Healthcare websites contain highly sensitive patient information, so it is crucial for healthcare organizations to follow best practices for security and privacy when hosting their websites. Adhering to regulations like HIPAA and implementing technical controls like encryption are essential. This article outlines key considerations healthcare entities must make when choosing a web hosting provider, implementing security controls, ensuring compliance, and creating policies and procedures to safeguard healthcare data online.
Choosing a Secure and Compliant Web Host
One of the most important decisions when creating a healthcare website is choosing the right web hosting provider. The host will physically store and transmit the website and data, so assessing security and compliance is critical.
Healthcare organizations should only use web hosting services that are HIPAA compliant. The web host should sign a business associate agreement (BAA) certifying they implement physical, network, and process security controls in accordance with HIPAA. Potential hosts should also provide third-party audit reports demonstrating compliance.
In addition to HIPAA, healthcare web hosts should comply with other relevant regulations like HITECH and country/region-specific laws like GDPR. Make sure the host meets security best practices like ISO 27001 certification.
The web host’s data centers should have robust physical security protections like 24/7 monitoring, cameras, access control systems, and more. They should also have backup generators, fire suppression, and other environmental safeguards.
On the technical side, the web host should utilize intrusion detection/prevention systems (IDS/IPS), web application firewalls (WAF), DDoS mitigation, multi-factor authentication, encrypted data transmissions, vulnerability testing, and other cybersecurity best practices.
Healthcare organizations should inquire about the web host’s incident response plan in case of a breach. The provider should have clear policies for notifying impacted individuals and entities in a timely manner.
When researching potential healthcare website hosting providers, healthcare entities should ask for client references to verify other healthcare customers’ experiences with security and compliance. Web hosts optimized for the highly regulated healthcare industry tend to offer the best security capabilities.
Implementing Security Controls and Protections
While choosing a compliant healthcare web host sets the foundation for privacy and security, healthcare organizations must also implement several technical controls themselves:
Encryption: All ePHI or other sensitive data should be encrypted both at rest and in transit using protocols like TLS 1.2+ or SSH. This converts data into cipher text only decipherable with a cryptographic key. SQL and database encryption provide additional protection beyond just HTTPS.
Access controls: Set up role-based access controls so users only access data necessary for their roles. Use the principle of least privilege. Implement multifactor or two-factor authentication for all users.
Logging/auditing: Logging user access and system events provides an audit trail in case of a breach. Implement intrusion detection and file integrity monitoring software.
Vulnerability management: Routinely scan for and patch vulnerabilities in server environments and web apps. Perform penetration testing to identify weaknesses.
Backups: Maintain regular backups stored in a secondary location in case recovery is needed after an incident. Backups should also be encrypted.
Software updates: Always keep OS, software, and frameworks like WordPress up to date. Enable auto-updates when possible.
Malware prevention: Use threat detection and anti-malware tools. Be vigilant against phishing emails.
Session management: Invalidate sessions after periods of inactivity. Implement tokens and/or device fingerprinting to detect unusual access.
Error handling: Do not reveal system details or other overly verbose error messages.
By implementing these technical measures on top of choosing a secure web host, healthcare entities add critical redundancies that safeguard sensitive data.
Ensuring Compliance with Healthcare Regulations
Healthcare websites must comply with federal and state/regional healthcare privacy laws and regulations.
At the federal level, covered entities and business associates must comply with HIPAA and HITECH requirements around security and breach notification. This includes implementing addressable and required safeguards.
Entities operating in the European Union must adhere to GDPR’s data privacy and security stipulations for protecting EU citizen data. Related regulations include Europe’s NIS Directive and ePrivacy Directive.
In the United States, regulations vary by state with some like California having robust healthcare privacy laws equivalent to HIPAA. State attorneys general can also enforce HIPAA within their states.
To ensure compliance, healthcare organizations should:
- Perform risk analyses to identify compliance gaps.
- Cross reference implemented security controls with those required by relevant regulations.
- Create policies, procedures, and training to operationalize compliant practices.
- Stay up to date on new or changed regulatory requirements.
- Consider designating a Chief Privacy Officer and/or Security Officer.
- Develop relationships with knowledgeable legal counsel.
