The shift to remote working arrangements in healthcare has made HIPAA compliance even more critical, especially for behavioral health professionals. Achieving HIPAA compliance working from home can be complex, but it is non-negotiable for safeguarding Protected Health Information (PHI). This article delineates a set of practical suggestions to establish and maintain a HIPAA-compliant home office, concentrating on the unique challenges and obligations relevant to behavioral health providers. It is Part II of a series of Telehealth.org articles about home-based telehealth service delivery.
Maintaining HIPAA Compliance Working from Home in Behavioral Health
While a home office commonly refers to a location separate from a centralized workplace, it can be the principal work setting for solo practitioners, part-time workers, or telehealth providers in behavioral health. Regardless of the nature of employment—full-time, part-time, or contract-based—compliance with HIPAA is obligatory if your home-based activities involve the management of PHI (45 CFR Parts 160, 162, and 164).
The Multifaceted Utility of a Home Office
A home office can serve various functions in the healthcare ecosystem. For behavioral health professionals, roles may include:
Teletherapy provider
Medical coder/biller specialized in psychiatric conditions
Behavioral health research coordinator
Substance abuse counselor
Mental health consultant
Whether subject to state laws or operational policies, any role requiring the handling of PHI must prioritize the establishment of a HIPAA-compliant home office.
A Manageable To-Do List for a HIPAA-Compliant Home Office
Conduct Risk Assessments
Periodically perform risk assessments to identify vulnerabilities in your home office setup, from data storage to transmission security. The focus here is on identifying both permitted and impermissible uses and disclosures of PHI (45 CFR § 164.308(a)(1)(ii)(A)). See October Is For Cybersecurity Awareness Month: Essential HIPAA Security Risk Assessment for implementation suggestions.
Ensure Data Security
Invest in secure, lockable storage solutions for paper-based PHI and data backups. For digital records, utilize encrypted storage solutions and secure cloud services compliant with HIPAA’s Security Rule (45 CFR § 164.312(a)(2)(iv)). See The Telehealth. org Behavioral IT Directory of Cloud Service vendors for companies who may be able to help you.
Update Business Associate Agreements
Ensure you have up-to-date Business Associate Agreements with all third parties that may come into contact with PHI, as specified under HIPAA regulations (45 CFR § 164.504(e)).
Monitor Device Security
Use only PIN-locked devices with automatic logout features for electronic PHI access. Start with your mobile phone. Call the developer of the phone for someone to walk you through the process if you need help. Ensure you use a secure and private Wi-Fi network through a trusted Internet Service Provider fortified by multi-factor authentication and firewalls (45 CFR § 164.312(d)). While multi-factor authentication can be a nuisance, like airport checkpoints, they can prevent many, if not all, security breaches. Firewalls are needed wherever your clients or patients will communicate with you, such as through software installed on your website or built into the software that you buy to connect through patient portals, practice management software, videoconferencing, etc.
Develop Continuity Plans
Create a robust continuity of operations plan in case of hardware failure, data loss, or cyberattack. This should include secure backup options and immediate steps for breach
