The healthcare industry is experiencing an explosion of data. Medical records, insurance claims, prescriptions, doctor‘s notes, radiology images, and genomic sequencing data are being generated and stored at astronomical rates.
It is estimated that the total volume of healthcare data will grow at an annual rate of 36% and reach 2,314 exabytes by 2020.1 This avalanche of data holds enormous potential to enable precision medicine, improve quality of care, and save lives. However, it also brings immense responsibility to protect patient privacy.
Data encryption has become a critical component of healthcare data security and privacy programs. In this comprehensive guide, we will explore:
- The importance of data encryption in healthcare
- HIPAA requirements for encryption
- Top use cases for healthcare data encryption
- Best practices for implementing encryption
- Expert insights on deploying encryption securely
I draw on my over 10 years of experience in healthcare data analytics to provide both technical and strategic perspectives on harnessing encryption to protect healthcare data.
Why Data Encryption is Critical in Healthcare
Healthcare organizations today handle an unprecedented amount of highly sensitive patient information. This includes medical records, insurance details, social security numbers, financial data, and more.
If such sensitive data falls into the wrong hands, it can lead to fraud, identity theft, and irreparable harm to patients. Healthcare cyber attacks are rising at an alarming rate, with 328 incidents publicly reported in 2021 – a 47% increase from 2020.2
Data encryption provides a vital safeguard by scrambling data into ciphertext that is inaccessible without a decryption key. Properly implemented strong encryption provides the following key benefits:
Protecting Patient Privacy: Encryption prevents unauthorized access to protected health information (PHI), preserving patient confidentiality.
Regulatory Compliance: HIPAA and other regulations mandate encryption to secure patient data proactively.
Preventing Data Breaches: Encrypted data is useless to attackers, preventing PHI exposure even if breached.
Secure Data Sharing: Encryption enables safe transmission of PHI between providers, insurance companies, researchers and other entities.
Building Patient Trust: Patients expect privacy of their sensitive information. Encryption provides the assurance needed to foster trust.
In the past decade, healthcare providers have paid $50.85 million to the U.S. Department of Health and Human Services (HHS) in resolution amounts for potential HIPAA violations – many resulting from unencrypted PHI.3
Clearly, data encryption is no longer optional – it is a mandatory component of privacy and security strategies in healthcare.
HIPAA Requirements for Encryption
The Health Insurance Portability and Accountability Act (HIPAA) provides data protection requirements for covered entities including healthcare providers, health plans, healthcare clearinghouses and their business associates.
HIPAA‘s Security Rule designates encryption as an "addressable" safeguard – meaning that healthcare organizations must implement it wherever feasible to secure protected health information (PHI).
Specifically, the HIPAA Security Rule requires organizations to:
- Assess encryption needs based on risk analysis.
- Encrypt PHI whenever deemed appropriate based on the risk assessment.
- Adopt encryption standards published by the National Institute of Standards and Technology (NIST).
- Implement encryption key management processes.
Additionally, encrypted PHI is generally exempt from the Breach Notification Rule. This means breaches involving encrypted data may not trigger mandatory regulatory reporting, provided the encryption keys were not compromised.
In recent years, The Office for Civil Rights (OCR) has imposed stiff HIPAA fines and penalties for failure to encrypt mobile devices, storage media and other locations containing PHI:
- Memorial Healthcare System paid $5.5 million as settlement for failing to encrypt photocopiers and other devices.4
- New York Presbyterian Hospital was fined $4.8 million after unencrypted backup tapes with PHI were stolen from an employee’s car.5
These examples demonstrate the risks of non-compliance. Healthcare organizations must make data encryption central to their compliance programs.
Top 5 Use Cases for Encryption in Healthcare
Encrypting healthcare data requires going beyond general policies to implementation in specific technologies and environments. Let‘s review some of the most important use cases for deploying encryption.
1. Securing Electronic Health Records (EHRs)
EHRs contain patients‘ most sensitive information including medical history, diagnoses, medications, insurance details and more. Unauthorized EHR access can lead to fraud, identity theft or medical identity theft.
