Building healthcare applications requires navigating complex regulatory requirements. HIPAA (Health Insurance Portability and Accountability Act) violations can result in fines up to $1.5 million per incident—but more importantly, they can harm patients whose data is exposed. This guide covers what you need to know to build compliant healthcare applications.
Understanding HIPAA
What is HIPAA?
HIPAA is a US federal law that protects sensitive patient health information (PHI) from disclosure without patient consent. It applies to:
- Covered entities: Healthcare providers, health plans, healthcare clearinghouses
- Business associates: Companies that handle PHI on behalf of covered entities
What is PHI?
Protected Health Information includes any individually identifiable health information:
- Medical records and history
- Lab results and diagnoses
- Treatment information
- Health insurance information
- Any data that could identify a patient linked to health info
If your application touches any data that could identify a patient and relates to their health, HIPAA likely applies.
Technical Requirements
1. Encryption
HIPAA requires protecting PHI in transit and at rest:
- In transit: TLS 1.2 or higher for all data transmission
- At rest: AES-256 encryption for stored data
- Key management: Secure key storage and rotation
- End-to-end: Consider E2E encryption for messaging
2. Access Controls
Only authorized users should access PHI:
- Unique user identification: Every user has unique credentials
- Role-based access: Users only see data they need
- Automatic logoff: Sessions expire after inactivity
- Multi-factor authentication: Required for accessing PHI
3. Audit Logging
Every access to PHI must be logged:
- Who accessed the data
- When they accessed it
- What data they accessed
- What actions they took
- Logs must be tamper-proof and retained
4. Data Integrity
Ensure PHI isn't altered or destroyed improperly:
- Checksums or digital signatures
- Version control for medical records
- Backup and recovery procedures
5. Transmission Security
Protect data during transmission:
- HTTPS everywhere (no HTTP)
- Certificate pinning for mobile apps
- Secure API authentication (OAuth 2.0, JWT)
- No PHI in URLs or logs
Infrastructure Considerations
Cloud Hosting
Major cloud providers offer HIPAA-eligible services:
- AWS: Extensive HIPAA-eligible services, BAA available
- Google Cloud: HIPAA-compliant services with BAA
- Azure: Healthcare-specific compliance offerings
Always sign a Business Associate Agreement (BAA) with your hosting provider.
Database Security
- Encrypt at rest (built into most managed databases)
- Encrypt in transit (SSL connections)
- Network isolation (VPC, private subnets)
- Regular backups with encryption
Third-Party Services
Every service that touches PHI needs a BAA:
- Email services (if sending PHI)
- Analytics (ensure no PHI in tracking)
- Error reporting (redact PHI from errors)
- Push notifications (no PHI in notifications)
Application Design
Authentication
Strong authentication is mandatory:
- Complex password requirements
- Multi-factor authentication
- Account lockout after failed attempts
- Secure password reset flows
- Biometric authentication for mobile
Session Management
- Short session timeouts (15-30 minutes)
- Secure session tokens
- Session invalidation on logout
- No session data in URLs
Data Minimization
Only collect and display PHI that's necessary:
- Don't store data you don't need
- Mask sensitive data in UI when possible
- Limit PHI in search and filtering
Mobile App Specific Requirements
Device Security
- Require device passcode/biometrics
- Implement app-level authentication
- Don't store PHI in plaintext on device
- Use secure storage (Keychain, Keystore)
Network Security
- Certificate pinning to prevent MITM attacks
- No PHI transmission over insecure networks
- Offline mode security considerations
App Distribution
- App Store guidelines compliance
- Enterprise distribution security
- Remote wipe capabilities
Operational Requirements
Business Associate Agreements
BAAs are legally required contracts that must cover:
- Permitted uses and disclosures of PHI
- Required safeguards
- Breach notification procedures
- Termination provisions
Risk Assessment
HIPAA requires regular risk assessments:
- Identify where PHI is stored and transmitted
- Assess current protections
- Identify vulnerabilities
- Implement and document remediation
Incident Response
Have a breach response plan:
- Detection procedures
- Containment steps
- Assessment requirements
- Notification timelines (60 days for breaches over 500 records)
Training
All employees handling PHI need HIPAA training:
- Initial training for new employees
- Regular refresher training
- Documentation of training completion
Common Mistakes to Avoid
Technical Mistakes
- PHI in application logs
- Unencrypted backups
- Weak authentication
- Missing audit trails
- Third-party services without BAAs
Process Mistakes
- No documented security policies
- Missing risk assessments
- Inadequate employee training
- No incident response plan
Getting Started
Building a HIPAA-compliant application:
- Determine if HIPAA applies to your application
- Conduct a risk assessment
- Design with security in mind from day one
- Choose HIPAA-eligible infrastructure
- Implement required technical safeguards
- Establish operational procedures
- Document everything
- Consider third-party audits
Conclusion
HIPAA compliance isn't optional for healthcare applications, but it's achievable with proper planning and implementation. The requirements aren't just regulatory checkboxes—they're security best practices that protect patients and your organization.
TechOrigins has built multiple HIPAA-compliant healthcare applications. Contact us to discuss how we can help you build a secure, compliant healthcare solution.