HIPAA vs. HITRUST: What You Need to Know

When it comes to safeguarding personal digital information, data privacy is crucial, especially in the context of digital health records. Healthcare organizations have a responsibility to protect sensitive data using strong frameworks like HIPAA and HITRUST.

By following specific conditions outlined in HIPAA, healthcare organizations ensure that individuals have control over their personal health information. 

Explore the features, requirements, and benefits of HIPAA and HITRUST compliance. Discover how these frameworks work together to protect patient data.

HIPAA's Role in Securing and Safeguarding Patient Health Information: An Overview

The Health Insurance Portability and Accountability Act of 1996 (HIPAA), a U.S. law, sets standards for healthcare organizations to ensure the security, privacy, and proper handling of protected health information (PHI). Covered entities and business associates must prioritize HIPAA compliance to avoid penalties, including significant fines and harming their reputations.

HIPAA consists of three main rules that outline specific requirements for covered entities and their business associates:

1. Privacy Rule:

The Privacy Rule establishes national standards for how healthcare organizations can use and share patients' protected health information (PHI). It ensures that individuals have control over their health information by outlining the conditions for accessing, sharing, and disclosing PHI.

2. Security Rule:

The Security Rule establishes requirements for safeguarding patients' electronic PHI (ePHI). It mandates that covered entities implement appropriate administrative, physical, and technical safeguards to protect ePHI from unauthorized access, use, or disclosure.

These safeguards include access controls, encryption, audit trails, and employee training.

3. Breach Notification Rule:

The Breach Notification Rule requires covered entities to notify affected individuals, the U.S. Department of Health and Human Services (HHS), and, in some cases, the media when a breach involving unsecured PHI occurs.

This rule ensures that individuals are quickly notified of unauthorized access or disclosure of their protected health information (PHI). It enables them to take necessary steps to protect their privacy.

HIPAA is Not The Only Compliance Framework

While HIPAA serves as a comprehensive framework for covered entities and business associates, it's important to note that it does not provide a specific roadmap or checklist for achieving compliance.

Organizations under the purview of HIPAA must conduct annual self-audits to evaluate their adherence to the regulations. It is their responsibility to establish and enforce appropriate policies, procedures, and safeguards to safeguard protected health information (PHI) and ensure compliance with HIPAA requirements.

Oftentimes, healthcare organizations face significant challenges in meeting the stringent demands of HIPAA, as well as other industry-specific and international security regulations. The implementation and maintenance of HIPAA compliance can be complex and incur substantial costs.

This is exactly where the Health Information Trust Alliance (HITRUST) comes into play.

READ MORE: An Overview of HIPAA Attestation

What is the Health Information Trust Alliance (HITRUST), and Why Do Health Organizations Need It?

HITRUST offers a solution to simplify compliance efforts by harmonizing various security standards, frameworks, and regulations into a unified framework called the HITRUST CSF (Common Security Framework).

By adopting the HITRUST CSF and following the corresponding HITRUST Assurance Program, organizations can demonstrate their commitment to protecting patients' sensitive health information and upholding the integrity of the healthcare system.

HITRUST is a valuable resource for healthcare organizations, providing a comprehensive and streamlined approach to regulatory compliance and risk management.

The Role and Benefits of HITRUST Compliance for Health Organizations

Health organizations need HITRUST to navigate the complex landscape of data security and privacy regulations effectively.

The HITRUST CSF offers several benefits:

1. Simplified Compliance:

By following the HITRUST CSF, organizations can ensure compliance with various regulations, including HIPAA, GDPR, ISO, NIST, PCI-DSS, and more. It consolidates these standards into a unified framework, eliminating the need for separate assessments and audits.

2. Streamlined Risk Management:

The HITRUST CSF not only focuses on compliance but also facilitates effective risk management. It provides organizations with a structured approach to identify, assess, and mitigate risks associated with data privacy and security.

3. Reliable Certification:

HITRUST offers a certification program called the HITRUST Assurance Program, which enables organizations to obtain a recognized certification. This certification demonstrates their commitment to data security and compliance, enhancing trust among patients, partners, and stakeholders.

4. Enhanced Security:

The HITRUST CSF incorporates a comprehensive set of security controls, enabling organizations to strengthen their security posture. By adopting HITRUST's guidelines, organizations can proactively protect sensitive data and mitigate potential risks.

5. Competitive Advantage:

Achieving HITRUST certification sets organizations apart in the healthcare industry. It showcases their commitment to maintaining the highest standards of data security and privacy, which can give them a competitive edge when seeking partnerships and contracts.

By adopting HITRUST's guidelines and pursuing HITRUST certification, health organizations can ensure compliance, enhance security practices, and gain a competitive advantage.

Clarifying the Misconception: HITRUST vs. HIPAA Compliance—A Synergistic Approach

It's time to debunk the misconception that HITRUST and HIPAA are at odds. In reality, HITRUST doesn't replace HIPAA; it works hand in hand with it.

