HIPAA Compliance Requirements and Tokenization

The “big data” revolution that’s affected myriad industries around the world has driven health care systems to innovate and modernize their practices. This has created opportunities for organizations to adopt emerging technologies to make their operations more efficient and effective, resulting in an industry-wide movement toward digital systems and electronic records to simplify the jobs of physicians, nurses, and other hospital staff.

Now patients can enter their information on tablets instead of visitors’ forms, video chat their doctors for checkups rather than relying on in-office visits, and review their records digitally without needing to pull the physical files . The list of benefits goes on and on, but as with most technology, greater convenience can bring its fair share of drawbacks, too.

As more and more health information systems transition to the digital realm, the need to protect the privacy and security of that sensitive data has only grown—and become more difficult. No longer can physical patient records simply be locked away in filing cabinets and monitored via on-site security. In addition to the process of digitizing paper files, hospitals now have to worry about protecting patient records from hackers and other cybercriminals who can use remote devices to access sensitive data from anywhere, potentially crippling IT systems and compromising the databases within.

To address these concerns, legislators and industry organizations enacted laws and regulations such as the Health Insurance Portability and Accountability Act (HIPAA), resulting in the creation of a complicated compliance landscape for meeting the requirements of safe data processing, storage, and transmission. Originally enacted by congress in 1996, HIPAA is a far-reaching law that covers everything from employer health insurance plans to stipulations about who is allowed to access certain sensitive personal and health information.

In this post, we’re going to focus on the data aspects of the law, specifically how to sufficiently protect patient records to comply with them. We’ll discuss key elements of the legislation and examine tokenization as a potential solution.

What is HIPAA compliance image

What is HIPAA Compliance?

In many ways, HIPAA compliance is similar to Payment Card Industry Data Security Standard (PCI DSS) compliance. HIPAA compliance rules mandate that all personal health data and identifying information must be secured and transmitted according to certain guidelines and standards. The penalties for violating these standards can be substantial—similar to the fines outlined in the PCI DSS—and those are often weighed against the cost of ensuring your organization is fully compliant, which requires internal expenses for operations and infrastructure, as well as the cost of audits.

The main difference between PCI compliance requirements and HIPAA compliance requirements is the much greater scope of HIPAA data that must be protected. The PCI Security Standards Council (PCI SSC) mandates that only the actual credit card numbers—known as primary account numbers (PANs)—and other vital transaction information—known as “sensitive authentication data”—must be secured to achieve PCI compliance.

In contrast, HIPAA compliance rules are enormously complex. The protected data includes names, addresses, insurance policy numbers, and rates, medical history data, doctor and hospital information, and far more. Obviously, keeping this amount and variety of information secure is a much more challenging proposition.

Another hurdle to ensuring full HIPAA compliance is the requirement that only the minimum information necessary to conduct business be shared among different parties. In other words, if a doctor needs access to a patient’s medical history, looking up his or her record shouldn’t pull up the whole file—just the specific portion that contains the necessary information.

When you consider the diversity of the parties that require access to this information, the difficulty of keeping it all secure becomes apparent. Insurers, doctors, hospital billing departments, and patients themselves will all need different sets of data with differing levels of access and permissions. And that’s only the beginning.

HIPAA Compliance Requirements Explained

Five components, referred to as titles, comprise HIPAA. It can be essentially boiled down to two primary areas of regulation: the Standards for Privacy of Individually Identifiable Health Information (the Privacy Rule) and the Security Standards for the Protection of Electronic Protected Health Information (the Security Rule). Put simply, the Privacy Rule determines which information is protected under the statute, and the Security Rule lays out how that information should be protected—i.e., it contains recommendations for what equipment, systems, and processes need to be in place as safeguards.

