Protected Health Information - PHI

Anything that can be used to identify a person, including private information, face photos, fingerprints, and voiceprints, is referred to as PHI, or Protected Health Information. Any health data produced, transferred, or kept by a HIPAA-covered entity is considered PHI under the law. It comprises textual records, test results, x-rays, bills, electronic records (ePHI), verbal communications including personally identifying information, and other types of data as well. In accordance with the HIPAA Privacy Rule, patients have a number of rights in relation to the personal health information that covered companies hold. Failure to comply with the above rules leads to serious consequences and fines for the company.

Why PHI is so important? 

Patients have confidence in healthcare practitioners to protect their private information, encouraging open dialogue and encouraging patients to get the appropriate care without worrying about being exposed. Additionally, Safeguarding PHI makes it possible for medical practitioners to exchange health information effectively, promoting teamwork and continuity of treatment. It gives patients control over their health information and the ability to actively engage in decision-making processes.

PHI can occasionally be transmitted without the patient's specific agreement, despite the fact that most times it does. 

For instance, PHI may be exposed without authorization in a prison context for monetary transactions and legal proceedings or only by disclosure can major harm to a person's health or well-being be avoided. Other scenarios in which protected health information may be disclosed without authorization include those involving scientific studies, child abuse, and public health initiatives like disease control.

What is the difference between PHI and ePHI? 

The main distinction between PHI and ePHI standards is in the method by which providers transmit and store data. Any type of PHI that is received, sent, or kept electronically is digitised PHI, also known as electronic protected health information (ePHI). 

Digital tools make healthcare more accessible, but they can have drawbacks. ePHI is more susceptible to theft in the form of cyberattacks because it is in a digital format and is shared and kept on enterprise networks and the internet. 

Because ePHI can be accessed, altered, and stolen in a variety of ways, HIPAA mandates that you have strong cybersecurity procedures in place to safeguard electronic patient data. Actually, HIPAA expanded its Security Rule to call for the use of physical, administrative, and technical safeguards for ePHI.

Healthcare organisations must work with their cybersecurity team to develop a unique approach for ePHI protection in an era where knowledgeable cybercriminals may steal ePHI with a few keystrokes and where the delivery of healthcare is continuing to move away from centralization and towards data-driven decision-making. Securely exchanging ePHI is the next step in healthcare compliance as providers of healthcare increasingly digitise patient care and share it with patients, organisations, and other parties involved in the care.

How to implement PHI in a Healthcare App? Guide

Understand PHI and Regulatory Requirements:

Before embarking on the implementation process, it is crucial to familiarize yourself with relevant regulations, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States or the General Data Protection Regulation (GDPR) in the European Union.

Designing Secure Data Storage:

a. All PHI stored in the app's databases should be encrypted using strong encryption algorithms, such as AES-256;

b. Role-based access control (RBAC) can help ensure that only authorized personnel can view or modify sensitive data;

c. Employ secure protocols, such as HTTPS, for data transmission between the app and the database. This prevents eavesdropping and tampering during transit.

User Authentication and Authorization:

Implement robust authentication mechanisms, such as password-based authentication or 2FA.

Secure Communication Channels:

a. Implement TLS to secure data transmitted between the app and external systems, such as APIs or third-party services.

b. Validate API responses and implement data validation checks to prevent injection attacks or data manipulation.

Secure Application Development Practices:

a. Implement strict input validation to prevent common security vulnerabilities like SQL injection or cross-site scripting (XSS). 

b. Perform penetration testing and code reviews to ensure the app's security measures are effective and up to date.

Audit Logs and Monitoring:

a. Implement robust logging mechanisms to record access to PHI, including user actions, timestamps, and IP addresses.

b. For immediate response and mitigation measures employ real-time monitoring and intrusion detection systems to identify any suspicious activities or breaches promptly. 

What about location? 

The Personal Information Protection and Electronic Documents Act (PIPEDA) in Canada and the Privacy Act in Australia are two examples of national laws that safeguard PHI. The GDPR is a regulation that governs how personal data, including PHI, is protected in the European Union. For patient permission, data transfer, and breach reporting, it establishes strict guidelines. 

• Physical security measures and technical security measures are used to protect PHI. 
• Physical security measures are crucial for avoiding unauthorised access to PHI, such as facility access controls, video monitoring, and secure storage. 
• Protecting PHI in electronic form from unauthorised access and data breaches is made easier with the use of encryption, secure authentication, firewalls, and intrusion detection systems.

Last words: When it comes to PHI protection, every member of the healthcare team is held to the same standard of accountability. Clinicians, nurses, chemists, therapists, technologists, office workers, and even other staff members like cleaning and nutritionists are included in this. In order for the team as a whole to be able to recognise PHI, understand the boundaries involved, and recognise and, if required, report breaches of patient privacy to the appropriate authorities, training and refresher courses on the issue of PHI are essential.