HIPAA Compliance In the Cloud: Azure Use Case
Privacy and security management of protected health information (PHI) in the healthcare industry is mandatory under HIPAA regulations. That’s why it’s one of the key decision points for organizations adopting the cloud. In fact, 93 percent of hospital CIOs are hiring staffers to maintain a HIPAA-compliant cloud infrastructure, according to a survey by Black Book Research.
As one of the leading public cloud service providers, Azure addresses HIPAA compliance challenges in the cloud by integrating enterprise-class security features in a majority of the services. In scenarios where there is a shared responsibility between the cloud service provider and the customer, detailed best practice guidelines are provided to ensure compliance.
In this blog, we’ll discuss the many advantages of using the Azure cloud to build and deploy HIPAA-compliant infrastructure to meet the stringent security and compliance requirements of the healthcare industry – and why a Managed Cloud Services like Navisite, with our Microsoft Azure Expert MSP certification and 117+ Azure experts, can help your organization ensure it has all angles of its cloud HIPAA compliance covered.
Cloud Adoption in Health Care: Major Considerations
Modernization and availability of cutting-edge technologies are the primary factors that motivate healthcare organizations to adopt cloud platforms. Cloud service providers like Azure help in this journey by offering a wide variety of certified and secure services.
HIPAA stresses the security and confidentiality of electronic protected health information (ePHI) under all circumstances, such as stored data, application-processed data, and data stored for backup and DR purposes. To avoid compliance violations, this confidentiality requirement needs to be taken under consideration when moving data from on-premises environments to the cloud.
Long-term retention of patient records and files for compliance purposes can often lead to concerns about infrastructure capacity and costs. When leveraging cloud-based storage options, this annual capital expenditure is converted to an operating expenditure on a pay-as-you-go basis.
Data coming in various sources like imagery or test reports is further fed into advanced data service applications and algorithms to derive valuable insights. In such cases, the vertical and horizontal scaling capacity of the cloud can be leveraged to meet on-demand computing and storage needs.
In the healthcare industry, it’s important that any patient-related ePHI-related is available on-demand 24x7x365 without interruption. Cloud services often come with financially-backed SLAs that assure round-the-clock availability. Most of these high-availability configurations are taken care of by the cloud service provider, thereby allowing organizations to focus on application and data management, but managed cloud services providers like Navisite offer even better uptime guarantees for services they manage for clients.
Understanding BAA and HIPAA Compliant Services
Healthcare organizations that utilize public cloud services are mandated by HIPAA to enter into a business associates agreement (BAA) with the cloud provider. Microsoft Azure offers qualified organizations a BAA that enables flexibility and choice while covering more services than any other cloud service provider. However, it’s important to understand that having a BAA does not automatically guarantee HIPAA compliance. Microsoft provides guidance regarding additional steps the customer should take to ensure end-to-end compliance.
Compared to other service providers that offer BAAs, Azure is more flexible regarding customer-implemented controls. For example, Azure allows customers to use their own encryption keys for many storage services; Azure offers direct integration with its key vault service for secure storage of keys. Cloud services covered under a BAA are regularly audited by independent agencies for compliance standards like ISO 27001, SOC1, and SOC2. The audit reports regarding these services can be accessed by customers at the Microsoft Service Trust Portal. Navisite also signs BAAs with its clients.
Hybrid Architecture and Workload Migrations
Most organizations adopting a cloud architecture would start with a hybrid architecture that allows the coexistence of services on-premises as well as in the cloud. This helps organizations to use a combination of powerful cloud-native services along with traditional applications to be migrated to the cloud over time. In both cases, a secure mode of connection and transfer of data is important. Azure offers tailor-made services to enable this process, ensuring the implementation of an HIPAA-compliant hybrid architecture.
Azure Express Route offers a dedicated connection to Azure from on-premises environments that do not traverse the internet. It offers the most secure, intercept-free method of establishing communication between elements of the application tiers distributed across these environments. Express Route provides a resilient, always-on connection that ensures availability of your critical ePHI in the cloud. Azure also offers a secure VPN connectivity option that carves an encrypted tunnel for safe access of data.
The secure connectivity offered by a VPN and Azure Express Route ensures that workload migrations are executed within the constructs of HIPAA regulations. When neither of these options are available, Azure Site Recovery (ASR) can be used for the secure migration over the internet of sensitive workloads from on-premises locations to Azure. The data remains encrypted throughout the process and can be decrypted only by using a key that is created and owned by the customer.
