devices were the source of stolen patient records. In February 2011, someone stole an
unencrypted laptop from the vehicle of a Texas Health and Human Services Com- mission employee. The laptop contained ePHI for nearly 1,700 patients, including names, dates of birth, Medicaid identi- fication numbers, procedure codes, and diagnoses. The agency punished the em- ployees involved for failing to encrypt the data on their laptops. A thief took an unencrypted laptop
from Methodist Charlton Medical Center in Dallas in April 2011, potentially ex- posing 1,500 patient records. Afterward, the clinic revised its encryption policy. Mr. Southrey says physicians can mitigate their risk of breach by encrypt- ing their laptops and mobile devices. En- cryption renders patient data unreadable so even if hackers access ePHI, they can’t read it. Only physicians or authorized employees can access encrypted data. A HIPAA-secure app is available for
physicians. TMA offers DocbookMD,
www.texmed.org/DocbookMD, a free app for members that automatically encrypts messages sent on your smart- phone or tablet. Using DocbookMD, physicians can send HIPAA-compliant messages containing text and photos at times when texting is the fastest way to send important information. To down- load the app, visit
docbookmd.com. Physicians can work with their soft-
ware vendors to ensure all computers and electronic devices include encryp- tion software. For desktop or laptop computers, a system administrator, or in the case of smaller practices, a hired contractor, will typically install and con- figure the encryption products. Practices also can contact their EHR or practice management system vendors about en- cryption technology.
After implementing the encryption
software, physicians should be able to encrypt and decrypt data simply by specifying which information they want to protect.
Most operating systems carry built-in encryption programs like these:
• Microsoft Encrypting File System for Windows,
http://bit.ly/1jeE6TU;
• BitLocker Drive Encryption for Win- dows,
http://bit.ly/1dmeSxQ;
• Pretty Good Privacy by Symantec for Windows and Mac, http://bit .ly/1rLoh9S; and
• FileVault 2 for Mac, http://support
.apple.com/kb/ht4790.
What to do in case of a breach If you suspect a breach of confidential information, HIPAA requires you to make several important notifications. You must alert affected patients in
writing within 60 days of the discovery of the breach. If you have insufficient contact information for more than 10 af-
Are you covered?
John Southrey, Texas Medical Liability Trust’s (TMLT’s) manager of consulting services, says the company recommends practic- es conduct a cyber insurance review to ensure they have cover- age that addresses regulatory fines, breach notification costs, first-party coverage of digital assets, and cyber extortion in which a thief demands money for sensitive patient information. Here are some sample questions TMLT recommends physicians ask themselves to evaluate their practices’ cyber security:
• How are you currently safeguarding electronic patient data? • Are you using encryption or other secure methods of pre- venting access to patients’ protected health information?
• Do you keep your antivirus and antispyware software active and up to date at all times?
• Do you use hardware and/or software firewalls to block outside access to your computer systems and unauthorized outgoing activity?
• Do you currently have any coverage for cyber liability losses, and if so, how comprehensive is the policy?
• Do you understand your responsibility in notifying your pa- tients if there is a cyber-related security breach resulting in invasion of their privacy?
• Have you considered the costs of lost production, lost time by employees working to fix the problem, and the overall loss of efficiency and potential reputational loss from a cyber claim?
If you think cyber security is lacking at your practice, you can learn more about TMLT’s cyber liability coverage at www
.tmlt.org.
July 2014 TEXAS MEDICINE 29
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