HIPAA audit at hospital riles health care IT

Computerworld - An audit of Atlanta's Piedmont Hospital that was initiated by the U.S. Department of Health and Human Services in March is raising concerns in the health care industry about the prospect of more enforcement actions related to the data security requirements of the federal HIPAA legislation.

The audit was the first of its kind since the Health Insurance Portability and Accountability Act's security rules went into effect in April 2005, joining data privacy mandates that were already in place. The security rules require organizations that handle electronic health data to implement measures for controlling access to confidential medical information and protecting it against compromise and misuse.

Neither Piedmont nor the HHS has confirmed that the audit was launched, and few details about it have been disclosed publicly. But an HHS document obtained by Computerworld shows that Piedmont officials were presented with a list of 42 items that the agency wanted information on.

Among them were the hospital's policies and procedures on 24 security-related issues, including physical and logical access to systems and data, Internet usage, violations of security rules by employees, and logging and recording of system activities. The document also requested items such as IT and data security organizational charts and lists of the hospital's systems, software and employees, including new hires and terminated workers.

The mere fact that an audit of HIPAA security compliance was conducted for the first time has many in the health care industry preparing for more enforcement actions, according to Barry Runyon, an analyst at Gartner Inc. "I don't think Piedmont was an anomaly," he said. "My sense is that there is going to be more feet on the street from HHS going on unannounced audits."

Randy Yates, director of security at Memorial Hermann Healthcare System in Houston, said the Piedmont audit contributed in a big way to the approval of a $1.3 million budget item for data encryption during the health care provider's next fiscal year.

"Everybody is aware of the Piedmont audit notification," Yates said. He added that after hearing about it, "we did our own gap analysis and found out where we are at highest risk for noncompliance, and we have since taken steps to shore up [those areas]."

As part of its efforts to bolster security, Memorial Hermann is also rolling out access management tools developed by Courion Corp. in Framingham, Mass. Yates said the software is expected to help the health care system automate policies for controlling access to protected medical information by its 19,000 employees.

Also driving the increased focus on HIPAA compliance at Memorial Hermann is a directive issued last December by the federal Centers for Medicare & Medicaid Services (CMS), Yates said. The directive ordered entities that handle patient health information to implement stronger authentication mechanisms for controlling access to the data.