physician/nurse messages without the threat of unsecured e-mail.
From www.abetteranswer.com -	February 21, 11:30 AM
HIPAA compliance is a vital part of any medical practice, especially as technology continues to advance. It is more important than ever that medical practices are safeguarding their protected patient health information (PHI). This is especially important for medical practices that work with partners to handle any of their sensitive information, such as billing or patient calls.
HIPAA Compliance Across the Care Continuum
New advances in technology allow the healthcare industry to be more efficient. Organizations can store and share data more easily through systems like electronic medical records (EMRs) software. Unfortunately, this created the side-effect of making patient data vulnerable in new ways.
Medical practices should be ready to look for HIPAA compliance anywhere their data goes. It’s important for medical practices to evaluate the risks to data exposure and take the appropriate documented steps to protect it. This includes vetting any partner exposed to or directly handling PHI.
Under the Privacy Rule, all information that can be used to individually identify someone is protected. Protection occurs no matter what form the information takes. This information can include all historical data on a patient’s condition, what health care they’ve received, any billing information, and anything else that can reasonably be used to identify someone. This, of course, includes the expected information such as name, address, date of birth, etc.
The Privacy Rule leaves a little room for interpretation, so it’s best to protect all of the information you have on your patients to be safe.
Staying Adaptive and Vigilant
Technology continues to march forward with new innovations seemingly every day. It’s important to be able to understand how to utilize new security advances as well as the risks associated with new technology.
To stay HIPAA compliant you must always be vigilant to adapt and make changes in accordance with any new risks, whether from the technology you use or otherwise. This means it can be difficult to find a partner to trust for services such as an answering service, scheduling service, data storage, etc. Partners have to invest to become HIPAA compliant, with the right systems, training and more. Not every company is going to be able to, or willing to, make that investment.
What HIPAA Means for Your Partnerships
All authorized users of protected health information must be HIPAA compliant. This means that any of your partners that are authorized to handle your patient data must be compliant as well. They have to be just as vigilant as you and understand the intricacies of each regulation.
You need partners that don’t just offer HIPAA compliant services and products, but understand it and can help you proactively protect data and prevent fines. Establishing processes to vet your partners is key. Factors to account for in a partner can include but are not limited to: ensuring they provide a business-to-business agreement that outlines compliance measures, and that they place a concerted effort on mandatory, continuing education for all team members exposed to patient data, not just team members handling the data.
For additional information on HIPAA regulations HHS has provided a summary of the Security Rule.
HIPAA Compliance in Answering Services
An answering service is going to handle some of your patient’s most important data and be exposed to information such as their appointment types, personal/identifying information, diagnoses and more. They are also storing and conveying information to your practice, so it’s vital that they have the systems to meet the safety requirements and the ability to store data for the appropriate amount of time.
When looking for any partner, make sure that they have taken the steps required to be HIPAA compliant in advance so they don’t leave your patients’ data at risk and your organization accountable.
From www.onsip.com -	January 16, 2:28 AM
If you work in a pharmacy, insurance company, hospital, or any kind of healthcare practice, you know about HIPAA. The Health Insurance Portability and Accountability Act of 1996obligates all healthcare providers or payers to safeguard the privacy and integrity of the personal health information, or PHI, of patients. You also know that it's about much more than securing digital data files: It's what obligates the pharmacy technician to ask customers in line to step back from the pickup counter; it's what requires hard copy patient records to be kept out of reach of unauthorized personnel.
As with oral or written information, compliance in digital voice and video is achieved through a combination of technology tools and proper practices. When you store it, (think voicemails, recorded calls) digital voice puts the "e" in ePHI (electronic personal health information) where HIPAA's more stringent security (as opposed to privacy) rules apply. Here, it's important not just to keep patient information from unauthorized persons; it's important to ensure such data is locked down or encrypted in such a way that it can't be accessed or changed.
It's no small chore to establish HIPAA compliance; that's why few hosted VoIP providers have performed the required policy and procedure improvements, documentation, employee training, ongoing monitoring, and physical security audits. Some, however—including OnSIP—have taken this step. By being certified to sign the Business Associate Agreements that HIPAA requires, providers assure customers that they take on responsibility for compliance as regards their voice and video platform. In the process, they extend to healthcare the considerable benefits of cloud communications that non-regulated industries have enjoyed for years.
