Technical Safeguards is the third area of safeguard defined by the HIPAA Security Rule. The technical safeguards are intended to create policies and

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1 Technical Safeguards is the third area of safeguard defined by the HIPAA Security Rule. The technical safeguards are intended to create policies and procedures to govern who has access to electronic protected health information.

2 Access controls are one type of technical safeguard. For this requirement, a covered entity must implement technical policies and procedures for electronic information systems that maintain ephi to allow access only to those people or software programs that have been granted access rights under Information Access Management. This requirement is made up for 4 different specifications. Unique User Identification and Emergency Access Procedures are required standards. Automatic log-off and encryption and decryption are addressable standards.

3 A covered entity must make sure that policies and procedures are in place for the required access control specifications. The first standard is Unique User Identification and requires a covered entity to create and assign a unique log-in name or number for each individual user in the software system. When developing the policy and procedure for this requirement, the process for assignment of unique user identification should be specified. The emergency access procedure requires a covered entity to establish and implement procedures for obtaining necessary ephi during an emergency. When developing this policy and procedure, a covered entity should: Determine the type of situation that may required emergency access to ephi. Determine who will need access to ephi in case of an emergency

4 The next access control specification is automatic log off. This standard refers to when an electronic session automatically terminates after a specified time of inactivity. For this specification, a covered entity should create a policy and procedure that governs automatic log off for each application. The predetermined time should be documented within the policy based on the application. There are no requirements on the time when the system should terminate access; it is based on a covered entity s review and determination. It is best practice to be consistent across the entire organization unless a business need supports a different timeframe.

5 Encryption and Decryption is the last addressable specification for the access control requirement. A policy and procedure should be developed to manage encryption and decryption by a covered entity. Encryption refers to a method of converting an original message of regular text into encoded text using an algorithm. If information is encrypted, there would be a low probability that anyone other than the receiving party who has the key to the code or access to another confidential process would be able to decrypt (i.e., translate) the text and convert it into plain, comprehensible text. From a breach notification standpoint, if a device is lost or stolen and it is encrypted, it is not considered a breach. There are many different encryption methods. Some of these include: Full Disk Encryption - which is the process of encrypting all the data on the hard drive used to boot a computer, including the computer s operating system, and permitting access to the data only after successful authentication to the full disk encryption product Virtual Disk Encryption - refers to encrypting a file called a container, which can hold many files and folders, and permitting access to the data within the container only after proper authentication is provided, at which point the container is typically mounted as a virtual disk. Volume Encryption the process of encrypting an entire logical volume and permitting access to the data on the volume only after proper authentication is provided

6 File/Folder Encryption process of encrypting individual files on a storage medium and permitting access to the encrypted data only after proper authentication is provided

7 The next area of requirements for the technical safeguards are audit controls. This requirement focuses on implementing hardware, software, and/or procedural mechanisms that record and examine activity in information systems that contain or use ephi. A policy and procedure should be developed to help support the use of audit trails. No specifications exist for this requirement. An audit trail is defined as a record that shows who has accessed a computer system, when it was accessed, and what operations were performed. The HIPAA Security Rule doesn t define what information must be gathered or how often the reports should be reviewed. The covered entity must evaluate their internal systems and determine the requirements for their organization. Some examples of when HIPAA Audit Trails should be used are during: Access to PHI by anyone not directly related to the patient s treatment, payment, or healthcare operations Access to records not corresponding to the role of the user Access to PHI of VIPs or community figures Review of records that have not been accessed in a long time Access to an employee s PHI Access to PHI of a terminated employee Access to sensitive records such as psychiatric records

8 The next standard under the technical safeguards is integrity, which includes an addressable specification. The integrity standard requires a covered entity to implement policies and procedures to protect ephi from improper alteration or destruction. The addressable specification for this standard is to implement mechanisms to authenticate ephi to assure that it has not been altered or destroyed in an unauthorized manner. Some examples of mechanisms are sum verification or digital signatures. Sum verification is a function that uses an algorithm to determine if the input data matches the stored data. A digital signature is a mathematical scheme for verifying the authenticity of an entry in an electronic system.

9 The next technical safeguard is person or entity authentication. This standard does not have any specifications defined. For this safeguard, a covered entity needs to implement procedures to verify that a person or entity seeking access to ephi is the person they claimed to be. Examples of proof of identify are: Require a password or PIN that only the user would know Require a physical possession such as a smart card or token for authentication Utilize biometrics such as fingerprints, voice patterns, or facial patterns This policy should relate to the unique user identification and password management policies as defined in other areas of the HIPAA Security Rule.

10 The last technical standard is transmission security. This standard requires a covered entity to implement technical security measures to guard against unauthorized access to ephi that is being transmitted over an electronic communications network. This standard has two addressable specifications: Integrity Controls and Encryption.

11 The integrity control specification focuses on a covered entity implementing security measures to ensure that electronically transmitted ephi is not improperly modified without detection until disposed of. This specification differs from the previous integrity standard as it is specifically focused on ephi that is being transmitted. The encryption specification focuses on the covered entity implementing mechanisms to encrypt ephi whenever deemed appropriate. This standard specifically focuses on the encryption and decryption of information that is being electronically transmitted, also referred to as data in motion. An example of an area where the implementation of encryption for data in motion should be evaluated is communication. A policy and procedure should be created to manage each of these specifications.

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