HIPAA compliance primarily applies to the cloud provider's security measures, encryption, access controls, and willingness to sign a business associate agreement (BAA), regardless of the location.
Data sovereignty and HIPAA compliance
Data sovereignty refers to the principle that data is subject to the laws and regulations of the country where it is physically located. When healthcare organizations store protected health information (PHI) in the cloud, the handling of that data must comply with HIPAA, regardless of physical location.
Here's how data sovereignty can influence HIPAA compliance:
Physical location and legal jurisdiction
HIPAA compliance instructs that PHI is stored in line with US regulations. Data stored on cloud servers outside the United States might be subject to different legal jurisdictions and data protection laws. This can create challenges in ensuring that data remains protected per HIPAA standards.
Data transfer and transmission
HIPAA places restrictions on the transmission of patient data. When data is transmitted across international borders, it may be susceptible to interception or surveillance by foreign governments. Data sovereignty issues can emerge during data transfer, potentially leading to HIPAA violations.
Data access and control
Cloud storage providers often have access to the data stored on their servers. If these servers are located in a different country, the cloud provider may be subject to the laws and regulations of that country. This can affect the healthcare organization's ability to control and access PHI in compliance with HIPAA.
Data residency and encryption
Data sovereignty may influence how data is encrypted, where encryption keys are stored, and who has access to them. Healthcare organizations must implement encryption practices to comply with HIPAA standards, irrespective of the data's physical location.
Business associate agreement (BAA)
HIPAA compliant cloud storage providers must offer a business associate agreement to healthcare organizations. A BAA is a legal contract establishing the cloud provider's commitment to safeguarding PHI and complying with HIPAA.
Compliance certification
Cloud providers that have obtained significant compliance certifications, such as SOC 2 or HITRUST, demonstrate a commitment to safeguarding sensitive data.
As per the Health Information Trust Alliance (HITRUST), certification "means that a company has taken extensive measures to ensure the security of sensitive data. It is widely considered the gold standard of trust and reassurance, as it signifies a company is taking cybersecurity seriously and has taken necessary steps to prevent data breaches."
Data backup and disaster recovery
Cloud providers should have data backup and disaster recovery plans in place. The geographic diversity of data centers can influence data availability in the event of a disaster.
Go deeper:
Practical considerations for healthcare organizations
While cloud storage offers multiple benefits and the adoption of cloud technology in healthcare has surged, a survey by Bitglass indicates that healthcare is lagging behind other industries due to the stringent requirements of HIPAA regulations. Healthcare providers can begin to bridge this gap by gaining a deeper understanding of effective, secure, and compliant data storage in the cloud.
In the news
Radiology is leading the adoption of cloud storage and computing in healthcare, driven by the rapid growth of digital imaging and the increasing value of historical medical records in the era of big data. At recent conferences like RSNA and HIMSS 2023, this trend was evident. Esteban Rubens, Oracle's healthcare CTO, explained that the surge in data, including digital pathology, is pushing health systems to adopt cloud solutions to manage on-premises growth.
Enterprise imaging systems, which consolidate images and data for easier sharing across departments, are also fueling this shift. Traditional on-site storage struggles with cybersecurity, disaster recovery, and operational costs, making cloud storage an attractive alternative for archiving and backups. Old medical images and reports are now valuable for big data studies, analytics, and AI training, necessitating their preservation.
Cloud adoption varies, from detailed migrations to selective archiving, with archive storage being the primary entry point. Outsourcing to the cloud can also address health IT staffing shortages, allowing IT staff to focus on more important and innovative tasks, ultimately enhancing healthcare operations.
FAQs
How do cloud storage locations affect HIPAA compliance?
The location of cloud storage directly impacts HIPAA compliance because data stored in the cloud must adhere to HIPAA regulations regardless of where it is physically located.
Can healthcare organizations use any cloud storage provider for storing PHI?
Healthcare organizations can use cloud storage providers for PHI, but they must ensure the provider signs a Business Associate Agreement (BAA) and complies with HIPAA's security and privacy rules.
Are there specific requirements for storing PHI in cloud storage?
Yes, PHI stored in cloud storage must be encrypted both at rest and in transit, and access controls must be in place to restrict unauthorized access.
Can cloud storage providers located outside the United States be used for PHI?
Yes, cloud storage providers located outside the United States can be used for PHI, but additional precautions must be taken to ensure compliance with HIPAA, including verifying that the provider complies with international data protection laws and signing appropriate agreements.
What are the consequences of using non-compliant cloud storage for PHI?
Using non-compliant cloud storage for PHI can result in HIPAA violations, potential fines, legal actions, reputational damage, and loss of patient trust. It is necessary for healthcare organizations to carefully vet cloud providers to ensure compliance with HIPAA regulations.
See also: HIPAA Compliant Email: the Definitive Guide
Farah Amod