Here are eight examples of how a healthcare practice can benefit from an HIPAA-compliant cloud phone system:
1. Share phone numbers, recordings, menus, and more across multiple locations.
Cloud communications can bring multiple sites under one shared administrative account. This not only saves money previously spent on individual phone lines, but also lets users dial any phone as a in-network extension, with call handling functions such as hold and transfer. OnSIP's network-wide encryption ensures that such calls cannot be tapped at any point on the IP network. (For a good example of how this works, see how Open Arms Treatment Center unified multiple office locations.)
2. Pool personnel across multiple locations to reduce calls on hold and provide foreign language assistance.
With system-wide call queuing, multi-site practices or insurance companies can pool office staff in every location to answer all incoming calls to a main number, reducing patient wait times. If they want to respond even faster, they can even recruit home-based workers. These remote staff can use personal computers or phones as extensions on the network. Organizations can also leverage, for example, the Spanish-speaking staffer in one location to handle Spanish-speaking callers to all other sites.
3. Provide staff with EHRs and patient information from PMS apps upon incoming calls.
Just as cloud phone systems are easily integrated with business CRM software to pop customer information on customer service agent screens, an integration with a PMS can pop patient info, saving office staff time in making appointments or handling insurance claims. Such integrations also makes it easier to dial out to patients, by enabling click-to-dial functionality on a computer. It further helps ensure that patients are reached through the numbers they requested to receive calls—as required by HIPAA—since it is easy to embed those clickable numbers prominently on their records.
4. Make and receive calls with professional caller ID from any phone or location.
Many cloud phone system providers offer softphone applications that run on a computer or smartphone. These apps allow users to access the phone system remotely, so doctors can answer work calls and view inbound caller ID information, no matter where they are. They can also easily transfer calls colleagues. When they need to make a work call, their outbound caller ID will display the office phone number, a favorite feature for on-call staff who may be away from the practice and carry only their personal phone.
5. See who's available across the organization to receive transferred calls.
With a clear view of coworkers' availability—available on some services—users can avoid transferring patients' calls to unattended extensions or voicemail, averting frustration. When staff are there to answer, patients can be transferred from lab results to follow-up scheduling or refill requests, accomplishing more with each call.
6. Video calling can extend physician reach to underserved areas and workplaces.
While patients are by now well acquainted with video calling, the Skype and Facetime appsthey use are not HIPAA compliant. If a HIPAA-certified cloud phone service includes video calling, practitioners can leverage this richer medium for better informed (and more billable) consultations. These calls can support technician-assisted telehealth visits and remote medical device readings, extending clinicians’ reach into underserved areas. Technician-assisted medical kiosks, equipped with video calling and devices such as digital stethoscopes and blood-pressure monitors, have been installed in workplaces to encourage employees to take better care of their health.
7. Video calling aids and encourages use of online patient portals.
Since voice and video sessions can be provided through a web browser, video chat can be embedded in an online patient portal. Being able to see the medical assistant, say, answering questions, may encourage more patients to sign up for these increasingly popular portals. By logging into a secure website, patients can access personal information as well as view lab results, send secure messages to doctors, track immunization records, and schedule appointments.
8. Easily retrieve voicemails and other call recordings attached to EHRs and PMRs.
Many hosted VoIP services offer call recording, which is gaining use in healthcare settingsfor a variety of reasons, from documenting remote visits, to training employees, to protection from spurious malpractice suits. As a digital file containing individually identifiable health info, these recordings require encryption in transit and at rest. With a HIPAA-certified cloud service and proper policy enforcement, these recordings can be securely shared among other members of the practice group, or attached to a patient record in a similarly secured practice management or EHR system.
At the end of the day, healthcare organizations must recognize that HIPAA compliance is only one part technology. Policy establishment and documentation, training, and enforcement make up the other parts. Oral, paper, and digital media, storage strategy and messaging must be thoroughly considered.
If you’re considering a cloud phone system for your office or practice, a good place to start is by reviewing HIPAA’s privacy and security rules. Since at least 11 states add more stringent patient protections to the ones imposed federally, their rules must be reviewed as well. For this, we recommend Health Information & the Law, a project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation. If you provide medical care, you should consult a lawyer familiar with your state’s health privacy laws. Finally, you should also commission a third-party auditor to determine what parts you may be missing before implementing a cloud-based communications solution.
Manjeet Singh's comment,	January 17, 4:36 AM