Atlantic.Net Blog

Real World Case Study for HIPAA Storage and Sharing: Nextcloud & HIPAA Compliance

Kent Roberts
by Atlantic.Net (80posts) under HIPAA Compliant Cloud Storage

Every organization that handles the electronic protected health information (ePHI) of US citizens must be concerned with federal healthcare compliance: that is, abiding by the parameters established in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH). A central element of HIPAA federal law is the Security Rule, which mandates implementation of appropriate cybersecurity measures to protect digital health records.

While the standards and practices outlined within the HIPAA law provide general guidelines, every situation is a bit different – and, to some extent, the understanding of that difference is expressed as flexibility within the regulations. That flexibility can be helpful in terms of avoiding violations, but it can be challenging when you are determining how to move forward. Case studies can be very helpful in these situations so that you can see what healthcare compliance looks like in practice. HIPAA compliance features of one cloud platform suggest a specific system you can adapt to meet regulatory parameters.

Hospital System Needs HIPAA-Compliant Document Collaboration and Communication

A hospital system contacted Atlantic.Net to help them setup a storage and sharing site that would meet HIPAA-compliance standards. The site would allow the developers to create various folders for each of the organization’s hospitals so that each could upload its patient reports. Access to this site would be limited to two users per hospital, whose unique login credentials would enable them to enter the site and download the folder and data related to their own hospital – while blocked from being able to see or access the folders of other hospitals.

Atlantic.Net offered to configure and manage a server-side HIPAA compliant storage solution. While the infrastructure and security is from Atlantic.Net, the underlying software platform is from Nextcloud.

How Does Nextcloud Help Deliver HIPAA Compliance?

Nextcloud is designed for secure productivity along with ease-of-use.  You do not want the user’s experience to be complicated – especially not in the critical environment of healthcare, in which errors can have devastating consequences. Access is clear. Everything is visible to those who are authorized to see it.

File Access Control is a key capability of Nextcloud that allows organizations to maintain compliance. Through FAC, you can build policy and legal guidelines into your processes. You can create strict rules that prevent anyone from viewing, uploading, or downloading who does not have proper authorization based on various characteristics.

One key aspect of a HIPAA-compliant environment, possibly more evident than anything else, is encryption. Encryption is easy to implement within Nextcloud. ePHI should be encrypted (or protected via alternative means) whether it is in transit or at rest, as a best practice. In accordance with that requirement, Nextcloud can be configured to use SSL/TLS encryption whenever data is transferred. When data is at rest in storage, you can set it up to encrypt at AES-256 – a military-grade cryptographic algorithm. Key management for this system could either be within the server or via a custom portal. Nextcloud is simple to integrate with your current systems or to pair with leading healthcare cloud offerings. Additionally, Nextcloud gives you the ability to closely monitor and log everything – with or without the addition of tools such as OpenNMS, Splunk, or Nagios.

Through features such as these – features to allow for a HIPAA-compliant environment – Nextcloud enhances the security of your documents and communication.

Ease of Use

Nextcloud’s offering gives you integration for better overall productivity. The Nextcloud clients deliver a seamless experience regardless of the means of access – throughout all your desktop and mobile devices.

Your team is able to collaborate on files in real-time; perform secure video and audio calls and perform secure chat. Nurses and doctors are simply able to locate files t and revert files to earlier saved versions. Together, these capabilities improve productivity as they enhance security.

HIPAA Security Rule and the Cloud

To understand this healthcare platform, it helps to review HIPAA itself. At the core of HIPAA, particularly for digital systems, is the Security Rule – which takes the patient privacy rights established in the Privacy Rule and protects them through a mandate for technical, administrative, and physical safeguards. These designations are a bit broader than they may first seem. Technical protections, for instance, not only refer to data-safeguarding tools (such as a virtual private network), but also to policies and procedures applicable to those tools.

HIPAA protections must be robust, whether they are in public, private, or hybrid Cloud models; the Department of Health and Human Services stipulates that the business associate agreement (BAA) of a provider should reflect the nature of the environment, with risk evaluation revealing necessary points of focus for the BAA.

With the Cloud, as with other technologies, security steps that are taken must be reasonable and appropriate based on the situation; for example, the anti-malware posture of a large healthcare system is expected to be reasonably and appropriately more sophisticated than the typical system of a small doctor’s office. To be clear, Nextcloud, wherever it’s hosted, can be used by organizations of all sizes to meet their HIPAA-compliance needs.

Strengthening Cloud Security

The security of cloud (or presumed lack of security) used to be seen as its biggest weakness. Today that is not the case, with IT thought leaders even suggesting that cloud’s security is stronger than that of the average company’s self-hosted solutions. Nonetheless, organizations should approach the cloud carefully as compliance and data safety are not as simple as selecting technology. For better cloud security, consider these two critical tasks:

Confront the Insider Threat

Time and resources invested in security often go toward high-end security tools that use artificial intelligence, machine learning, and other cutting-edge technologies. You can only put so much trust in those systems, though. It is important to recognize that hacking efforts such as social engineering target your people specifically as a way into your organization. Additionally, human error can occur, as when phishing succeeds. People might also not follow proper mitigation or authentication steps.

Adapt to the Ongoing and Evolving Challenge

You may not reach perfection when it comes to cybersecurity or healthcare compliance – especially given the increasing complexity of IT systems that now typically include internally supported systems integrated with those of Cloud Hosts and other Managed Service Providers. You simply need to minimize risk in any way possible.

Your HIPAA-Compliant Cloud Storage

Are you in need of HIPAA-compliant storage? At Atlantic.Net, we help you reduce risk through access to our tested, trusted healthcare solutions. Our one-click Nextcloud app allows you to integrate server-side compliance seamlessly into your IT approach. See our HIPAA-compliant cloud storage.

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