When it comes to PHI, it is necessary to begin with the possible consequences of the Health Insurance Portability and Accountability (HIPAA) violation. According to the HIPAA Journal (2021), all potential violations are divided into four tiers depending on their severity:
- Tier 1: organization was unaware of violation, could not have realistically avoided it, and attempted to abide by HIPAA Rules; minimum fine of $100, going up to $50,000 per case;
- Tier 2: organization was aware of risks but could not have avoided a violation; willful neglect of the HIPAA Rules did not happen; minimum fine of $1,000, going up to $50,000 per case;
- Tier 3: organization violated HIPAA Rules due to willful neglect on its part but tried to mitigate the damage; minimum fine of $10,000, going up to $50,000 per case;
- Tier 4: organization wilfully neglected HIPAA Rules and did not attempt to correct the violation; minimum fine of $50,000 per case;
In addition, healthcare professionals may become criminally liable in HIPAA rules violation; possible penalties range from 1- to 10-years prison sentence (HIPAA Journal, 2021). Therefore, all staff members must become acknowledged with current legislation and undergo the necessary training in HIPAA Rules in order to avoid such undesirable consequences. The following sections describe the key laws in PHI protection and possible measures of safeguarding sensitive medical information.
Security and Privacy: Key Rules under the HIPAA
The U.S. Department of Health and Human Services (HHS) established a legal framework for PHI protection. It is possible to highlight its two key elements: the HIPAA Security Rule and HIPAA Privacy Rule. According to the HHS (2013a), Security Rule operationalizes protective measures contained in the Privacy Rule. Therefore, Security can be defined as technical and non-technical safeguards, which a healthcare organization must implement in order to protect patient information.
Whereas Security can be understood as the means, Privacy should be treated as an ultimate goal of the PHI protection effort. The HIPAA Privacy Rule creates a necessary balance by defining what information uses are permitted in a healthcare setting (HHS, 2013b). In particular, the concept of Privacy covers such information as an individual’s past, present, or future health condition, any payments for healthcare provision, and the fact of healthcare provision itself (HHS, 2013b). Overall, Privacy encompasses what PHI an interdisciplinary healthcare team must protect, and Security governs how this goal should be achieved.
Interdisciplinary Collaboration in Safeguarding PHI
Once security measures fail to prevent the breach, it creates various risks for patients and healthcare organization. For instance, sensitive health data may be used to discriminate against people during employment or incur reputational damage (Price & Cohen, 2019). Furthermore, healthcare organization would likely face charges in HIPAA violation, which would damage its reputation as well. As such, professionals from various fields: nurses, IT specialists, administrative personnel, and even healthcare organization’s leadership must combine efforts to ensure compliance with the HIPAA Security and Privacy rules. Kruse et al. (2017) determined three major categories of security safeguard themes:
- Administrative: risk analysis and management, contingency and business continuity plans;
- Physical: workstation security, assigned security responsibility;
- Technical: data encryption, firewall protection, access control.
Regardless of the preferred tools for safeguarding patient privacy, their implementation requires collaborative action from interdisciplinary professionals. Contingency plans cannot be developed without the involvement of the organization’s leadership; however, it is impossible to implement them efficiently without feedback from nurses. Any technical security measures would require the involvement of IT professionals, such as EHR system support specialists. In the end, the chain is as strong as its weakest link — and weakness in PHI protection might lead to significant legal troubles.
References
HIPAA Journal. (2021). What are the penalties for HIPAA violations? Web.
Kruse, C. S., Smith, B., Vanderlinden, H., & Nealand, A. (2017). Security techniques for the electronic health records. Journal of Medical Systems, 41(8), 1-9. Web.
Price, W. N., & Cohen, I. G. (2019). Privacy in the age of medical big data. Nature Medicine, 25(1), 37-43. Web.
U.S. Department of Health and Human Services. (2013a, July 26). Summary of the HIPAA Security Rule. Web.
U.S. Department of Health and Human Services. (2013b, July 26). Summary of the HIPAA Privacy Rule. Web.