- Ensure business associates adhere to compliant practices.
Following healthcare privacy and security regulations protects patient data and mitigates the risks of fines, litigation, and reputational damage in cases of noncompliance.
Developing Website Privacy and Security Policies
Documented website privacy and security policies are the foundation for operationalizing compliant practices that safeguard healthcare data.
These policies should cover:
Privacy policy
- Types of data collected and stored
- How collected data gets used, disclosed, and protected
- Patient rights surrounding healthcare data
- HIPAA disclosures and compliance practices
Security policy
- Access controls and authorization policies
- Password policies, multifactor authentication
- Encryption policies and key management
- Backup policies and procedures
- Patching and vulnerability management
- Secure software development requirements
- Logging, auditing, and monitoring policies
- Incident response and breach notification plan
- Acceptable usage policies for users
- Cybersecurity awareness training requirements
These formal policies align to and help implement the standards within regulations like HIPAA. The policies should be disseminated via training for workforce members, vendors, contractors and posted on the healthcare website.
Employee Cybersecurity Training
In addition to technical controls, robust cybersecurity awareness training for employees helps maintain privacy and security. Training should cover:
- Applicable regulations like HIPAA and their obligations
- Proper data handling, storage, transmission, and disposal
- Identifying and reporting potential incidents
- Dangers of phishing and other social engineering
- Secure authentication practices like proper password hygiene
- Physical security basics for workstations, servers, mobile devices etc.
- Any organization specific policies, systems, tools etc.
Annual refresher training keeps employees vigilant. More advanced role-based training can be implemented for IT staff and others handling PHI. Documentation of training completion provides auditable evidence of compliance.
Third Party and Vendor Risk Management
Third parties like web hosting providers, application/software vendors, billing companies etc. must also be compliant as business associates.
To manage business associate risks:
- Vet vendors’ HIPAA compliance and security controls through due diligence processes like audits or questionnaires.
- Have vendors sign business associate agreements contractually obligating HIPAA adherence.
- Include service level agreement clauses mandating compliant security controls.
- Conduct periodic reviews of vendors and their protection of healthcare data.
Managing third party compliance reduces the risks of regulatory violations and breaches impacting healthcare website data.
Securing Content Management Systems like WordPress
Many healthcare websites run on content management systems (CMS) like WordPress which require additional security measures:
- Harden the CMS installation by disabling unnecessary features, removing default accounts/passwords and more.
- Limit user roles and permissions to only allow needed access.
- Leverage available plugins like brute force attack protections and firewalls.
- Maintain CMS software updates for newly discovered vulnerabilities.
- Install security-related plugins from trusted providers and validate plugin reputation.
- Backup both the CMS files and database regularly in case malware gets deployed.
- Use reputable commercial CMS hosting optimized for security if possible.
- Install a web application firewall (WAF) for deep packet inspection and attack blocking.
Proactively securing CMS platforms protects the website while minimizing disruptions from infections or unauthorized access.
Responding to Security Incidents and Breaches
Despite best efforts, website breaches may still occur. The healthcare entity should have an incident response plan detailing:
- How incidents/breaches get identified and classified based on risk analysis.
- Response team roles and responsibilities during an incident.
- Containment procedures like isolating/shutting down affected systems.
- Eradication steps like cleaning malware infections or closing security gaps.
- Recovery procedures to restore systems to normal operations.
- Documentation and reporting requirements when incidents involve PHI.
The plan should also outline breach notification procedures aligned to HIPAA/HITECH regulations including:
- Notifying affected individuals and government entities within 60 days of discovery.
- Providing details like date of breach, types of data compromised, steps individuals should take etc.
- Descriptions of remediation efforts.
With strong incident response, organizations can mitigate regulatory violations and damages to both patient privacy and trust.
Conclusion
Developing and hosting secure healthcare websites involves diligence across many facets – choosing a compliant provider, implementing technical controls, creating policies, training staff, managing vendors, hardening CMS platforms and more.
Robust security and privacy practices protect patient data and engender trust. They demonstrate the healthcare entity values and respects data stewardship responsibilities. Implementing these best practices provides a strong foundation for hosting healthcare websites that comply with complex regulatory obligations while avoiding potentially severe consequences.