Social media is everywhere—even inside the walls of hospitals. Staff may log into personal accounts during lunch breaks, and many organizations maintain official social media accounts; plus, of course, patients and visitors often rely on social media to keep in touch with friends and family. For many, social media is so much a part of their everyday routine that the benefits are almost too obvious to list. Yet the risks—including potential HIPAA violations—are often not as clear, and privacy and security officers need to stay aware of them.
Cyber threats continue to grow and evolve, but most share a similar origin: phishing. Phishing emails, seemingly innocuous or legitimate emails used to infiltrate an organization, are a common source of malware and are used for scams in which a criminal impersonates another individual to obtain sensitive information. A study released in March by PhishMe estimated that up to 93% of phishing emails contain ransomware.
Although the damage phishing emails can do is tremendous, security officers can help their organizations turn the tide by using a combination of technical controls and targeted education.
The danger and the success of phishing emails lies in their ability to manipulate the individual on the receiving end. Phishing emails may be sent from domains that are a near-identical match for an organization's and come with what appear to be legitimate and urgent attachments or links. It's a simple scheme that criminals can use for a variety of purposes.
"They hope to get malware installed so they can control the computers they infect or even the entire network. They hope to get network or application login credentials. They hope to trick people into performing certain actions, i.e., a wire transfer of money," Kevin Beaver, CISSP, independent information security consultant at Principle Logic, LLC, in Atlanta, says. "The possibilities are endless."
Q: We recently received a request for a patient's records. The patient transferred to another provider several years ago and we subsequently transferred all the patient's records to the new provider. Should I direct the request to the provider the patient transferred to? I'm unsure that we should be responsible for retrieving and releasing information for this patient since we transferred the patient's entire record to the new provider.
A: If you sent a copy of the patient's records to the new provider and still have the original records, it would be appropriate for you to respond to the request. If you transferred all records to the new provider and no longer have the patient's information, refer the request to the new provider.
Editor's note: Mary Brandt, MBA, RHIA, CHE, CHPS, is a healthcare consultant specializing in healthcare regulatory compliance and operations improvement. She is also an advisory board member for BOH. This information does not constitute legal advice. Consult legal counsel for answers to specific privacy and security questions. Opinions expressed are those of the author and do not represent HCPro or ACDIS. Email your HIPAA questions to Associate Editor Nicole Votta at nvotta@hcpro.com.
There are no federally recognized HIPAA certification standards for covered entities (CE) and business associates (BA) and it's unlikely one will be. However, that doesn't stop larger CEs from requiring some form of certification to demonstrate compliance with HIPAA and proof that BAs have implemented sound information security programs. The Health Information Trust Alliance (HITRUST) published its first common security framework (CSF) in March 2009 with the goal of focusing on information security as a core pillar of the broad adoption of health information systems and exchanges. Larger CEs, primarily large health plans, now require their BAs to become HITRUST certified.
Q: What recommendations do you have for handling medical records for staff members who are also patients at the organization where they work? Should we provide extra protection for these patients? What can we do to ensure that staff members are not accessing their coworkers' records without permission or need?
A: I am a firm believer in not adding special protection to any record, because it implies that some records are more confidential than others. In fact, all records are confidential and staff should not access any record unless it is necessary to do so to do their jobs. And, if it is necessary, they should only access the minimum necessary to do the job. HIPAA requires access monitoring, so your organization should conduct routine audits to determine whether staff are accessing records without a work-related reason. There is now software available that can conduct routine audits by staff member and department. This software can be used to reassure staff that their information is not being accessed by coworkers and to hold accountable those who are not following the policy/law. When a staff member raises a concern, an audit should be run to determine whether inappropriate access has occurred, and if it has, sanctions should be applied. Organizations should also consider having a policy that staff should not handle coworkers' (or family members') records (except in an emergency) without the permission of their supervisor.
All of these points should be reviewed at orientation and during (at minimum) annual training to ensure all staff understand that the organization takes such transgressions seriously and will take action as needed to protect the privacy of every patient's information.
