Follow HIPAA to Build a Regulatory Compliant Telehealth Platform

When starting a telemedicine business, companies must consider many things, including compliance with the Healthcare Insurance Portability and Accountability Act (HIPAA). This act is the core data security regulation in healthcare, determining how medical facilities process PHI. If you fail to comply, you may lose patients’ trust and pay million-dollar fines that can make you bankrupt.

This guide explains how telehealth and HIPAA rules affect telehealth platform development and implementation in the US. From government oversight by groups like HHS and the FCC to the nitty-gritty of HIPAA compliance, we’ll explore how healthcare providers protect patient data and HIPAA meaning. Learn how to build a HIPAA-compliant telehealth platform and common slip-ups.

Few Words on What is HIPAA Compliance

Signed by President Bill Clinton in 1996, HIPAA law protects patients’ sensitive medical data by regulating its processing and exchange methods. It outlines national standards to protect sensitive patient health information from being disclosed without consent or due cause. HIPAA applies to health plans, healthcare providers, and healthcare clearinghouses that conduct certain electronic healthcare transactions. Telehealth platforms, as a medical software subtype, also fall under HIPAA.

All medical HIPAA laws are mandatory, and HIPAA-covered entities are penalized for non-compliance. The fines for HIPAA infringements may reach up to $2.1 million or even be followed by criminal allegations.

Main Rules a HIPAA-Compliant Telehealth Platform Must Meet

The HIPAA Privacy Rule, Security Rule, Enforcement Rule, Breach Notification Rule, and Omnibus Rule are the five components of HIPAA that are mandatory to develop a HIPAA-compliant telemedicine platform. Learn more about each of them below for better understanding and complying with HIPAA.

The HIPAA Privacy Rule

The HIPAA Privacy Rule obliges all medical organizations to guard their clients’ personal health information (PHI) privacy. ePHI (electronic personal health information) covers personal details and medical data transmitted and stored in digital format. This rule states the following:

• Healthcare clients must have full access to their PHI, which they are free to copy, change, or update;
• An organization must respond to patients’ requests for changes and updates within 30 days;
• If a healthcare provider intends to reveal patients’ PHI data to a third party, patients should give their consent under “Notices of Privacy Practices”

The HIPAA Security Rule

According to the HIPAA Security Rule, a digital system or an individual with access rights to patient data must be responsible for its security. Medical service providers must implement all the safeguards necessary to protect PHI. These safeguards fall into three categories:

• Technical. Patients’ data stored in electronic systems must be encrypted according to the NIST standards.
• Physical. Covered entities must limit physical access to the data center, cloud, or server.
• Administrative. Companies must introduce procedures to follow HIPAA privacy and security standards. In particular, organizations must hire or train Privacy and Security Officers to ensure adherence to HIPAA standards.

Healthcare providers are subject to regular Office of Civil Rights (OCR) audits to assess risk and identify security hazards.

The HIPAA Enforcement Rule

This rule defines the size of fines and compensations that medical companies must pay in case their clients’ data gets revealed or stolen. The penalties vary from $100 to $50,000 per violation depending on how serious the violation is, how timely it was resolved, and whether it was done with intent. The violations of HIPAA rules may result in criminal charges if a patient decides to sue a company for inflicted damage. Therefore, it is crucial to consider and comply with all the established policies.

The Breach Notification Rule

The Breach Notification Rule explains the procedure that needs to be followed during data leakage. Per this rule, patients must be the first to know in case of data leakage. Next, the organization must inform the Department of Health and Human Services. The notice should contain the following info:

• The type of data exposed
• The individual who unrightfully accessed PHI or to whom the data was revealed
• The type of harm inflicted
• The repercussions of a violation that were alleviated (if any)

The organization has 60 days to issue the breach notice and to inform patients about the precautions they must take to safeguard themselves from its outcomes. A covered entity must also reveal the situation to the media if a breach has negatively impacted more than 500 patients. If the privacy of less than 500 patients is affected, a healthcare company is obliged to inform an OCR portal.

