HIPAA (the Health Insurance Portability and Accountability Act of 1996) is U.S. legislation created to improve healthcare standards. Covered entities and their business associates must be HIPAA compliant to protect the rights and privacy of patients and their protected health information (PHI). We know the HIPAA industry is vast and that it is important to correctly create notations for proper patient care while remaining HIPAA compliant.
SEE ALSO: HIPAA compliant email
This is especially true with the recent move toward remote working and the increase in cyberattacks against healthcare. Today, we will determine if Bear is HIPAA compliant or not.
About Bear
Bear is a flexible writing app for Apple products (iPhone, iPad, Mac, and Apple Watch) used to craft notes and prose. The app was created by Shiny Frog, an “artisanal app crafting team” from Italy, Ireland, and the U.S. Bear is their latest project and is currently only available for Apple. However, the app can export and import several file types. It utilizes markdown language for text formatting and can include images and other file types. Users create and store notes on a simple interface rather than in a folder system using tags to keep the notes organized. The majority of Bear’s features are free.
Bear Pro, available for a monthly or yearly subscription, includes:
- Syncing between all devices via iCloud
- Advanced exports to PDF, HTML, DOCX, JPG, EPUB
- A dozen new writing themes
Bear includes an edit mode to allow for easy, simple editing.
Bear and the business associate agreement
A major part of HIPAA compliance is ensuring a business associate will sign a business associate agreement (BAA). A business associate is a person or entity that performs certain functions or activities that involves the use or disclosure of PHI. In this instance, Bear is a business associate of a healthcare organization if a note includes any electronic PHI (ePHI), like a name or an email address. Generally, the HIPAA Privacy Rule allows healthcare providers to disclose PHI if they receive assurance that the information is protected through a signed BAA. There is no mention of HIPAA or a BAA on the Bear or Shiny Frog website.
Bear and cybersecurity
Bear’s privacy policy states that the app uses Apple’s CloudKit technology to sync notes. The CloudKit framework provides an interface for moving data between an app and iCloud. According to Shiny Frog on the privacy policy:
We chose CloudKit instead of a file based solution like iCloud, DropBox, or Google Drive because it performs much faster. Plus, CloudKit doesn’t require any registration or login to work; it relies on your iCloud credentials already stored in your devices.
Apple’s private keys encrypt information that passes through CloudKit. Moreover, all data transmits over Secure Sockets Layer (SSL).
RELATED: What is transport layer security (TLS)?
Shiny Frog states several times within its privacy policy that it doesn't want to access customers’ sensitive data or and it doesn't sell personal information. Therefore, no one on the team views user credentials or passwords. The only information collected is anonymous, in-app usage statistics. Finally, with Bear Pro, users can encrypt individual notes and keep them locked using a unique password or Face/Touch ID.
Is Bear HIPAA compliant?
The BAA is a key component of HIPAA compliance and Bear does not appear to sign a BAA. And while Bear is not an official Apple product, we would also like to note that Apple will also not sign a BAA with healthcare organizations. If a breach or HIPAA violation occurs and any PHI is breached, the covered entity is liable.
Conclusion Bear: is not HIPAA compliant.
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Kapua Iao
