The U.S. Department of Health and Human Services (HHS), which oversees HIPAA compliance, has contracted with the firm PricewaterhouseCoopers (PWC) to conduct surprise audits of hospitals this year, says Gartner analyst Barry Runyon.

"It's complaint-driven," says Runyon, noting that Tony Trenkle, director of the Centers for Medicare & Medicaid Services at HHS, last month publicly said the first 10 or so reviews will be at hospitals where CMS received complaints about security. In visiting the health care organization, the government regulatory probe will focus on security risks associated with remote access to data and portable storage concerns, with security managers expected to answer a lot of questions.

CMS plans to publish the results of these audits on its Web site but not the organization's name, unless it uncovers major lapses, which could result in fines or other penalties as defined under the HIPAA guidelines. Last month, Atlanta's Piedmont Hospital was revealed by HHS to be the first unannounced HIPAA security audit.

Health care, heal thyself
IT managers indicated they're taking proactive steps to secure external network access while also ensuring that authorized network users are limited to seeing only what they rightfully should.

At Mount Sinai Medical Center in New York City, the policy there is very strict about employees even looking at patient records without reason. "It's the curiosity factor," says Jack Nelson, CIO at Mt. Sinai, who notes that employees are told when hired they can be fired for online peeking -- and some have been.

"It's one strike and you're out -- and that's [for] clinicians as well," says Nelson, noting that the hospital's systems are generally role-based and keep track of every single access to a record.

Nelson says his biggest concern is not hackers trying to break in but sensitive data flying out over the network, including Mt. Sinai's voluminous clinical-lab test documentation. So Mt. Sinai recently installed Symantec data-loss prevention software on client computers to monitor outbound traffic.

HIPAA isn't the only set of security and privacy regulations that Mt. Sinai cares about. "When you have a data loss of about the magnitude of 10 patient records, you have to report that to the New York State Dept. of Health," says Nelson. "That's a serious violation."

Like Mt. Sinai Medical Center, Miami-based health benefits company AvMed Health Plans is also making use of data-loss prevention monitoring equipment to make sure sensitive data related to health claims is transferred appropriately.

Some e-mail communications with physicians' offices and hospitals must be encrypted under the HIPAA guidelines, notes Charles Hibnick, chief systems security architect at AvMed. The Palisades PacketSure monitoring equipment deployed since last October provides a way to determine that policy is being followed since it flags errors that might occasionally occur, such as someone forgetting to encrypt an e-mail's content.

"People sometimes say thank you when we catch this," says Hibnick. The monitoring is increasingly important since about 80 percent of health claims at AvMed are electronic, rather than predominantly fax, as they were just five years ago.

The prospect of an unannounced HIPAA audit by the government is an event that could shake anyone up, but in the final analysis, the federal probes are probably good for the health care industry, says Mark Jacobs, director of technology services in the datacenter operations at Pennsylvania-based WellSpan Health.

"HIPAA did help in some regard, getting the health information community to do audit, logging, and secure messaging and encryption," Jacobs notes, adding HIPAA has propelled his health care organization into new practices, such as adopting a security governance framework, single sign-on, and password provisioning.