HIPAA Considerations Applicable to Digital Health Providers
- Digital Health, Tech

HIPAA Considerations Applicable to Digital Health Providers

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The pandemic has led to the widespread use of digital health services worldwide. However, with the restrictions and risks of COVID-19, many people have preferred to have online health checkups and over-in-patient consultations. In fact, according to a study by McKinsey, the use of telehealth services has multiplied 78 times in April than February 2020.

Digital health providers can deliver health solutions without leaving the safety of one’s home. Online options became an attractive alternative to in-patient consultations because of their convenience and low cost. It also uses mobile and wearable technology to monitor a patient’s health, giving them more power over their health. 

At the same time, digital health services present new challenges to data privacy. This article will discuss how the Health Insurance Portability and Accountability Act of 1996 or HIPAA regulations serve as a guide to ensure the patients’ rights to data privacy with improved security that will help uplift patient experience and give you the HIPAA guide to achieve this.

What is HIPAA?

HIPAA is a federal law that aims to protect patients’ sensitive health information privacy. Under HIPAA, such information cannot be released without consent or knowledge. In addition, it observes rules to protect confidentiality, to require notification in the event of a breach, and to ensure just compensation for victims of data privacy violations.

Covered entities are required by law to observe HIPAA regulations and regulate disclosure of patient data. These include the following:

  • Medical service providers. Doctors, nurses, clinics, psychologists, and pharmacies transmit data electronically, such as transactions for claims, benefits, and authorization requests. 
  • Business associates. An individual, organization, or entity conducts sensitive health information to provide claims and benefits processing, data analysis, and billing services.
  • Health insurance companies. Health plans such as government or company healthcare plans pay for health insurance.
  • Health care clearinghouse. A public or private third-party system transmits medical claims between health care providers and insurance payers.
  • Employer-sponsored and group health plans. Businesses, organizations, and government programs provide, subsidize, and pay for healthcare.
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How does HIPAA apply to digital health providers?

What is Patient Health Information?

Generally, HIPAA regulations seek to protect Protected or Patient Health Information (PHI). Therefore, electronic patient data falls under the HIPAA guide when it meets the two criteria for digital service providers. 

  1. Any data that can be used to identify an individual seeking medical care.
  2. Any data sent to covered entities in the duration of providing medical service.

Examples of Patient Health Information include, but are not limited to the following:

  • Name
  • Address
  • Telephone number
  • Email address
  • Social security number
  • Medical record number
  • Photos with patient’s face
  • IP Address

It is important to note that although some institutions or organizations collect health information if covered entities do not contract them, these cannot be considered PHI. Examples are educational institutions and businesses that record employees’ health conditions or companies that make applications and wearable devices that track health records.

Digital health providers and HIPAA regulations

Digital health providers, or mobile health applications, must strictly comply with HIPAA regulations. In addition, improved security will help uplift the patient experience and ease the anxieties of sharing sensitive information online.

As a budding innovation, there are yet to be more defined rules and regulations that cater specifically to digital health providers. For example, HIPAA guides are vague regarding the wellness domain, even if the information shared is highly personal and sensitive. 

Mobile health apps can be categorized into four types:

  1. Physiological. These apps and wearable devices monitor physiological data such as heart rate, insulin level, blood pressure, respiration rate, and ovulation and menstrual cycles.
  2. Activity. These apps track and monitor physical activity such as step counts, cycling distance, exercises, and workouts. This also includes food intake, diet habits, and consumption of addictive substances. 
  3. Information. These apps record and access health information, such as medical records.
  4. Telehealth medicine solutions. These are apps that facilitate online communication between patients and medical service providers.
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That said, there are several considerations applicable to mobile health providers. The following serve as parameters to identify if digital health providers are required to comply with HIPAA.

  1. If the process, send or receive patient health information.
  2. If they cater to individuals, organizations, and businesses that can be categorized as covered entities.
  3. If they transact with entities that also transact with covered entities.
  4. They are contracted by entities that develop mobile health applications to process PHI.

The growing number of mobile health app developers, wearable devices, and teleconsultations available in the market bridges the differences between in-person and online health services. With this level of popularity comes the challenges of ensuring data privacy, compliance with health information regulations, and providing overall security for patients. However, this also highlights the limitations of HIPAA, a law that was made with in-person health services in mind. Therefore, it is a challenge for digital health providers and regulatory boards to provide safe and better health services to patients in an increasingly digital age.

HIPAA Considerations Applicable to Digital Health Providers