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AJMC Study Reveals Common Characteristics of Hospital Data Breaches

The American Journal of Managed Care has published a study of hospital data breaches in the United States. The aim of the study was to identify common characteristics of hospital data breaches, what the biggest problem areas are, the main causes of security incidents and the types of information most at risk.

The study revealed hospitals are the most commonly breached type of healthcare provider, accounting for approximately 30% of all large healthcare security incidents reported to the Department of Health and Human Services’ Office for Civil Rights by providers between 2009 and 2016.

Over that 7-year time period there were 215 breaches reported by 185 nonfederal acute care hospitals and 30 hospitals experienced multiple breaches of 500 or more healthcare records. One hospital experienced 4 separate breaches in the past 7 years, five hospitals had 3 breaches, and 24 hospitals experienced 2 breaches. In addition to hospitals experiencing the highest percentage of security breaches, those breaches also resulted in the theft/exposure of the highest number of health records.

While hacks were commonly experienced, it was not electronic healthcare data that was the biggest problem area. Paper and film were the most common locations of breached protected health information. 65 hospitals reported paper/film data breaches over the time period that was studied; however, while those breaches were the most common, they typically affected a relatively small number of patients.

Recently, there has been an increase in hacks and malware and ransomware attacks on network servers, although between 2009 and 2016 – for hospitals at least – network servers were the least common location of breached PHI. While the least common, they were the most severe. Network server breaches resulted in the highest number of stolen records.

The second most common location of breaches was PHI stored in locations other than paper/film, laptops, email, desktops, EHRs, or network servers. Those breaches had been reported by 56 hospitals. In third place was laptop breaches, reported by 51 hospitals.

The types of data breaches most commonly experienced were theft incidents, which had been reported by 112 hospitals. Unauthorized access/disclosures were in second place with incidents reported by 54 hospitals. Hacking/IT incidents was third and was behind 27 hospital data breaches.

Multivariate logistic regression analyses were performed to explore factors associated with hospital data breaches. The researchers found significant differences between hospitals that had experienced a data breach and those that had not.

Teaching hospitals and pediatric hospitals were found to be the most susceptible to data breaches. 18% of teaching hospitals had experienced at least one data breach, compared to 3% without a breach. Six percent of pediatric hospitals had experienced a breach compared to 2% that had not.

Larger hospitals were also more prone to data breaches than smaller facilities. 26% of large hospitals had experienced a data breach, compared to 10% that had no breaches. Investor-owned hospitals had reported fewer breaches than not-for profit hospitals.

There were no significant differences based on the level of IT sophistication, health system membership, biometric security use, hospital region, or area characteristics.

The researchers suggest that while hospitals have invested in technology and have digitized health data to meet Meaningful Use requirements, security has not been a major focus and investment in data security has been lacking. Hospitals are typically only spending 5% of their IT budgets on security and that needs to improve if hospital data breaches are to be prevented. Security measures also need to be improved for paper/films to reduce the opportunity for unauthorized access and theft.

The researchers suggest hospitals should be conducting regular audits to determine who is accessing PHI, while audits of data security protections will help hospitals identify vulnerabilities before they are exploited.

The use of biometric identifiers can limit the potential for unauthorized access of ePHI and 2-Factor authentication should be implemented on all user accounts.

The researchers also suggest access to PHI should be limited to the minimum necessary amount to allow employees to complete their work duties. By restricting access, the severity of data breaches will be reduced.

The methodology, full results, and conclusions can be found on this link.

Author: Steve Alder is the editor-in-chief of HIPAA Journal. Steve is responsible for editorial policy regarding the topics covered on HIPAA Journal. He is a specialist on healthcare industry legal and regulatory affairs, and has several years of experience writing about HIPAA and other related legal topics. Steve has developed a deep understanding of regulatory issues surrounding the use of information technology in the healthcare industry and has written hundreds of articles on HIPAA-related topics.