The Health Insurance Portability and Accountability Act or commonly referred to as HIPAA is now vital in the healthcare industry. This shouldn’t be a surprise considering many people nowadays are very conscious about the safety of their personal and confidential information. It’s due to this concern that led HIPAA in 1996 to be enacted to set standards that need to be observed by all players in the healthcare industry from insurance companies, healthcare providers, and hospitals. As a medical professional or medical student, learning about HIPAA compliance is essential, and here's a guide elaborating every essential detail you need to know.
What Is HIPAA Compliance?
The Health Insurance Portability and Accountability Act or HIPAA are set of standards to protect sensitive patient data. It’s a process whereby the covered entities and business associates adhere to secure and safeguard Protected Health Information (PHI) as recommended by the Health Insurance Portability and Accountability Act.
The covered entities under HIPAA compliance are the persons practicing in the healthcare sector with access to and use of PHI. These usually include nurses, doctors, and insurance companies. On the other hand, the business associates are the persons who work in a non-healthcare capacity with the covered entity. These individuals are also expected to observe HIPAA compliance and others including IT professionals, accountants, administrators, and lawyers in the healthcare field.
What Are The Things You Need To Know About HIPAA Compliance?
Now that you understand the definition of HIPAA compliance, the next thing is understanding the things you need to do to comply with it. Here are the details about HIPAA compliance you should know if you’re training to become or are a medical professional;
1) HIPAA Compliance Is Mandatory
As a student or employee in the healthcare industry, you need to be trained on how to create suitable security policies and implement them accordingly. This is the only way you can guarantee to safeguard the data safety of your patients. Therefore, undertaking HIPAA training as a medical student or a medical professional is mandatory; after all, you wouldn’t be able to implement the procedures and policies without first understanding them.
The training needs to be done regularly as the HIPAA compliance procedures and policies keep on being updated from time to time. This is essential to ensure you’re well-versed with the current HIPAA compliance standards. In addition, the training needs to be documented well to prove that you've undoubtedly undergone training to know the latest security measures to guarantee the privacy of patient information.
2) Understand The HIPAA Privacy Rule
The HIPAA privacy rule applies to everyone who comes into contact with Protected Health Information (PHI), which means the business associates and covered entities. This Privacy Rule is also referred to as Standards for Privacy of Individually Identifiable Health Information. The purpose of the HIPAA Privacy Rule is to govern how, when, and how the authorized parties should access PHI. This usually includes lawyers, healthcare professionals, administrators, and anyone else working in the health information ecosystem.
The Privacy Rule expects suitable precautions which are put in place to safeguard the privacy of Personal Health Information. In addition, it grants the patient or a nominated representative the power over their health details. This includes the right to get and examine a duplicate of their health records and request changes if needed. The Privacy Rule expects the covered entities to get back to their patient’s requests for access within 30 days. Also, the patients and plan members will be given Notices of Privacy Practices (NPPs) and be advised about the circumstances in which their data is being shared or used. It’s due to this that acquainting yourself with the Privacy Rule is necessary.
Reading over the Privacy Rules also helps the covered entities get advice on how to;
The covered entities have to confirm that the patient authorization forms are up-to-date. This ensures they contain the option for patients to forbid disclosing their PHI to a health plan, release immunization records to schools, and give a patient an electronic copy of their healthcare records upon their request.
3) Which Information Is Safeguarded By HIPAA?
It’s also critical you know what patient information falls under the HIPAA Privacy Rule. Usually, the data to be under the Privacy Rule should be any individually identifiable health information that’s either stored or disclosed by the covered entity regardless of the state it’s in. Therefore, HIPAA compliance applies when the data is stored or transmitted in written form, orally, or electronically.
The patient’s information that’s classified as PHI includes;
In addition to this, HIPAA covers demographic information and any data like addresses or names which can be used in identifying someone.
4) Find Out Whether the Privacy Rule Applies to You
As a student or employee, you don’t want to find yourself having a violation of HIPAA compliance. The best way to prevent this from happening is by examining and confirming whether the Privacy Rule does apply to your practice, business, or healthcare organization. Knowing this is vital as every covered entity from insurance providers, doctors, nurses, accountants, and lawyers are expected to observe the Privacy Rule.
Organizations and individuals categorized under covered entities are the ones which hold and process PHI data for their patients and customers. It’s the duty of these covered entities to ensure that they report when a HIPAA violation happens and to know who’s expected to settle fines levied by the Office of Civil Rights.
According to HIPAA, the organizations and individuals categorized as covered entities include;
Health Insurance Companies
Health Care Providers such as;
Health Care Clearinghouses
If you fall under any of these covered entities, then you need to implement HIPAA compliance on how you store, use, and disclose PHI in your company’s environment. In addition, you need to know the flow of the PHI within your company’s system boundaries and when the data is conveyed to a third party.
5) Assess The Past to Avoid Repeating the Same Mistake
There’s a lot that can be learned from past mistakes and this is something that you should look after to if you work in a healthcare facility or hospital. This is because the HIPAA security reviews help pinpoint certain mistakes that shouldn’t be repeated in the future. The most common mistakes that are identified after these HIPAA security reviews are completed including;
Learning from such mistakes is vital to ensure that crucial patient data isn’t used or transmitted in violation of the HIPAA standards.
6) HIPAA Doesn’t Set and Recommend Procedures
There aren’t set procedures or recommendations made by HIPAA on how the patient’s data should be safeguarded. Instead, it’s the duty of the healthcare provider to implement the best industry standards to avoid getting fined for the violation. Therefore, you need to take it upon yourself to do exhaustive research to know what’s the best thing to do to follow the HIPAA compliance security procedures and protocols.
If you don’t adhere to the HIPAA regulations, then be ready to suffer the consequence for your actions and this is usually very expensive. The fines may reach $1.5 million each year depending on what kind of HIPAA violation has been broken. Other than the fine, you also ruin your organization’s reputation as patients no longer trust that you can safeguard their vital data. This loss of trust can also end up affecting patient care, making it harder to come back from this long-term damage.
7) What Is Classified as Protected Health Information?
The primary purpose is to manage and safeguard the health information of a particular patient. Data that falls under protected health information is broad and needs to be handled under the HIPAA regulations. Here are some of the details which are classified as PHI;
If you’re training to work or already working in the healthcare industry, understanding HIPAA compliance is mandatory to avoid fines due to violation of the set standards. Therefore, it’s prudent that you familiarize yourself with the system rules to ensure your documentation and training procedures are uniform to the laid down standards and error-free. Reading this guide has taken you through the HIPAA compliance facts that you need to know as a player in the healthcare industry.