By Ken Lynch


The security of people’s healthcare information has long been a hot topic in the country and around the world. If sensitive healthcare information were to end up in the wrong hands, people’s privacy could be affected in many different ways.

HIPAA stands for Health Insurance Portability and Accountability Act, and was enacted to define parameters for securing people’s health information. This legislation stipulated the kind of information that should be protected, along with specific parameters that establish compliance with HIPAA requirements.

Simply put, many different types of businesses need HIPAA compliance when coming in contact — both directly and indirectly — with health information.

Compliance includes meeting the necessary provisions of HIPAA safeguards, carrying out a risk assessment, and implementing a continuous risk management process.

What Is the HIPAA Security Rule?

HIPAA was initially established in 1996 to protect the personal health information of people who were moving from one job to another. Because employers and many other businesses handle sensitive healthcare data, the need to keep this data secure at all times was apparent early on.

These HIPAA safeguards eventually evolved into a Security Rule that covers the access, communication, and storage of healthcare data. The law specifically defined Personal Healthcare Information (PHI) as any information concerning the health status, provision of healthcare services, and payment for such services that can be linked to an individual.

The HIPAA Security Rule requires that any entities handling PHI become compliant in the areas of:

  • Administrative safeguards – policies and procedures
  • Physical safeguards – access control to data storage
  • Technical safeguards – communication systems that transmit PHI

Because of the new guidelines that HIPAA puts in place, almost any organization that comes in contact with personal healthcare information, whether online or in physical copy, needs to ensure they’re compliant with HIPAA requirements. 

This includes healthcare providers, software providers for healthcare organizations, audit firms that work with HIPAA-compliant businesses, and even payment processing firms that provide services to companies that handle PHI.

Compliance with the HIPAA Security Rule casts a wide net to cover not only healthcare firms but also all third-party providers of those firms. This is necessary because it only takes one weak link in the system to expose the entire chain to data breaches.

Why It’s Important to Stay Compliant with Security Rule Requirements

HIPAA compliance isn’t just an additional requirement for your business; it’s an operational necessity.

The Department of Health and Human Services (HHS) has a specific department that helps enforce HIPAA compliance. In recent years, the Health Information Technology for Economic and Clinical Health Act (HITECH) made HIPAA compliance even more critical for businesses.

With the overall goal being the protection of personal health information, violating HIPAA requirements can result in both hefty fines and possible jail time.

HIPAA provisions have been consolidated under the Omnibus act, which also includes requirements set forth by HITECH.

If you need better training to help employees stay compliant with the HIPAA Security Rule and other regulations, BizLibrary has you covered. Check out this video preview and  learn more about our online training library for healthcare organizations. 

Continuous Monitoring of HIPAA Security Rule Safeguards

Being compliant with the HIPAA Security Rule features three main pillars – administrative, physical, and technical safeguards.

Under the administrative guidelines, businesses handling PHI need to establish a risk assessment plan, followed by a risk management plan. Risk assessment involves analyzing the risks that your systems face daily.

The central pillar of HIPAA compliance is important because it determines the implementation framework that you’ll follow for your entire security plan moving forward.

In other words, the policies and procedures you establish to become compliant with HIPAA requirements will affect all other elements of your information security plan.

Risk Analysis as Part of HIPAA Compliance

Analyzing risk (as part of your risk assessment framework) includes evaluating the possibility of a risk occurring, as well as the impact it may have on personal health information.

In light of these risks, the next step should involve implementing security measures that will address the risks you face, followed by documenting these measures as part of a formal process for establishing compliance with the HIPAA Security Rule.

After all risk factors are identified and addressed, the last step in risk analysis will involve maintaining a continuous plan for security protections moving forward.

Cybersecurity threats to personal health information continue to evolve daily.

Attackers frequently review their strategies and come up with innovative ways of breaching your security systems, often through mistakes made by employees unaware of the threat.

To keep up and remain compliant, you need a continuous risk analysis plan. This involves carrying out regular reviews of your records and evaluating the effectiveness of all security measures in place.

Continuous Security Rule Compliance Makes Risk Management Easier

An essential component of risk management is constant monitoring and compliance. Risk management will primarily involve the regular monitoring of your security environment and being one step ahead of any emergent threats.

Why is continuous compliance with the HIPAA Security Rule important?

It gives you real-time visibility into your security practices so you can remain equipped to handle new risks.

Not only will you be able to detect risks in a timely fashion, you’ll also be able to implement an effective response that minimizes downtime and keeps PHI secure.

Continuous compliance also makes it easier for you to protect electronic PHI from unauthorized tampering. HIPAA compliance guidelines require all covered entities to have integrity controls in place, which specify that sensitive health information should be free of alteration, tampering, or being destroyed.

Continuous compliance is more effective than constant monitoring.

This is because monitoring may reveal that you’re lagging in a specific area of your security framework (such as updating a security patch), but this doesn’t mean you’ll take active steps toward fixing the problem.

On the other hand, continuous compliance involves maintaining HIPAA safeguards by immediately addressing any shortfalls in your systems.

Developing an Action Plan for Continuous HIPAA Auditing

While you may be compliant with all requirements of HIPAA’s Security Rule, you need to establish a method for proving this compliance.

Proof of compliance can be done through a continuous auditing plan. Such a plan should involve documentation demonstrating that you found various risks and implemented steps toward mitigating them.

The audit can also be used both internally and externally to provide proof of compliance at any given time.

To carry out an effective audit, you need automated tools to help you connect between your continuous monitoring plan and relevant documentation. This connection gives a holistic overview of all your monitoring and compliance efforts.

The benefits provided by an appropriate automated tool will put you on the path towards faster and more efficient monitoring practices. Seek out automated tools that have control management features, record-keeping platforms, and streamlined workflows.

Is your HIPAA training a pain to deliver to employees and accurately track for audits? BizLibrary’s online solutions streamline the entire process to make delivery, tracking, and even auditing of training completely painless.


Ken Lynch is an enterprise software startup veteran, who has always been fascinated about what drives workers to work and how to make work more engaging. Ken founded Reciprocity to pursue just that. He has propelled Reciprocity’s success with this mission-based goal of engaging employees with the governance, risk, and compliance goals of their company in order to create more socially minded corporate citizens. Ken earned his BS in Computer Science and Electrical Engineering from MIT.