HIPAA Compliance Requirements: Privacy Rule

First adopted in 2000, the Privacy Rule defines an individual’s protected health information (PHI). According to the law, PHI is “all individually identifiable health information a covered entity creates, receives, maintains or transmits in electronic form,” meaning all of your digital data possessed by healthcare companies must be protected in accordance with HIPAA. As one might imagine, this includes a huge collection of personal data—from basic identifiable information to medical history and specific doctor information. This covers data related to:

  • An individual’s past, present, or future physical and/or mental health
  • The provision of health care for the individual
  • Payment for the provision of health care that can be used to identify the individual
  • Common identifiers such as name, date of birth, Social Security number, and demographic information when it can be associated with the individual’s health information

HIPAA Compliance Requirements: Security Rule

Originally implemented in 2003, the Security Rule outlines how PHI should be protected, leaving much to the individual companies to determine their own security measures and placing the responsibility on covered entities to decide how best to meet the requirements while considering their own limitations and unique needs. This keeps the rules from being overly stringent and unnecessarily hamstringing businesses.

By placing the ultimate responsibility on individual businesses, HIPAA allows for rules that are flexible, scalable, and capable of being customized for a specific entity. But with this freedom comes the added challenge of self-policing to ensure compliance, which is further complicated by vague language such as “[maintaining] continuous, reasonable, and appropriate security protections.”

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Other Privacy Obligations Compared to HIPAA Compliance Requirements

We’ve already mentioned the PCI DSS as a data protection measure comparable to HIPAA, but in terms of specific principles and scope, other similar regulations would be the European Union’s General Data Protection Regulation (GDPR) or the U.S.’s California Consumer Privacy Act (CCPA). These regulations cover data privacy, specifically the protection of consumers from the improper collection, sharing, and use of their data by outside entities.

GDPR regulates how organizations can handle the personal data of EU residents, and CCPA applies similar rules to California citizens and households. Although these mandates differ in several aspects, they both can be met via the appropriate use of pseudonymization, or de-identification.

De-identification is the process of removing an individual’s personal identifiers from a given data set. This mitigates the risk of data theft in the event of a data breach, supports secondary uses of the data (such as marketing analytics), and potentially exempts it from qualifying as sensitive data, thereby removing it from the scope of compliance. It’s also synonymous with tokenization, which is the process of replacing sensitive data with nonsensitive placeholders called “tokens.” But before you choose the right de-identification technology and technique for your organization, you should consider the benefits of a risk analysis.

The Need for Risk Analysis

One of the most important methods a covered entity can employ to ensure it is protecting PHI in accordance with HIPAA guidelines is a risk analysis. Performing regular risk analyses of its security practices can give a covered entity insight into whether it is adequately addressing security risks. It can also highlight how to expand measures in the event that unforeseen risks are identified. This practice is critically important to maintaining relevant and effective safeguards in a constantly evolving technological realm where the development of new capabilities is often met quickly with new risks and threats.

Once these risks are identified, however, protecting against them is still no simple task. As mentioned earlier, the information protected by HIPAA is far-reaching—it includes everything from basic information, such as names and addresses, to medical histories, and provider information—and the rules for limiting access to such data based on the potential viewer's role—doctor, insurer, or hospital staff—can be complicated and difficult to enforce. But once risk is quantified, problem areas are discovered, and sensitive data types are identified, you can begin the process of securing the relevant data within your organization’s internal systems.

Doctor reviewing patient record PHI demonstrating HIPAA compliance

Tokenization for Meeting HIPAA Compliance Requirements

Although we often trust doctors and insurance companies to be responsible for our information, time has shown that maybe we shouldn’t. Regardless of intent, cases abound of doctors, pharmacists, and hospital employees accessing information they shouldn’t or leaving records in easily accessible locations.

So, how do you manage this complicated issue of security and compliance? Traditionally the answer has been a combination of encryption and the honor system. Many hospitals and insurers use encrypted files to protect sensitive data, but encryption systems are expensive, slow, and require the management of huge numbers of keys to access the data. Far from an ideal solution. Instead, we suggest tokenization.

