So, you’re a software developer who just got the news: your next project is a telehealth platform that healthcare providers will use to conduct virtual visits and store patient records. Welcome to the world of HIPAA compliance! If you’ve never had to think about protected health information (PHI) before, it can feel a bit daunting. This post is here to help you break down the essentials, no matter what platform you’re using. This won’t cover everything, but it should give you some good starting points.
Understanding What Counts as PHI
Your first step, as a dev, is to figure out exactly what data is considered PHI in your healthcare app. Start with the obvious things like patient names and diagnoses.
In a telehealth context, PHI can include anything that identifies a patient and relates to their health. That means appointment times, treatment notes, video recordings of virtual visits, and even metadata that could tie a session back to a specific person. If you’re not sure, err on the side of assuming something is PHI during your initial triage. Then, go back over your list with the regulation in hand and check.
Encryption: At Rest and In Transit
Once you know what data is PHI, you’ll need to ensure it’s encrypted both at rest and in transit. That means encrypting any data stored on disk directly or in databases, and making sure all data transmitted over the network (like video calls or API requests) is sent over secure protocols like HTTPS.
Most cloud providers offer built-in encryption options. Realistically, you should be doing this even if you’re not required to comply with HIPAA. Plaintext is a great, durable data format, but a really bad encryption stance. To keep things properly encrypted, you need a solid key management and distribution plan.
Access Control: Keep it Role-Based
Not everyone on your team needs (or wants) access to PHI. Use role-based access control to ensure that only those who genuinely need to see patient data can access it. If you’re building custom software, this might look like a custom roles and permissions tree.
But, protection goes beyond just locking down access through your user-facing application. You also need to think carefully about who on staff has access to production systems that might themselves have access to PHI. Use your cloud provider’s identity and access management (IAM) tools to lock down sensitive resources.
Audit Logging: Know Who Did What and When
HIPAA requires you to keep track of who accessed PHI and when. Set up audit logs that record access attempts and data changes. This will help you detect suspicious activity and prove to auditors that you’re doing your due diligence.
Make sure these logs are also protected and reviewed regularly. While we’re talking logs, you’re going to want to make sure you audit your production application and system logs. Are you emitting any patient information straight to STDOUT? That’s something you’ll want to fix up front, and then periodically check.
Infrastructure as Code: Make It Repeatable
Finally, treat your technical infrastructure as code. This is table stakes for most software projects these days, and with health tech projects, it’s extra important. Use tools like Terraform, Ansible, or your cloud platform’s own templating system to define your environment. This makes it easier to review changes, roll back mistakes, and prove that you have consistent security settings. It also helps new team members get up to speed quickly and ensures that you’re not relying on manual configuration.