The Omnibus Rule

This rule reveals all the previously unmentioned details: new definitions, policies, and compliance procedures. It also extends the list of covered entities to include third parties who must comply with HIPAA.

The Omnibus Rule introduces the umbrella term ‘Business Associates’ for all parties that may access PHI while cooperating with a healthcare firm.

The five core aspects of the Omnibus rules include the following:

• Recent amendments, namely, the HITECH act
• The most recent structure of fines according to HITECH act
• The changed post-breach harm threshold and the Breach Notification Rule for Unsecured ePHI. 
• Provisions by the Genetic Information Nondiscrimination Act (GINA) 
• The ban to use PHI data for marketing purposes

Also read a guide on HIPAA-compliant payment processing.

Governmental Bodies and Regulations That Oversee Telehealth Services in the US

Several federal and state governmental bodies regulate telehealth platform requirements in the US to ensure proper patient privacy, secure technology standards, and appropriate reimbursement policies. Let’s review the central bodies and regulations affecting the use of HIPAA-compliant telemedicine platforms.

The United States Department of Health and Human Services (HHS)

HHS oversees various agencies and laws that impact telehealth. The Centers for Medicare & Medicaid Services (CMS) sets requirements for telehealth reimbursement and coverage under federal healthcare programs like Medicare. The HHS Office for Civil Rights enforces the HIPAA Privacy and Security Rules that telemedicine platforms must follow to protect patient health data. The Health Resources and Services Administration (HRSA) provides grants and resources to promote telehealth adoption, especially in rural and underserved areas.

The Federal Communications Commission (FCC)

The FCC regulates interstate and international communications for telehealth technologies. This includes internet and broadband services required for video consultations, wireless spectrum utilized for mobile telehealth apps, and communications equipment standards for telehealth devices.

CARES Act

The 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act included several provisions to expand telehealth access during the COVID-19 pandemic rapidly. These provisions include waivers to allow Medicare reimbursement for more telehealth services, funding to strengthen healthcare organizations’ telehealth capabilities, and relaxed rules to enable more healthcare providers to furnish virtual care.

State Laws and Policies

In addition to federal regulations, each state enforces specific telehealth laws regulating HIPAA-compliant telemedicine software. These include telehealth practice standards and clinic/provider licensing, private payer telehealth reimbursement policies, and consent requirements for virtual care delivery.

How to Develop a HIPAA-Compliant Telemedicine Software

For secure telemedicine app development, you must take all the necessary steps to make a telemedicine platform HIPAA-compliant. Here are some tips on setting you on the right track and developing a HIPAA-compliant telehealth platform.

Set Up Secure In-App Connection

First and foremost, set up a secure connection. You can’t use Skype, Zoom, email, and other popular means of web communication for telemedicine, as they lack the necessary security features. For a secure solution, consider either building your secure in-app messaging or video-chat tools using end-to-end encryption or using a HIPAA-compliant solution by a third-party provider under a special security agreement (which typically comes at a fee). For example, telemedicine platforms like AmWell and Teladoc have built-in secure video conferencing and messaging features that meet HIPAA telehealth requirements.

Use Appropriate Data Storage

Your data and how you store it with a HIPAA-compliant telehealth platform can enhance or weaken your app security. The main principle applies here: Do not store unnecessary or obsolete data that you no longer plan to use. Avoid storing data altogether unless you have to.

According to HIPAA guidelines, protected health information (PHI) should be retained for at least six years after the last date of service or encounter. Regularly deleting old files will free up storage space and allow for better data management. The correct workflow principles implemented in software on an architecture level can minimize unnecessary duplicates that can render your system vulnerable to hacker attacks.

Use Secure Data Encryption

Encryption is a cornerstone of medical data protection. Even if hackers capture sensitive personal data, they won’t be able to use it because a secure encryption mechanism makes it unreadable. The data must be encrypted during transmission, i.e., telemedicine video conferencing and message exchange. Also, it is always best to store data encrypted to reduce the theft risk. Major telemedicine companies like Amwell and Doxy.me use end-to-end encryption to protect data during transmission and storage.

