Advances in Digital Healthcare Innovation: Designing Compliant Medical Systems in a Cloud-Native World

Data security is critical in every industry, but it carries particularly sobering ramifications within the healthcare sector. Because a healthcare data breach puts patient information at risk and can also leave healthcare providers vulnerable to severe legal ramifications, concerns about data security and HIPAA compliance take top priority for providers. As these concerns have evolved in the wake of new and better technology, so has the development and adoption of cloud technology to address them.

Healthcare organizations all over the world increasingly face pressure to invest in digital transformation to stay ahead, even while patient care demands grow. In 2019-2020, healthcare companies ranked personalized healthcare (52%) and AI assistants (44%) as two significant factors positively impacting their cloud adoption. In light of these evolving needs, embracing cloud-native technology has become essential for healthcare organizations seeking to deliver the most advanced care.

Unfortunately, healthcare has historically lagged behind other industries in cloud adoption because of regulatory compliance concerns. That is beginning to change as cloud security becomes more robust, however. For example, an Amazon data center with several layers of security is now much more secure than an “old-fashioned” physical server in a healthcare clinic’s back office. The cloud is designed to be more secure and more readily available than an on-premise server, which provides clear benefits to any independent healthcare provider.

How Cloud Adoption Impacts Compliance
To comply with HIPAA and other industry regulations, healthcare organizations must be able to:

• Gain the patient’s signature on a copy of the office’s HIPAA compliant policies.
• Maintain audit logs that demonstrate compliance with policy (this is a strict HIPAA requirement).
• Keep track of who accesses records and why.
• Encrypt all data while at rest and in transit (this is also a strict HIPAA requirement).

But what does “at rest” and “in transit” mean to healthcare providers? Most vendors understand that they must encrypt databases and use HTTPS to encrypt data sent to the UI. In order to remain HIPAA compliant, all patient data must be encrypted both in transit and at rest. Using a managed service for an event bus that is HIPAA compliant is often overlooked, which leaves both providers and patients vulnerable to data breaches.

The takeaway is that organizations should always have a plan in place for responding to a security incident. This plan should include heavy, consistent monitoring, a strict incident response protocol, and instant notifications as part of that protocol.

It’s helpful to note that both Amazon and Azure have HIPAA-rated services. The latest versions include encryption at rest, and their teams make sure the services used in this cloud environment are compliant.

Is Cloud Right for Every Medical Application?
Hospitals and practices should consider carefully what should and should not move into the cloud.

Some things to consider:

• Data Encryption for Medical Devices
  • Medical devices (e.g., pacemakers, insulin monitors) collect and store information that is not in the data center. For these cases there will always be local storage. A medical device like a CT scanner may not encrypt its data. There would likely need to be a separate step that encrypts this data if it is to move into the cloud.
• Cost
  • If a practice is doing everything that it should with its on-premise server (backups, disaster recovery, encryption, etc.), then moving to the cloud may be a significant cost savings.
  • If there are areas that need to be improved in the management of data on-premise, then moving to the cloud will likely not be a significant cost savings over the current system. However, it very likely will still cost less than bringing the current system up to where it should be.

Another factor to consider is the differing needs among doctors’ offices and hospitals. Hospitals will have facilities that must be constantly disaster-ready, which requires on-premises computing power. Cloud software solutions will benefit certain aspects of the hospital organization, but should be carefully considered for specific applications.

Small care providers (e.g., special practice, psychologist offices, allergy specialists, x-ray specialists) typically have fewer requirements to be constantly disaster-ready. In these cases, cloud software solutions are more feasible.

Managing the Compliance Burden in the Cloud
Navigating the world of HIPAA compliance, data security, and best-in-class patient care can be overwhelming, to say the least. That’s especially true when an organization is considering the security of any cloud-based services they choose to implement. Still, as cloud services have improved their security and encryption protocols, these options have become more feasible and more attractive to healthcare providers.

When considering any specific service, providers need to know that both their internal system and the cloud service itself meets all governance requirements. This includes auditing, encryption, and security that meets both HIPAA and non-HIPAA-related medical requirements.

At Worthwhile, we help healthcare organizations manage the compliance burden by making sure that the system we design, implement, and run makes it easier to meet the requirements of HIPAA and other regulations. We also serve as an intermediary between organizations and the cloud vendor so providers can rest assured that the cloud service meets all of their requirements.

There are (literally) hundreds of regulations that healthcare organizations must navigate. Our goal is to help each client master this process as it relates to their software system, and to relieve the burden of ensuring compliance and security during the Software Development Life Cycle. As healthcare providers bring their practices into the new world of security, partnering with a trusted resource like Worthwhile for cloud-native technology will be a determining factor for success and growth.

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