Healthcare organizations have a responsibility to protect the sensitive personal and medical information of their patients. With more patient engagement happening through healthcare websites and patient portals, healthcare providers need to make sure their websites are secure and meet privacy regulations. This article will outline some best practices for healthcare organizations to keep in mind when developing and hosting their websites to ensure patient data remains protected.
Understand Applicable Regulations
One of the first steps healthcare organizations need to take is understanding the regulations and laws that apply to protecting patient privacy and securing electronic protected health information (ePHI). This includes:
- HIPAA – The Health Insurance Portability and Accountability Act outlines regulations for protecting medical records and other personal health information.
- HITECH Act – An addendum to HIPAA that outlines security breach notification requirements, electronic transaction standards, and extended the scope of privacy and security rules.
- State laws – Many states have additional regulations regarding patient privacy and notification requirements in case of a breach.
Having a comprehensive knowledge of the regulatory environment will help guide the policies and procedures put in place to ensure compliance. Failing to comply with these regulations can result in hefty fines and damage to the organization's reputation.
When developing the healthcare organization's website, keeping privacy and security in the forefront of design decisions is crucial. Here are some best practices to follow:
Choose a Reputable Vendor
Work with an experienced web development vendor that has expertise in building secure healthcare websites. Make sure they are able to implement the necessary precautions and are well-versed in regulations such as HIPAA.
Encrypt all web pages and secure communication channels with SSL/TLS certificates. This protects information as it is transmitted back and forth between the browser and web server.
Implement Access Controls
Have mechanisms in place to control access to data and different sections of the website. This includes password-protected portals for patients to access their records, role-based access levels for employees, and using firewalls to block unauthorized traffic.
Validate and sanitize any input from website forms or other user inputs. This prevents against attacks like cross-site scripting and injection attacks that could compromise security.
Conduct frequent security testing of the website, including vulnerability assessments, penetration testing, and compliance audits. Identify any risks or gaps and remediate them.
The hosting environment and infrastructure for a healthcare website also requires diligent security considerations:
Use a specialized healthcare cloud hosting provider that complies with all applicable regulations. They will provide the levels of security, encryption, reliability and compliance required.
Servers should be hardened to industry security standards, encrypted, and access tightly controlled. Make sure any servers or data centers used by third-party vendors also have proper physical and operational security controls.
The website infrastructure should have redundancy, backups, and disaster recovery protocols in place to minimize any downtime in the event of an outage or breach. This maintains the accessibility and availability of patient information.
Vet any third-party tools, widgets, or services used on the website to identify and address any vulnerabilities they introduce. Limit connections to only trusted partners.
Have automated monitoring in place to detect any anomalous activity, bandwidth issues, intrusion attempts, or potential denial of service attacks. A quick response can help mitigate any breach or breakdown.
Access, Authentication & Authorization
Proper access controls, identification and role-based access provide key layers of security:
Patients accessing their records online should have secure authentication in place. This includes unique usernames, strong password requirements, multi-factor authentication, and other methods to validate identity.
Grant employees access to only the resources and data relevant to their roles using the principle of least privilege. Have protocols for securely onboarding and offboarding staff.
Log all access to patient records and website activity for auditing. This provides visibility into any anomalous or inappropriate access attempts.
Automatically log users out after a period of inactivity. This prevents unauthorized access from an unattended device.
Use protection against common authentication attacks like brute force attempts, credential stuffing, and account lockouts after a number of failed logins.
Policies & Procedures
The right policies, procedures, and documentation ensures the entire organization is aware of security protocols and requirements. This facilitates compliance from the top down.
Privacy & Security Policies
Have clearly defined privacy and security policies that outline the proper handling and protection of patient information. Update as needed to stay current with regulations.
Require all personnel to complete HIPAA training on protecting patient data and exercising caution around website access. Update training on any new protocols.
Acceptable Use Policy
Have a formal acceptable use policy outlining proper usage of workplace information systems. This sets ground rules for employees accessing the website or patient records.
Secure Coding Practices
Set and follow secure coding standards and best practices for any custom code or integrations developed for the healthcare website. Adhere to OWASP standards.
Have a vulnerability management process to track any reported bugs or flaws. Determine risk levels, test patches before deploying, and fix critical issues immediately.
Incident Response & Notifications
Despite best efforts, breaches can still occur. Preparing an incident response plan helps manage any intrusions.
Incident Response Plan
Have a formal plan in place detailing steps to contain, investigate, and remediate breaches or exposure of patient data. Include data recovery provisions. Test periodically.
Follow applicable federal and state data breach notification laws, including informing patients, regulators, credit bureaus, and other entities as required in a timely manner.
Forensics & Monitoring
Conduct root cause analysis on breaches to prevent a recurrence. Continue monitoring systems for anomalies that may indicate additional compromise.
Maintain adequate cyber insurance coverage for costs around investigations, legal expenses, settlements, or regulatory fines that apply in the event of a breach.
Auditing & Risk Assessments
Routine audits and risk assessments enable ongoing monitoring and identification of vulnerabilities:
Conduct scheduled HIPAA compliance audits covering all aspects of privacy and security practices – from website controls to internal policies and procedures.
Contract external ethical hackers to conduct penetration tests against the website to identify vulnerabilities and attack vectors from an external attacker's point of view.
Perform in-depth cybersecurity risk assessments to determine levels of risk across infrastructure, policies, third-party connections, patient portals, and other aspects of the online environment.
Catalog any gaps or weaknesses uncovered in audits/assessments. Track remediation tasks to completion and validate fixes.
Use tools like user activity monitoring and data loss prevention to continuously audit compliance, policy adherence, unauthorized access attempts, and any loss of sensitive data.
In addition to the steps taken by the healthcare provider, patients should also be educated on how they can help protect their own data. This includes:
- Using unique complex passwords and not reusing credentials on other sites.
- Being cautious of public computers or Wi-Fi when accessing portals.
- Watching for any suspicious emails or calls requesting personal information.
- Reporting any suspected fraud or identity theft related to their medical records.
Providing patients with good cyber hygiene and security tips through the website or other materials can bolster the mutual goal of securing their medical information.
Keeping healthcare websites and portals secure requires vigilance, investment, and constant adaptation to the evolving threat landscape. Following these best practices around privacy, encryption, access controls, policies, auditing, infrastructure hardening, and personnel training can help protect patient data from compromise. Healthcare organizations have an obligation to be proactive about securing their online platforms and should enlist the help of privacy and security experts when needed to identify and remediate any risks or gaps. With healthcare delivery increasingly happening through websites and mobile apps, taking the proper precautions is critical to maintaining patient trust and regulatory compliance.