Even though encryption requires additional infrastructure capacities and increased network workload during transmissions, ensuring the security of sensitive health data is worth the investment.

Admin Access Control

Set up clear data access policies indicating who and when may view, update, copy, or transmit patients’ data. Distinct user roles will reduce the number of app users with access to PHI to a reasonable minimum and help you avoid data breaches. Have an administrator manage and assign user roles. For example, in a telemedicine platform, administrators can restrict access to PHI only to healthcare providers, while patients can only view their medical records.

For instance, the admin creates user roles with varying PHI access levels, assigns roles to users based on job duties, defines PHI data access policies per role, monitors user activities via audit logs, manages emergency access overrides, terminates departed staff access, reviews/updates privileges periodically for compliance, and trains staff on proper PHI handling while restricting sensitive data access to minimum required.

User Authorization

You must set up user authentication to eliminate the possibility of unauthorized access. Make users confirm their identity by SMS and use complex passwords. You may also implement biometric authentication solutions that recognize the user’s voice, face, or fingerprint. 

A study found that a biometric patient ID system was accurate over 96% of the time. This could help stop patient mix-ups and medical identity theft. It also makes it easier for healthcare workers to identify patients without manually guessing or typing in data.

Authorization Monitoring

A log file containing instances of every successful or failed authorization attempt can help you detect suspicious activity in patients’ accounts. Blocking an account after several failed login attempts and having users confirm their identity may not appear user-friendly, but it will protect user accounts from hijacking.

Data Backup

Yes, you still have to back up some patients’ sensitive data, although it may contradict the Proper Storage principle. Have a security policy in place, indicating which of the patients’ information you back up. Note that it is only safe to have duplicates of the least vulnerable data. According to HIPAA guidelines, backups of PHI must be encrypted and stored securely, with access limited to authorized personnel only.

Automatic Log Off

When users forget to log off, hackers can access their accounts more easily. Have your telemedicine software log off automatically after some time of inactivity. For example, if a user remains idle for two minutes, the software automatically logs off, following best practices for securing healthcare applications.

Secure Documentation Management

A secure documentation management system will facilitate your document flow, help you manage user roles, and protect patients’ PHI from breaches and hijacks. It must include access controls, audit trails, and encryption to ensure the confidentiality and integrity of sensitive medical records.

Appointing Compliance, Privacy, and Security Officers

Having someone take individual responsibility for meeting HIPAA standards will maximize the efficiency of your security efforts. This is also a requirement of the federal HIPAA law and will help you ensure compliance. The designated HIPAA compliance officer should develop and implement policies and procedures to safeguard PHI and oversee regular risk assessments and employee training.

Personnel Training

Offer personnel training options for healthcare entities using your telemedicine platform. Educate their staff about the principles of secure data sharing, tips on how to avoid accidental disclosure, and best practices for handling PHI. Regular training is crucial for maintaining HIPAA compliance and preventing data breaches.

Regular Self-Audits

Regular self-inspections will help you identify weak spots in your security protection before it’s too late and prepare for HIPAA audits. The most difficult parts of preparing for audits are understanding the HIPAA requirements and ensuring the technology’s compliance. Learning from the industry’s best practices and staying at the forefront of all changes in healthcare security legislation is crucial to a successful HIPAA compliance program.

Custom or Third-Party HIPAA-Compliant Telehealth Platform

When implementing telehealth systems, most healthcare providers choose between investing in custom software development or integrating one of the ready-made solutions. Custom telehealth development takes more time and initial investment, but it also gives you more freedom over functionality and data storage. You get a competitive advantage over providers that use standard systems with lookalike functionality. Integration of off-the-shelf solutions, on the other hand, is more convenient and takes less time to launch. Such platforms include HIPAA safeguards by default but have limited customization and less flexible functionality. View the comparison table below to better understand what you gain or lose.

Contact our team to get an estimate for HIPAA-compliant telehealth platform development or customization.