HIPAA-Compliant Hosting in Azure: Common Use Cases
Though the Azure platform is regularly audited for compliance with leading standards and regulations, Microsoft does not analyze the data and application plane of services being used by customers. It’s the clients’ responsibility to configure their Azure services and use them in a manner that complies with HIPAA compliance.
Azure storage is encrypted by default through storage service encryption that uses 256-bit AES encryption. Customers can also bring their own keys to Azure by utilizing the Azure Key Vault service. Data stored in Azure VM disks can also be encrypted using keys stored in Azure Key Vault. Disk encryption in Azure uses the industry standard BitLocker for Windows and dm-crypt for Linux VMs. That way, applications using Azure blob storage or hosted in Azure VMs are secured in compliance with HIPAA regulations at the data plane.
Healthcare organizations can use the data and analytics services of Azure to derive useful insights from sensitive patient health records. While doing so, it is important to ensure that security and privacy norms aren’t violated or compromised. When using services like Azure HDInsight, it’s incumbent on the client to make sure that third-party applications or components are updated with the latest security patches. It is also recommended to use SSL-encrypted endpoints for all data transactions.
Backup and DR
HIPAA mandates contingency and disaster recovery plans to protect against data loss. Many organizations also need a secure method for long-term retention of data that might be required for re-analysis or audit purposes at a later point. When used for HIPAA BAA compliance, Azure Site Recovery and Azure Backup offer a comprehensive backup and disaster recovery solution for hybrid architectures. Backup can ensure a failsafe contingency plan for healthcare application data if it is lost due to software and hardware issues or human errors. On the other hand, Azure Site Recovery offers a real-time disaster recovery solution for quick recovery of ePHI in the event of a natural calamity or disaster.
Implementation of security and compliance measures in a sustainable and repeatable manner is very important for large-scale cloud deployments. Automation plays an important role here by reducing configuration time as well as human effort. It’s a good idea to include all standard configurations in Azure Resource Manager (ARM) templates and use them in deployment pipelines for relevant Azure services.
Machine Learning and AI
Microsoft Azure offers a tailor-made blueprint for HIPAA/HITRUST health data and AI for the deployment of an IaaS and PaaS solution that can be used for secure storage and analysis of health care data while meeting compliance regulations. This blueprint case is leveraged for use cases in which organizations want to enable machine learning and analytics for healthcare data that has been moved to cloud. This blueprint covers the end-to-end process on how organizations can securely import data to the cloud, analyze it, and gain useful insights using various Azure IaaS and PaaS components.
Healthcare organizations are looking to adopt cloud-based services to help with cutting-edge patient care, while reducing time spent on mundane IT activities. These HIPAA-mandated regulations should also be considered in the cloud adoption journey to ensure security and privacy of ePHI. Azure offers many turnkey solutions that can be used by organizations to achieve the goal of efficient adoption of cutting-edge technology that is compliant with HIPAA guidelines.
Enlisting an experienced Managed Cloud Service Provider (MCSP) like Navisite can be helpful in such scenarios, especially when the organization is new to the cloud and wants to make sure that the onboarding conforms to recommended best practices.
As a Microsoft Gold partner and Azure Expert MSP, with the extensive experience our 117+ Azure experts can help organizations understand the constructs of HIPAA in the cloud. We’ll help your organization design a secure strategy to migrate your data, applications and infrastructure to Azure, and configure services that fall under the ownership of clients once there and to ease the burden on your IT team, Navisite can assume the responsibility of the day-to-day management of your Azure cloud, so your team can focus on critical business initiatives that drive greater organizational nimbleness and success.
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Managing the privacy and security of Protected Health Information(PHI) in the healthcare industry is mandated using HIPAA regulations, and is one of the key decision points for organizations when it comes to cloud adoption. Based on a research conducted by Black Book Research, 93% of hospital CIOs are investing in staffing required to maintain a HIPAA-compliant cloud infrastructure.
Microsoft Azure is one of the leading public cloud service providers has managed to address HIPAA compliance challenges in cloud, by integrating many enterprise-class security features in the majority of the services.
In scenarios where there is a shared responsibility between cloud service provider and the customer, detailed best practice guidelines are provided to ensure compliance. This blog post will demonstrate o the advantages of leveraging the Azure cloud to build and deploy HIPAA-compliant infrastructure, to meet stringent security and compliance requirements of the healthcare industry.