HIPAA compliance primarily applies to the cloud provider's security measures, encryption, access controls, and willingness to sign a business associate agreement (BAA), regardless of the location.
Data sovereignty and HIPAA compliance
Data sovereignty refers to the principle that data is subject to the laws and regulations of the country where it is physically located. When healthcare organizations store protected health information (PHI) in the cloud, the handling of that data must comply with HIPAA, regardless of physical location.
Here's how data sovereignty can influence HIPAA compliance:
Physical location and legal jurisdiction
HIPAA compliance instructs that PHI is stored in line with US regulations. Data stored on cloud servers outside the United States might be subject to different legal jurisdictions and data protection laws. This can create challenges in ensuring that data remains protected per HIPAA standards.
Data transfer and transmission
HIPAA places restrictions on the transmission of patient data. When data is transmitted across international borders, it may be susceptible to interception or surveillance by foreign governments. Data sovereignty issues can emerge during data transfer, potentially leading to HIPAA violations.
Data access and control
Cloud storage providers often have access to the data stored on their servers. If these servers are located in a different country, the cloud provider may be subject to the laws and regulations of that country. This can affect the healthcare organization's ability to control and access PHI in compliance with HIPAA.
Data residency and encryption
Data sovereignty may influence how data is encrypted, where encryption keys are stored, and who has access to them. Healthcare organizations must implement encryption practices to comply with HIPAA standards, irrespective of the data's physical location.
Business associate agreement (BAA)
HIPAA compliant cloud storage providers must offer a business associate agreement to healthcare organizations. A BAA is a legal contract establishing the cloud provider's commitment to safeguarding PHI and complying with HIPAA.
Compliance certification
Cloud providers that have obtained significant compliance certifications, such as SOC 2 or HITRUST, demonstrate a commitment to safeguarding sensitive data.
As per the Health Information Trust Alliance (HITRUST), certification "means that a company has taken extensive measures to ensure the security of sensitive data. It is widely considered the gold standard of trust and reassurance, as it signifies a company is taking cybersecurity seriously and has taken necessary steps to prevent data breaches."
Data backup and disaster recovery
Cloud providers should have data backup and disaster recovery plans in place. The geographic diversity of data centers can influence data availability in the event of a disaster.
Go deeper:
Practical considerations for healthcare organizations
To comply with HIPAA while navigating data sovereignty concerns, healthcare organizations should take the following steps:
- Choose a compliant cloud provider: Select cloud providers that are HIPAA compliant and can guarantee that data will be stored in the United States or within the boundaries of your legal data agreements.
- Access control: Implement a data system that allows data access controls and encryption measures.
- International data transfer agreements: If your organization needs to transfer data internationally, establish appropriate agreements and safeguards to ensure data sovereignty and compliance.
- Regular compliance audits: Conduct frequent compliance audits of your cloud storage environment to guarantee it aligns with HIPAA requirements.
- Legal consultation: Seek legal advice and consultation to understand the specific implications of data sovereignty in your healthcare organization's context.
See also: HIPAA Compliant Email: the Definitive Guide
Farah Amod
