6 min read

In the rapidly evolving landscape of healthcare technology, the integration of third-party applications with sensitive patient data demands a big focus on security and privacy. For healthcare startups venturing into this realm, safeguarding patient information and adhering to regulations like HIPAA are not just best practices – they're ethical imperatives.

Here, you delve into the top 5 best practices for healthcare startups and developers who want to integrate third-party applications with healthcare data using SMART on FHIR. You’ll also learn insights into how SMART on FHIR's user authentication, authorization, and consent mechanisms work cohesively to ensure unwavering patient privacy.

1. Secure User Authentication and Authorization

User identity verification lies at the core of secure healthcare data integration. Robust authentication mechanisms, including 2FA, assure that only authorized personnel can access critical patient information. Implementing Role-Based Access Control further refines data access. It ensures that each user's permissions align with their responsibilities within the healthcare ecosystem. To elevate this, SMART on FHIR introduces the concept of "scopes". It allows applications to access only the precise data required for their functions, reinforcing a least-privilege principle.

In nearly every SMART on FHIR application we've developed, there is a robust security framework built on industry-standard protocols:

OAuth 2.0 allows us to securely manage user access by issuing access tokens and refresh tokens;
Two-factor authentication (2FA) improves security by asking users to provide a secondary authentication factor during login;
Role-Based Access Control (RBAC) further strengthens the system by ensuring data access control based on user roles, reducing the risk of unauthorized access.

In addition, we make use of SMART on FHIR's 'Scope' concept. It allows applications to access only the specific data needed for their designated functions. Together, these elements create a highly secure environment, aligning with industry best practices for healthcare data protection.

2. Consent Management

Explicit consent is a non-negotiable prerequisite for data access. When it comes to consent management, it is important to define what type of application are you dealing with:

Patient-facing
In patient-facing apps SMART on FHIR's dynamic consent model enables patients to grant, modify, or revoke consent for data access at any time. Granular consent options empower patients to define the extent to which third-party applications can access their data. It promotes a patient-centric approach to data privacy.
Provider-facing
Wherein, if the application is provider-facing, the clinician is the one who provides consent (to share the patient data with a specific app).
Backend application
When the application is a backend, there is no consent at all because there is no specific person that commits the action. That’s why EHRs push so strong to utilize patient-facing and provider-facing concepts as much as possible. An example of a backend system might be an automated scheduled task that runs in the background.

To further enhance data privacy, we recommend to provide granular consent options where possible. This means that users should have the opportunity to precisely define how third-party applications interact with patient data. It ensures a truly patient-centric approach to data privacy and control.

3. Data Encryption

A cornerstone of data protection, encryption ensures that sensitive data remains secure both during transmission and while at rest. The use of HTTPS protocols for data in transit prevents unauthorized interception. While encrypting data at rest within apps' databases fortifies protection against potential breaches. If you’re building a roadmap to HIPAA compliance for your app, robust key management mechanisms will bolster your encryption's effectiveness.

Encryption in Transit: Based on our own experience, we recommend you to fortify the data transmission with robust encryption protocols. For example, TLS (Transport Layer Security). This advanced security mechanism keeps the patient data safe during transit, creating an impervious barrier around it.
Data at Rest: When patient data is kept in the developer’s databases, it still must be locked up safely. Although most development teams are usually well-versed in cybersecurity, it’s important to always consider the human factor in safeguarding data. In Kepler Team’s case, we've implemented encryption mechanisms that follow the strictest security standards to ensure full confidentiality.
Key Management: It’s better for you to employ comprehensive key management mechanisms that include regular key rotation, robust access controls, and secure key storage. These measures bolster the overall effectiveness of encryption by ensuring that encryption keys are adequately protected and managed.

4. Audit Trails and Monitoring

To maintain a comprehensive trail of user actions is instrumental in maintaining data integrity and accountability. By implementing exhaustive audit logs, healthcare startups can track user interactions, data access, and modifications. Real-time monitoring via intrusion detection and prevention systems adds an additional layer of security. That allows swift response to any anomalies.

In our SMART on FHIR applications, we always make sure to implement exhaustive audit logs. These logs are helpful in tracking user interactions, data access, and modifications. Real-time monitoring through intrusion detection and prevention systems ensures timely response to any security incidents. Additionally, you can consider implementing pieces that are related to application monitoring. For example, AWS CloudWatch and CloudTrail, configuring AWS dashboards and alerts, Datadog, BugSnag, and other services.

Also, to identify and address potential vulnerabilities, you should conduct thorough testing, and perform regular security audits. It includes functional and security testing, vulnerability scanning, and penetration testing.

5. Regular Security Assessments and Training

Regular security assessments, unveil vulnerabilities that may otherwise remain hidden. Equally important is ongoing employee training. This way you can be sure that developers and users are well-versed in security best practices and understand the criticality of safeguarding patient data.

Some tips on how to approach this:

Define a Schedule: Establish a regular schedule for security assessments, so they become a routine part of your cybersecurity strategy. Conduct them at least annually, or more frequently if your environment is highly dynamic.
Act on Findings: It's not enough to identify vulnerabilities; you must act on the findings promptly. Create a well-defined process for remediation and ensure that vulnerabilities are addressed in a timely manner.
Gamify & tailor the training: Consider gamifying training sessions to make them engaging and interactive. Implement quizzes, challenges, and rewards to incentivize participation. Customize training content to the specific roles within your organization. Developers, for instance, may require different training than medical staff.

Conclusion

In the dynamic landscape of healthcare technology, where innovation meets patient privacy, adherence to best practices becomes the cornerstone of success. As a healthcare startup, your commitment to safeguarding patient data and complying with stringent regulations like HIPAA is not just commendable – it's pivotal.

As you embark on your journey to innovate within the healthcare space, consider Kepler Team as your trusted partner. We don't just develop software. We build bridges between technology and patient well-being. Reach out to us today to discuss how we can help you navigate the complexities of healthcare app integration, fortify your security measures, and build the tech-side of your roadmap to HIPAA compliance. Together, we can reshape the healthcare landscape, one secure innovation at a time.