HIPAA Compliance Software

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Buyers Guide

Last Updated: May 29, 2022

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides data security and privacy provisions to safeguard patients’ protected health information (PHI), including their name, date of birth, phone number, health records, social security number, and financial and insurance details. It’s mandatory for healthcare providers to comply with the regulation.

HIPAA compliance software helps healthcare providers and related entities ensure compliance with PHI privacy and security provisions. It also helps them prepare for federal and state-level audits.

There are various compliance software tools available on the market, and choosing the one that best serves your needs can be time-consuming. In this buyers guide, we’ve included all the information you’ll need to make the right purchase decision.

Here’s what we’ll cover:

What is HIPAA compliance software?

HIPAA compliance software is a solution that helps healthcare organizations comply with all the necessary security and privacy provisions to protect patients’ data. It provides a compliance framework that guides healthcare providers on the steps to take and processes to follow for ensuring the safety of patients' PHI.

The software is usually integrated with other healthcare solutions, such as electronic medical records (EMR), practice management, and medical billing software, to ensure that data across systems meets HIPAA guidelines. However, it can also be used as a stand-alone application.

List of policies and procedures in HIPAAMATE (Source)

Common features of HIPAA compliance software

Different vendors offer different features as part of their HIPAA compliance software. Selecting software with the right features is easier when you know what the most common features are and what they do.

Self-audits Receive a complete overview of your organization’s existing compliance posture. These mandatory audits span your organization's privacy and security infrastructure and are done to identify risk areas.
Remediation plans Address the compliance gaps identified during self-audits. Remediation plans are unique for each organization and lay out clear, actionable steps to patch up the gaps.
Policies and procedures Create organization-specific compliance policies and procedures—usually identified through self-audits and remediation plans—that can be implemented across business functions.
Documentation Document your compliance processes and store all related records at a centralized location. Documentation is mandated by federal regulations but helps maintain records to prove your organization has been following all necessary compliance steps.
Vendor management Manage relationships with vendors, such as billing companies and pharmacies. In some software tools, this module helps conduct vendor audits to ensure that they've implemented the IT security infrastructure required to protect patients' data.
Incident management Monitor and manage data breaches. You can document and report any data breach to the Office for Civil Rights (OCR).
User permissions Limit user access based on employee role so that only authorized employees can access sensitive compliance data.

What type of buyer are you?

Before you start evaluating software options, you'll want to know which buyer category you belong to so that you pick the right software. Most buyers fall into one of the following categories:

  • Solo and small healthcare providers: These buyers include solo physicians or small practices with two to five physicians. They should opt for a cost-effective stand-alone HIPAA compliance application that helps meet regulatory compliance using minimum resources. Self-audits, remediation plans, and compliance policies and procedures are the basic features that they can select.
  • Midsize and large healthcare providers: These buyers include healthcare organizations with six or more physicians. Considering their larger size, they have to manage more patients, users, vendors, and stakeholders. Therefore, they have larger volumes of documentation, need stricter access control, and must regularly monitor data across integrated systems. Such buyers should opt for a fully featured HIPAA compliance software that can be integrated with other medical software suites, such as EMR solutions.
  • Allied healthcare professionals: These buyers include third-party billing companies, insurance companies, and healthcare clearinghouses. They require HIPAA compliance software specific to their area of operations. For instance, billing companies and clearinghouses must ensure that the software they choose has access control features, such as user authorization, to maintain restricted access to sensitive data.

Benefits of HIPAA compliance software

In this section, we've listed the key benefits offered by HIPAA compliance software.

  • Ensure regulatory compliance: Federal regulations mandate that healthcare organizations and allied health professionals safeguard patients’ PHI. HIPAA compliance software offers a compliance framework that provides complete information about all the necessary steps and processes these organizations should follow to ensure regulatory compliance.
  • Stay up to date with compliance changes: Healthcare regulations and protocols change constantly. The software provides notifications about any upcoming compliance deadline or possible changes to existing protocols so that healthcare organizations have sufficient time to comply with the changes and avoid penalties. Also, every time a new software update is rolled out, users are informed of the latest regulatory changes.

Market trend to understand

As you start your software search, be sure that you're informed about this latest market trend:

  • Lack of HIPAA technology experts slowing the adoption of cloud services: HIPAA-covered entities that store PHI on the cloud are required to assess related technology risks and keep data safe. However, due to a lack of IT professionals with HIPAA expertise, the transition to cloud-based systems is expected to remain slow in the near future.

Note: The application selected in this article is an example to show a feature in context and isn't intended as an endorsement or a recommendation. It has been obtained from sources believed to be reliable at the time of publication.