"Healthcare organizations that had used an integrated approach had experienced 10% fewer privacy and security incidents in the past two years," James Koenig, director and co-leader of PwC's health information privacy and security practice, explained to InformationWeek Healthcare.
Privacy historically has been the domain of the compliance department and security the responsibility of IT. "The HIPAA privacy and security rules only reinforced those silos," Koenig said.
But the Health Information Technology for Economic and Clinical Health (HITECH) Act, the health IT portion of the 2009 American Recovery and Reinvestment Act, strengthened privacy and security requirements, adding the provision that healthcare entities notify people potentially affected by breaches, regardless of whether the information was in electronic form or not. HITECH also created the Meaningful Use incentive program to encourage adoption of electronic health records (EHRs) and health information exchange.
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These changes have led to larger databases and increased data sharing--as well as more active enforcement of HIPAA by the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS). HHS reported this month that the number of people notified that they had been affected by healthcare data breaches more than doubled in 2010.
Indeed, more than 70% of respondents to the PwC survey of 600 U.S. healthcare executives said they have sharpened their focus on privacy and security as a result of recent enforcement activity.
Still, threats are changing, and the healthcare industry may not be keeping up. In the report, "Old Data Learns New Tricks: Managing Patient Privacy And Security On A New Data-Sharing Playground," PwC said that just 58% of healthcare providers and 41% of insurers surveyed said that their employee privacy training includes education on appropriate uses of EHRs. "Sometimes the race for [stimulus] funds gets a little ahead of privacy and security," Koenig said.
And, Koenig added, three-quarters of those surveyed said they planned on using data in new ways, but fewer than half have addressed the privacy and security issues that these secondary uses raise.
Plenty of organizations also are looking for threats in the wrong places. Slightly more than half of those organizations surveyed reported at least one privacy or security-related issue in the past two years. More than any other threat, providers cited improper use of protected health information by people inside the organization.
"Historically, people have thought of outside threats," namely hackers, Koenig said. "Most breaches are not the result of IT hackers, but rather reflect the increase in the risks of the knowledgeable insider related to identity theft and simple human error--loss of a computer or device, lack of knowledge, or unintended unauthorized disclosure."
Another growing risk is identity theft; 36% of providers reported seeing patients trying to obtain services under someone else's name or identification.
The new HITECH provisions call for greater attention to agreements with business associates, as defined by HIPAA. More than half of the 288 breaches reported to OCR at the time of the PwC report involved data transfer with business associates, but only a third of organizations that exchanged data externally had signed data-sharing agreements with all participants, a finding that was "surprisingly low," according to Koenig. He does, however, report seeing an increase in organizations conducting pre-contract assessments of business associates.
The PwC report also said that healthcare organizations need to pay attention to new technologies, such as mobile devices. The survey found that 55% of healthcare organizations have not really addressed mobile-related privacy and security issues, and less than one-quarter have examined the privacy and security implications of social media.