How to Ensure Your EHR is HIPAA-Compliant - A Step-by-Step Guide

by Evercommerce

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Electronic Health Records (EHRs) have revolutionized healthcare by eliminating paper records and streamlining patient data management. However, they also present unique challenges regarding safeguarding Protected Health Information (PHI).

For example, 2024 was dubbed the “worst-ever year” regarding breached healthcare records. The year brought a record-breaking total of 184,111,469 breached records, or 53% of the 2024 population of the United States.

These cyberattacks are one of the many reasons HIPAA compliance is crucial to any EHR. It not only confirms that patient information remains secure, but it also helps healthcare providers avoid penalties and comply with standards.

To take the guesswork out of securing your system, we created a guide explaining what HIPAA compliance means for EHRs, why it matters, and how to achieve it starting today.

Let’s dive in.

What Does HIPAA Compliance Mean for EHRs?

To fully understand HIPAA compliance in the context of EHRs, it’s essential to uncover what it actually means. The Health Insurance Portability and Accountability Act (HIPAA) establishes standards for safeguarding PHI from unauthorized access.

This act can be broken down even further into the HIPAA Privacy Rule and the HIPAA Security Rule:

HIPAA Privacy Rule

  • Summarizes the standards for protecting PHI
  • Mandates compliance with an individual’s rights to access
  • Focuses on data privacy and the processes involved in using or revealing it

HIPAA Security Rule

  • Contains specific rules for medical billing compliance with the Administrative, Physical, and Technical Safeguards
  • Explains that healthcare organizations and partners ensure the confidentiality, accessibility, and security of PHI
  • Calls for organizations to have documented policies on HIPAA compliance

Regarding EHRs, it’s essential to focus on the three key categories of safeguards:

1. Technical

  • Data Encryption: Ensures that any stored or shared PHI is unreadable without the appropriate decryption key.
  • Audits: HIPAA-compliant EHR systems must track and log all access to PHI for future reference.
  • Access Controls: Mechanisms such as permissions ensure that only authorized users can view or edit private information.

2. Physical

  • Secure workstations and devices used to access private information.
  • Organizational access controls to limit where PHI-related systems are housed.

3. Administrative

  • Regular compliance training for staff members.
  • Appointing a dedicated staff member to oversee adherence to HIPAA rules for EHRs.

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Importance of HIPAA-Compliant EHRs

HIPAA rules are enforced by The Department of Health and Human Services (HHS) Office of Civil Rights (OCR). So, what happens if the rules are broken? Here are some potential outcomes:

  • Termination of a contract
  • The violation may be dealt with internally by an employer
  • Sanctions from professional boards
  • Criminal charges

In terms of criminal charges, this penalty depends on the level of culpability, such as whether the violation was committed knowingly. According to the American Medical Association (AMA), here is an example of a violation and fine:

HIPAA civil violation: Willful neglect and not corrected

Penalty range: $50,000 per violation, with an annual maximum of $1.5 million and imprisonment of up to 1 year.

These violations can ruin a provider’s reputation, affect licensure, and/or result in jail time. Still, using an EHR with HIPAA-compliant software features goes beyond fulfilling legal requirements.

Here are other reasons why it matters:

Protects Patient Information Breaches can lead to serious consequences for patients, including identity theft. A compliant EHR strengthens your practice’s defenses.

Mitigates Risk HIPAA-certified EHR systems are designed to minimize vulnerabilities, reducing the chances of cyberattacks that target healthcare data.

Wins Patient Trust A survey by the AMA revealed that nearly 75% of patients surveyed were concerned about protecting the privacy of their health data.

Building on this information, it’s evident that patients are more likely to trust healthcare providers who prioritize the safety and privacy of their information.

Avoids Financial Penalties and Protects Staff

HIPAA penalties and fines are applied to the following elements of electronic PHI or ePHI:

  • Use
  • Collection
  • Transmission
  • Storage

As indicated earlier, we revealed how non-compliance with HIPAA rules can result in heavy fines and even jail time. But how expensive can a violation get? The HIPAA Journal reveals:

  • The minimum penalty is $141 per violation.
  • The maximum penalty for a HIPAA violation is $2,134,831.

Providers are not the only target when facing penalties; their staff can also be fined for violating HIPPA rules. State laws are being increasingly used to bring private rights of action for violations and sanction workforce members who commit offenses like disclosing PHI on social media.

Choosing a reliable EHR solution that focuses on compliance not only ensures a practice saves money, avoids fines, and prioritizes operational security, but it also protects the staff as well.

Key Features of a HIPAA-Compliant EHR

What makes an EHR compliant? The OCR offers some must-have features to look for:

Data Encryption To prevent unauthorized access, all stored or transmitted PHI must be encrypted. Doing so supports security as well as efficiency and reduces errors.

Audit Trails Monitor and record all access to PHI to identify suspicious activities. These trails include detailed user access records, timestamps, and purposes for access.

Role-Based Access Control (RBAC) RBAC, also called role-based security, is a safety method that limits access to sensitive data based on user roles, ensuring only those who need the information can access it.

Interoperability While Ensuring Compliance EHR interoperability and HIPAA go hand-in-hand. Modern EHRs should support interoperability between systems, such as lab or pharmacy systems, without compromising compliance.