Top HIPAA-Compliant Telehealth Platforms to Consider

If using an off-the-shelf HIPAA-compliant telehealth platform is an option for you, we can help with telehealth integration. Our team can ensure proper implementation of telehealth software and connect it with your existing systems, maintaining HIPAA compliance. Here are a few of the top HIPAA-compliant telehealth platforms to choose from:

Doxy.me

Doxy.me can cover the needs of both individual providers and clinics, from small practices to large enterprises. This HIPAA-compliant telehealth platform is super convenient, with a browser-based format, virtual waiting rooms, and live chat support. It also provides custom branding, a dedicated landing page, and other customization tools.

Zoom for Healthcare

Zoom for Healthcare is a specialized HIPAA-compliant version of Zoom, adapted to the needs of healthcare providers. You can connect Zoom Workplace for Healthcare (solution with AI tools for employee, staff, and admin collaboration), Custom AI Companion for Healthcare that enhances the Zoom experience, and Zoom Workplace for Clinicians that streamlines clinical workflows with AI.

Amwell

Amwell offers telemedicine software following federal telehealth laws and other global regulatory requirements. The platform has features for providers, payers, government bodies, and higher education facilities. Amwell is an optimum choice for large-scale providers due to its extensive functionality and more complicated setup compared to other platforms.

Teladoc Health

Teladoc has always focused strongly on telehealth services and now offers anything, from urgent care to mental health and chronic disease management. It has separate solutions for clinicians, individuals, and organizations. If you want to integrate Teladoc for healthcare services, consider its platform for organizations that includes features for hospitals & health systems. It’s one of the top HIPAA-compliant telehealth platforms, but you should mind that it’s quite expensive and is built around its own provider network.

Find more details on top telehealth solution providers in our blog.

Challenges in Implementing HIPAA Rules in Telemedicine

As healthcare providers increasingly turn to remote options, ensuring the security and privacy of patient information becomes paramount. Let’s delve into the hurdles of building HIPAA-compliant telehealth platforms.

Keeping Telehealth Sessions Safe

Since cybersecurity threats are ever-evolving, you need continuous updates to maintain robust security protocols. Among the primary risks of telehealth meetings is the potential unauthorized access to video conferences or sensitive patient data. Implementing password protection, secure Wi-Fi networks, and encryption for both software and hardware is a must-have to mitigate these risks.

Sharing Patient Information Safely

The transmission of sensitive patient information between healthcare providers is another challenge. While convenient, conventional methods like texting or private messaging may compromise HIPAA standards. Establishing strict communication protocols and educating patients on secure information transmission methods are vital to prevent unauthorized access to sensitive data.

Keeping Stored Data Secure

Patient data is vulnerable to security breaches through remote hacking or internal tampering. Healthcare professionals must implement stringent security measures, including regular software updates, employee training, and robust data management practices, to safeguard against data breaches.

Staying Updated on Privacy Laws

HIPAA is the cornerstone of patient privacy protection in the United States, but healthcare providers must constantly monitor evolving data security regulations. Ongoing training and proactive compliance measures are essential to adapt to changing laws and regulations, ensuring comprehensive protection of patient information.

Adapting to New Technology

The dynamic nature of technology introduces opportunities and vulnerabilities in telemedicine platforms. Healthcare providers must stay updated on the latest hardware and software developments, ensuring proper implementation and integration with existing systems. Consultation with IT professionals may be necessary to optimize technology usage, achieve interoperability, and enhance security measures.

Summing up

HIPAA compliance is crucial for keeping patient information safe. It sets standards for protecting patient data in telehealth.

Ultimately, prioritizing HIPAA compliance in telemedicine development is essential for fostering patient trust and enabling transformative healthcare delivery. By aligning with the principles of HIPAA and telemedicine, stakeholders can navigate regulatory complexities while advancing patient-centric care in the digital age.

At Empeek, we know what it takes to develop HIPAA-compliant platforms. We can help you safeguard patients’ sensitive data and build HIPAA-compliant telemedicine software. Schedule a talk with our development experts to bring your telehealth app idea to life.