In the data security world, tokenization is well-known for its effectiveness as a low-cost, high-efficacy solution for addressing issues related to credit card security and PCI DSS compliance. Outside of the payments sphere, however, tokenization is not nearly as commonly known or prevalently used. The ultimate versatility of tokenization can be demonstrated by discussing an additional use case: how tokenization can help satisfy HIPAA compliance requirements via its deployment as a method for securing electronically protected health information (ePHI) and other sensitive data elements.

Tokenization presents a security technology capable of addressing many of these problems. There are several major benefits to tokenization over other data security methods when it comes to HIPAA compliance, but there are two primary differentiators that we’ll be covering: token integration and ease of management.

Token integration simply means that a tokenized solution is easy to implement in your current data environment. Because tokens are simply random data that represent sensitive values, a token can take almost any form. For instance, if you need a system to secure Social Security numbers (SSNs), you can implement a tokenized solution that replaces all the real SSNs with numbers that look and function just like them in your record-keeping system. However, these new numbers aren’t real SSNs and don’t carry the data compliance obligations that actual SSNs would. They just look and act similarly to enable business intelligence, marketing analytics, and other critical internal operations.

Because tokens can be integrated into your environment without requiring extensive alterations or disruptions, the changes you must make to your systems to implement tokenization are minimal. That means less downtime, fewer development requirements, and less hassle for you and your team.

The other way tokenization can improve HIPAA security is by making it easier to manage who has access to different sets of data. Because any data can be tokenized, it’s easy to create token sets for entire fields of medical data. And that data can be accessed only by someone who has the correct token—much like encryption can be decrypted only by someone who has the key. The difference, though, is that encrypted data can be cracked and decrypted, whereas tokens can’t be reverse-engineered—they have no exploitable relationship to the original, sensitive data.

Because of this, it’s easy to control who has access to different pieces of data. If a pharmacist needs to use certain medical records, they return the token for that information but not the tokens for other sensitive data. An insurance company could access insurance info without looking at a patient’s full medical history. Tokenization, in essence, allows you to compartmentalize your data and manage it across different users simply and effectively.

As referenced previously, tokenization is superior to the traditional model of encryption for securing data. Encryption simply takes sensitive information and exchanges it for a placeholder that cannot be returned for the original piece of information without first being read and decoded by an entity with access to the encryption key. The issue with encryption is that even without the key, hackers can still decrypt the placeholder, gaining access to the original information.

Tokenization, on the other hand, provides an extra layer of security. It follows the same initial steps of encryption, but instead of allowing that encrypted information to rest, it sends it on to a secure, offsite cloud to be exchanged for an additional, unrelated token and stored safely from hackers. This crucial extra step makes all the difference. It removes the sensitive data from your organization’s systems, so even in the event that a breach occurs, the only information accessible to hackers would be tokens that cannot be read or decoded without additional data.

Other benefits of tokenization include the ability to accept sensitive data from any channel, secure any structured value, and send data to any processor, provider, gateway, or other endpoints. This can be achieved through the use of TokenEx’s suite of security products such as our Secure Tokenization Field, Mobile API, Ecommerce Package, Batch Processing, Transparent Gateway, and more. The result is a comprehensive solution for data protection and compliance that provides virtually unmatched business utility, agility, and flexibility for maximum reduction of risk and compliance scope.

HIPAA compliance might seem burdensome, but with the right security partner, it doesn’t have to be as complicated as it appears. TokenEx is an industry-leading cloud security platform that specializes in enterprise tokenization solutions. Our versatile, scalable, easy-to-integrate tokenization systems can benefit business clients of all types and sizes.

In short, tokenization is easier to implement, easier to use, and easier to maintain than most data security alternatives—which is extremely valuable when it comes to something as crucially important and complex as HIPAA compliance. Contact us today to learn more about TokenEx’s data security solutions and how we protect the world’s most sensitive data from attack while enabling our clients’ most critical business processes.



Topic(s): data security , HIPAA , tokenization