Secure Messaging Features HIPAA-compliant software features should include secure communication channels, like portals, for healthcare providers and patients.

Automatic Logoffs To prevent unauthorized access, compliant systems should log out inactive users.

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Step-by-Step Guide to Ensuring HIPAA Compliance in Your EHR

Now that we’ve explained the key features of a compliant system, it’s time to learn how to take these elements and put them into action.

Here are seven steps to ensure your EHR is fully HIPAA-compliant:

Step 1. Perform a Risk Assessment

Identify potential vulnerabilities in your EHR system that could compromise sensitive data. For example, a practice or organization can undergo periodic audits from outside companies to maintain compliance; this may include a HIPAA Security Risk Analysis.

Your IT members should also consider “pen tests” (penetration testing). This testing is when evaluators mimic real-world attacks to identify ways to bypass the security features of an application, system, or network.

By taking these proactive measures, organizations can correct them before hackers find them.

Step 2. Select a HIPAA-Certified and Interoperable EHR

Work with reputable vendors. For example, the cloud-based DrChrono EHR is a fully integrated HIPAA-compliant platform. Some features include:

  • On-Patient portal: Patient portals enable patients to safely schedule and update visits, sign consent forms before appointments, conduct Video Visits from their iOS device, receive patient education materials and more.
  • eFax: HIPAA-compliant inbox with audit trail capabilities allows users to send and receive faxes.
  • Mobile app: The DrChrono mobile EHR app is an end-to-end HIPAA-compliant solution that integrates patient engagement, scheduling, clinical workflow, and medical billing.

DrChrono is also certified as a Complete EHR by the ONC, meaning the platform meets Meaningful Use (MU) standards. MU promotes interoperability, or the capability of different healthcare systems to exchange patient data without issues.

Step 3. Encrypt All PHI

Ensure your EHR solution uses strong encryption protocols to protect patient data during storage and transmission.

  • At-rest encryption protects patient data stored on servers and local devices. At rest means it’s not being actively transmitted or processed.
  • In-transit encryption protects data while transmitted from one device to another over a network. The goal is to protect data from eavesdropping, interception, and tampering during transmission.

Step 4. Implement Role-Based Access Controls

Set strict access controls to ensure only authorized users can view or modify sensitive information. Limiting network access is vital, especially for healthcare organizations with several workers and contractors or allowing third parties.

Step 5. Conduct HIPAA Compliance Training for Staff

Human error can often be a key cause of HIPAA violations. Here’s a recent case study highlighting this issue from the Department of Health and Human Services:

“A staff member of a medical practice discussed HIV testing procedures with a patient in the waiting room, thereby disclosing PHI to several other individuals. Also, computer screens displaying patient information were easily visible to patients. The OCR required the provider to develop and implement policies and procedures regarding appropriate administrative and physical safeguards related to PHI communication."

This case study reveals why staff, including new hires and contractors, must be trained on HIPAA regulations. Regular training (and testing) helps reinforce the importance of safeguarding PHI and ensures staff members know how to respond to potential threats or disaster scenarios.

Step 6. Set Up Audit Trails

Enable tracking and logging of all system activities related to PHI access. Practices that monitor audit logs regularly are well-prepared to mitigate suspicious activities. Some examples include:

  • Meticulous Logging: Track all user activities, including access attempts, data modifications, and deletions with timestamps and user identifiers.
  • Monitoring: Regularly review audit logs to identify suspicious activity.

Step 7. Appoint a Privacy and Security Officer

When selecting an officer, choose a staff member you trust to handle a significant portion of the auditing process. Having a Certified in Healthcare Compliance (CHC) certification or equivalent also helps. Make sure they can manage tasks such as:

  • Regularly scheduling policy reviews
  • Creating a list of safeguards
  • Recording and mitigating all breaches or incidents
  • Communicating with staff

Actionable Tips to Secure Your EHR Today

Not sure where to start? Here are some actionable tips to improve your EHR’s compliance and security right now:

  • Start with a HIPAA compliance checklist. Evaluate your EHR system against a detailed checklist covering encryption, access controls, and audit trails. Reviewing the HIPAA Security Rule Toolkit is a great place to start. The toolkit helps organizations better understand the requirements of the HIPAA Security Rule, implement them, and assess those implementations in their daily operations.

  • Limit and strengthen device access. Restrict EHR access to specific devices and ensure these are secure and monitored. Strengthen device access with identification, authentication, and authorization in mind. Some methods include login or sign-in tools, such as multi-factor authentication, biometrics, or wireless solutions.

  • Secure communication channels. Adopt HIPAA-compliant software and systems with encrypted messaging for internal and external communications. For example, DrChrono’s Security Policy states all communications through both doctor and patient-facing platforms are fully protected.

  • Upgrade outdated security systems. Patch and update your EHR software regularly to address vulnerabilities. Patches are software and operating system updates that address security vulnerabilities within a program. Software vendors may release updates to fix performance bugs and enhance security features.

Next Steps

Investing in a HIPAA-compliant EHR isn’t just about avoiding fines—it’s about building patient trust and ensuring the safety of sensitive healthcare data.

If you’re ready to take the next step in safeguarding your EHR, use this guide to protect your practice and your patients, and contact DrChrono to learn how our customizable HIPAA-compliant EHR can provide secure healthcare on demand with the most innovative tools currently available.