Healthcare providers must encrypt EHR databases, servers, and backups to prevent breaches. Encrypting EHR data in transit is equally critical when it is transmitted between providers, submitted to payers, or accessed from mobile devices.
Technologies like virtual private networks (VPNs), transport layer security (TLS), and digital signatures help encrypt EHR data in motion over the network.
2. Medical Devices and Internet of Medical Things
Wearables, implantables, ingestibles – medical devices are increasingly interconnected to hospital networks and the internet. This expands access to patient data for both authorized and unauthorized entities.
It is critical to encrypt data generated, stored and transmitted by medical devices using technologies like Bluetooth encryption, VPNs, and specialized medical device security platforms. This prevents interception of sensitive patient parameters.
3. Remote Patient Monitoring
Remote patient monitoring (RPM) enabled by wearables and mobile apps has surged during the pandemic. But patient data from RPM solutions can be exposed via the internet and WiFi networks.
Encryption is crucial for securing transmission of PHI from RPM devices, hubs and dashboards to provider EHRs and other systems. Australia‘s privacy watchdog fined a healthcare provider $25,000 for unencrypted RPM data.6
4. Telehealth
Telehealth adoption has skyrocketed, with telehealth claims increasing by 6,057% from 2019 to 2020.7 But virtual visits can expose PHI through video and audio feeds, texts, images and device data.
Using encrypted messaging apps and telehealth platforms is critical for protecting consultations and communications. Access controls should tightly restrict access to decrypted streams.
5. Healthcare Data Analytics
As healthcare analytics matures, massive datasets are extracted from EHRs and other sources for analysis. Since it may be shared with external partners, strong encryption is essential even for de-identified data to prevent re-identification.
Advanced encryption methods like homomorphic encryption allow certain types of computations on encrypted data. This enables privacy-preserving analytics.
Best Practices for Encrypting Healthcare Data
Implementing robust data encryption requires bringing people, processes and technology together effectively. Here are some leading practices for healthcare organizations:
Utilize Strong Encryption Standards: Use approved algorithms like AES-256 for data at rest and TLS for transmitting data. Evaluate quantum-resistant encryption for future-proofing.
Enforce Access Controls: Limit encryption keys to authorized users and processes. Integrate encryption with strong identity and access management.
Secure Key Management: Formulate processes for key generation, distribution, rotation, archival, auditing and access control. Utilize hardware security modules (HSMs) for storage.
Layer Security Controls: Augment encryption with data masking, activity monitoring, penetration testing, backups, access controls and auditing.
Conduct Risk Assessments: Assess assets, data flows, regulations and threats to determine optimal cryptosystems.
Work With Experts: Implementing encryption incorrectly can render it useless. Engage experienced professionals for deployment.
Train Staff: Educate users on policies, proper key handling, secure transmission protocols and other aspects.
Encrypt Data in Motion and at Rest: Cover data travelling over networks and stored on devices, media and cloud servers.
By approaching encryption holistically across people, process and technology domains, healthcare organizations can unlock data‘s value securely while complying with regulations.
The Future of Healthcare Security Lies in Data Encryption
Data is transforming every facet of healthcare, from pioneering research to routine care delivery. But this data-driven revolution critically depends on maintaining patient trust through ironclad security.
As cyber threats grow in scale and sophistication, data encryption provides healthcare providers with a reliable mechanism to stay a step ahead of attackers. When combined with cloud security, access controls, key management and other best practices, encryption forms the cornerstone of a future-proof healthcare data protection strategy.
However, encryption is only effective when implemented meticulously across the entire data lifecycle. Healthcare security teams must make encryption central to their security roadmap while collaborating closely with providers, researchers, and partners to ensure consistent data protection.
With robust encryption as a foundation, healthcare can continue its rapid digital transformation to enhance patient outcomes through data-driven care, analytics and research – all built securely on patient trust and confidence.