Securing Our Health Data: The Ongoing Pursuit of Electronic Health Record Privacy

The digitization of health records offers the promise of improved care, but also raises complex concerns around privacy. How can healthcare providers leverage the benefits of electronic health records (EHRs) while safeguarding sensitive patient data?

The Reality of Data Insecurity

In 2018, a hacking group infiltrated the networks of two U.S. laboratory testing giants, gaining access to sensitive medical diagnoses and health records belonging to millions of Americans. It was the largest healthcare data breach recorded in U.S. history. 

Yet health data breaches like this are increasingly common. In fact, the healthcare sector experienced 42% of all major data breaches across industries in 2020. From cyber criminals seeking quick profits to hackers aiming to sow chaos, medical records have become an attractive target.

Unlike financial data, health data contains immutable information that can be leveraged for insurance fraud, identity theft, and extortion. A 2016 study found that while credit card information sells for under $1 on the dark web, complete medical records fetch over $1000. 

With impersonal electronic health records now replacing paper files, breaches can compromise data at unprecedented scale. It’s clear the digital transformation of modern healthcare requires a corresponding transformation in how we secure sensitive health data.

The Balancing Act of EHR Security

Electronic health records (EHRs) comprise a patient’s sensitive medical history, diagnoses, medications, imaging scans, and more. 

While EHR systems have shown to improve care coordination, reduce medical errors, cut costs, and give patients more control over their records, they also introduce privacy risks related to how data is collected, stored, and shared.

To realize the benefits of EHRs for patients and providers, healthcare organizations must implement safeguards to earn patient trust while enabling efficient care delivery. This involves balancing security with usability across three key dimensions:

• Administrative Safeguards: Policies, protocols, training programs, and accountability measures governing appropriate EHR access and usage.
• Physical Safeguards: Protection of computing equipment, servers, and data storage through secured facilities and access controls.
• Technical Safeguards: Software tools and IT infrastructure like encryption, firewalls, antivirus programs, and access logs that protect data.

Getting these safeguards right requires understanding both the internal and external threats facing EHR systems today.

Threats to Health Data Security

From within the organization, EHR systems face threats from errant or malicious insiders misusing their access to view records without authorization or for personal gain. External threats include hackers using stolen credentials or exploiting vulnerabilities to steal health data.

Below are some of the key threats to health data security:

Healthcare Cybersecurity Threats

Threat	Description
Phishing	Emails seeking stolen credentials
Ransomware	Malware encrypting data
Insider Threats	Employee misuse of access
Vulnerable Devices	Unsecured networked devices
Cloud Misconfigurations	Insecure cloud databases

Phishing attacks aim to trick users into giving up login credentials through fraudulent emails. 

Ransomware like Ryuk and REvil has impacted hospitals' ability to deliver care. Insiders may wrongfully access data for improper purposes or by accident. Unsecured internet-connected devices can give hackers backdoor access. And misconfigured cloud databases can expose patient records online.

Meanwhile, over half of healthcare organizations surveyed had experienced a security incident related to IoT medical devices over the past two years.

These threats underscore the need for multilayered technical and administrative safeguards to harden EHR systems from both external attacks and insider misuse.

Protecting Patient Privacy in the Digital Age

While no data security system is impenetrable, healthcare organizations can implement robust controls to protect EHRs in accordance with industry best practices and federal regulations. Here are key steps healthcare CIOs and security teams can take:

Keep Track of Your Assets

Maintain inventories of authorized devices, apps, servers, and cloud services comprising your IT environment. Monitor them continuously for misconfigurations, unpatched vulnerabilities, unauthorized access, and other risks.

Fortify Defenses

Protect your network perimeter with tools like next-generation firewalls, intrusion detection systems, web gateways, and denial of service mitigation to filter malicious traffic. Segment your network to restrict lateral movement.

Control Access

Allow only authorized users to access patient records based on their role, enforcing least-privilege principles. Methods include role-based access controls, encryption, and multi-factor authentication. Logs and audits help detect unauthorized access attempts.

Protect Endpoints

Secure desktop computers, laptops, and mobile devices accessing EHR systems with endpoint security tools offering malware protection and media encryption. Keep software patched and disable unneeded services.

Safeguard Data

Encrypt clinical databases, backups, archives, and virtual machines storing patient data, both in transit and at rest. Destroy media securely when retiring hardware.

Plan for Incidents

Have an incident response plan with containment strategies to isolate affected systems and recovery processes to restore from backup data. Report breaches timely as required.

Foster Responsible Data Usage

Provide ongoing education to employees on privacy best practices. Ensure confidentiality agreements are signed. Set usage guidelines for records access and accountability protocols for violations.

Uphold Patient Rights

Under HIPAA, patients have rights to access, amend, and restrict sharing of records while requesting an audit trail of disclosures. Accommodate requests timely and offer transparency around data handling.

Advancing Standards Through Collaboration

Beyond individual provider efforts, advancing health IT security requires collaboration across the healthcare ecosystem on standards, best practices, and threat intelligence sharing. Entities like the National Institute of Standards and Technology (NIST) and the Healthcare Information Sharing and Analysis Center (H-ISAC) provide guidelines and resources to improve digital healthcare security maturity over time.

Meanwhile, policy groups like the American Health Information Management Association (AHIMA) advocate for modernized privacy regulations to support innovation while strengthening patient protections.

Training Healthcare Security Champions

While technology is crucial, human security practices often represent the weakest link. Robust and ongoing workforce education is key to reinforcing privacy best practices while fostering an ethical data stewardship culture. 

As interconnected systems and health data exchange with third parties grow, responsible handling of access and patient consent becomes even more critical.

Healthcare security teams strive to tune technical controls to balance risk mitigation with clinician productivity and patient experience. When EHR access by frontline staff becomes too restrictive, workflow constraints can perversely incentivize unsafe workarounds. 

By encouraging collegial dialog around security, both care and safety outcomes can continuously improve.

Emerging Opportunities to Close Health Data Gaps

Despite expanded use of EHRs, major gaps and vulnerabilities still allow health data to fall into the wrong hands, while patients struggle to access their own records. But new approaches are emerging to enhance protections:

• Blockchain-secured health information exchanges to restrict access
• Advanced analytics to detect abnormal EHR access patterns from within
• User behavior analytics to construct risk profiles and predict breaches
• Automated data rights management enforced through APIs
• Moving systems to zero-trust architectures

Meanwhile, natural language processing and AI are helping make sense of unstructured clinical notes and image scans, unlocking insights while reducing vulnerabilities created by fragmented health data storage.

Challenges around interoperability, legacy systems, and budget constraints during the digitization journey can slow security progress. 

But both risks and capabilities are growing in parallel. Healthcare leaders must be proactive, collaborative, and innovative to nourish a culture focused on earned patient trust.

Conclusion: Build Patient Trust with Calysta EMR

The challenges around securing electronic health records may seem daunting, but solutions exist to help healthcare providers demonstrate robust data stewardship.

Calysta EMR provides a HIPAA-compliant, cloud-based practice management platform designed to safeguard patient data. Its seamless care coordination tools help build patient trust by enhancing transparency and access to health records.

With Calysta, aesthetic practices can:

• Store and share patient health information securely using encrypted servers.
• Control access with role-based permissions and audit logs.
• Enable patients to conveniently access their latest test results and care plans.
• Seamlessly integrate with telehealth, billing, scheduling, and other systems.
• Scale protections as the practice and its data needs evolve.

By leveraging purpose-built solutions like Calysta, healthcare leaders can fulfill their duty to protect sensitive patient information. They can then unlock the full benefits of digital health transformation, from operational efficiency to superior care experiences.