HIPAA sets the foundation for protecting sensitive health information, while HITRUST takes it a step further. By integrating HIPAA requirements with other security frameworks, HITRUST offers a more comprehensive and stringent approach to data security.

HIPAA focuses primarily on safeguarding protected health information (PHI) and establishes national standards for its use and disclosure. On the other hand, HITRUST expands on HIPAA by incorporating a broader range of security controls and requirements.

It harmonizes multiple standards, such as PCI-DSS, ISO, NIST, and GDPR, into a unified framework, creating a holistic strategy for data security and regulatory compliance.

By adopting HITRUST, organizations demonstrate their commitment to HIPAA compliance (using a HIPAA compliance audit) while bolstering their overall security posture.

HITRUST provides a robust framework that addresses a wider spectrum of security considerations, empowering organizations to establish stronger safeguards and effectively mitigate risks.

Let's dispel the misconception: HITRUST and HIPAA are not competing frameworks; they work together as complementary components of a comprehensive data security strategy.

Healthcare organizations need to understand the differences between these frameworks. This will help them improve their security practices and meet industry standards.

So, is HITRUST HIPAA-compliant?

Yes!

HITRUST incorporates HIPAA requirements into its framework, ensuring that organizations achieving HITRUST certification meet HIPAA compliance.

However, it's important to note that HIPAA compliance doesn't automatically mean HITRUST compliance. HITRUST imposes additional security controls and standards beyond what HIPAA mandates.

Real-World Examples of Compliance Requirements

HIPAA and HITRUST are two standards organizations in the healthcare industry may need to comply with. HIPAA stands for the Health Insurance Portability and Accountability Act, which sets the rules for protecting patients' sensitive health information. HITRUST, on the other hand, is a certification framework that combines various security and privacy standards, including HIPAA, to provide a comprehensive approach to managing risk in healthcare.

Some examples of organizations that may need to comply with HIPAA, HITRUST, or both, include:

1. Organizations That Need HIPAA Compliance:

Healthcare Providers:

Hospitals, clinics, nursing homes, doctors' offices, and other healthcare providers that handle patient health information are required to comply with HIPAA.

For example, a large hospital network with multiple locations must ensure HIPAA compliance to protect patient data and maintain regulatory adherence.

Health Insurance Companies:

Insurance companies that handle and process health insurance claims and PHI are also subject to HIPAA requirements.

These organizations must implement appropriate security measures to safeguard sensitive data, such as a health insurance provider managing electronic claims and medical records.

2. Organizations that Need HITRUST Certification:

Health IT Vendors:

Organizations providing health IT solutions, including electronic health records (EHR) systems, telehealth platforms, and healthcare software applications, can benefit from HITRUST certification.

HITRUST provides a comprehensive security framework that demonstrates its commitment to data protection and establishes trust with healthcare organizations. For instance, a company offering cloud-based EHR solutions may pursue HITRUST certification to assure healthcare providers of their robust security measures.

Third-Party Service Providers:

Entities that handle, store, or process patient data for healthcare organizations, such as medical billing companies, data hosting providers, and medical transcription services, often seek HITRUST certification.

By obtaining HITRUST certification, these organizations demonstrate their commitment to maintaining the highest standards of data security and regulatory compliance.

3. Organizations needing HIPAA Compliance and HITRUST Certification:

Healthcare Clearinghouses:

Clearinghouses are crucial in processing and forwarding healthcare claims between providers, health plans, and other entities. As intermediaries in the healthcare data exchange, they must comply with HIPAA.

Additionally, HITRUST certification may be sought to enhance their security controls further and demonstrate comprehensive data protection capabilities.

Integrated Health Systems:

Large healthcare organizations that encompass multiple entities, such as hospitals, clinics, and health insurance divisions, often need to comply with HIPAA across their entire network.

Achieving HITRUST certification can provide them with a standardized and scalable security framework that aligns with their complex operations, ensuring consistent data protection practices and regulatory compliance.

HIPAA and HITRUST Are Partners in Health Compliance

Regarding data security in healthcare, organizations must carefully consider their compliance requirements.

HIPAA compliance is mandatory for entities handling PHI, while HITRUST certification provides an additional layer of comprehensive security controls.

By assessing specific security needs, scalability, and potential impact on partnerships and business opportunities, organizations can make informed decisions about pursuing HIPAA compliance audits or HITRUST certification— or both.

Ultimately, the goal is to maintain compliance, uphold patient trust, and establish a robust data security framework that aligns with the organization's objectives and future growth plans.

Partner with Johanson Group, Risk Advisory Specialists, to Safeguard Your Patient and Staff Data

At Johanson Group, we understand the importance of protecting patient and staff data in healthcare organizations.

With our expertise in risk advisory and privacy requirements, we specialize in helping healthcare organizations manage, maintain, and comply with stringent data privacy regulations.

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