Safeguarding patient data in healthcare cloud computing

The biggest reason cloud computing is beneficial for healthcare providers is the ability to securely store and access patient data from anywhere at any time. Any use of cloud computing by a healthcare organization needs to remain balanced with the adherence to HIPAA's requirements for the safeguarding of protected health information (PHI).

Challenges when using cloud computing services

1. Vendor reliability and service outages: Dependence on cloud service providers introduces the risk of service outages and disruptions. Organizations must assess cloud providers' reliability and uptime guarantees to mitigate potential downtime's impact on their operations.
2. Data governance and control: When data is stored in the cloud, organizations may have limited control over its physical location, management, and governance. 
3. Data transfer and integration: Transferring large volumes of data to the cloud and integrating it with existing systems can be complex and time-consuming. 
4. Data location and storage: HIPAA mandates that healthcare data must be stored and processed within the United States or in countries with equivalent data protection laws. Ensuring compliance with these requirements when utilizing cloud services may involve understanding the specific data storage locations offered by the cloud provider and verifying that they align with HIPAA guidelines.
5. Vendor lock-In: Transitioning from one cloud provider to another can be difficult and costly due to potential vendor lock-in. Organizations should consider strategies to mitigate vendor lock-in risks and ensure the portability and interoperability of their applications and data.

Related: The guide to HIPAA compliant text messaging

Encryption and protecting patient data in the cloud

Patient data can be encrypted before it is uploaded to the cloud. This ensures that even if the data is compromised, it remains unreadable and unusable to unauthorized individuals. There are two common encryption methods:

• Symmetric encryption, which uses the same encryption key, is used for both encryption and decryption. The key must be kept secure and shared only with authorized parties.
• On the other hand, asymmetric encryption uses a pair of keys—a public key for encryption and a private key for decryption. The public key can be freely distributed, allowing anyone to encrypt data, while the private key remains with the authorized recipient for decryption.

Data transmission between the client (e.g., a healthcare provider) and the cloud storage should alternatively be encrypted to protect against interception or unauthorized access. Secure protocols like HTTPS or SSL/TLS can be used to establish an encrypted connection.

Related: Encryption at rest: what you need to know

Data backup and disaster recovery planning

Data backup ensures that a copy of patient data is securely stored in a separate location or system. This redundancy protects against data loss due to hardware failures, human errors, malicious attacks, or natural disasters. In case of data corruption or loss, the backup can be used to restore the data and maintain continuity of patient care.

Backup and disaster recovery planning also allows that in the event of a hardware failure, natural disaster, cyberattack, or any other disruptive event, data backups allow for quick recovery and restoration. This minimizes downtime and ensures uninterrupted access to critical patient information.

Contractual considerations

The business associate agreement (BAA) between the cloud computing service and the healthcare provider should make provision for several factors. These include:

1. Data security: The BAA should clearly define the cloud provider's security responsibilities, including data encryption, access control, and auditing. The BAA should also specify the cloud provider's liability in the event of a data breach.
2. Data privacy: The BAA should ensure that the cloud provider complies with all applicable data privacy laws and regulations, such as HIPAA and the GDPR. The BAA should also specify the cloud provider's right to use and share data.
3. Data ownership: The BAA should clearly define who owns the data stored in the cloud. This is required to ensure that the healthcare organization has access to its data in the event that the cloud provider goes out of business.
4. Service level agreements (SLAs): The BAA should specify the cloud provider's service level agreements (SLAs), which define the level of service that the cloud provider will provide. SLAs should include uptime, response times, and data recovery time.

Related: HIPAA Compliant Email: The Definitive Guide