How Data Management Prevents HIPAA Violations

The HIPAA Privacy Rule and HIPAA Security Rule have existed long enough for healthcare payors to understand the business consequences and the potential threat of up to $50,000 per violation. What remains less clear are the ways their organization’s data management practices impact whether or not they remain compliant with these federal mandates.

In our experience, data management plays a significant role in the success of HIPAA compliance, helping organizations securely store electronic protected healthcare information (ePHI) and transmit it to any authorized Covered Entity (CE) or business partners without risking privacy violations. Here’s what your business needs to know to avoid expensive HIPAA violations:

Two Key Ways to Evaluate Potential HIPAA Threats

HIPAA compliance threats from your data are rarely waiting in plain sight. Dynamic data infrastructures require proactive data management to avoid HIPAA violations and ensure member privacy remains intact. Here are a few strategies that are best at identifying threats:

Conducting Data Discovery – Your data is not only going to be where you expect it. Modern healthcare databases are bustling, multi-user environments that can contribute to the migration of sensitive data in undesirable ways. When ePHI ends up in unsecured and unencrypted data storage, your organization might have an expensive violation on your hands.A regular data discovery routine minimizes this threat. By efficiently and discreetly finding the data within your discovery parameters, you can spot potential threats before hackers. Then, it’s a matter of identifying whether the proper security measures should be implemented or if the data is a duplicate and should go through a high-security file wipe instead.
Fostering Standardized Data – Do data transactions adhere to communication protocols and security standards? Claims and encounter information, coordination of benefits, enrollment and disenrollment, and other electronic exchanges of healthcare data are required under HIPAA to conform with the ASC X12 standards. To ensure that all data adheres, payor organizations need painstaking data dictionaries to keep them HIPAA compliant.Proper data management practices define and cross-reference all X12 transactions to verify that all data elements are standardized. Additionally, they can make sure that the appropriate data is included in the right fields, ensuring that sensitive data, placed in the wrong file, ends up being inaccurately pulled (and in turn revealed) in data reporting.

In the end, healthcare payors depend upon a sophisticated web of data management strategies to ensure that their organization remains HIPAA compliant. In an increasingly competitive industry, taking appropriate actions across technology and procedures can prevent thousands of dollars in fines that impact budgets and reduce trust.