Setting up a HIPAA-compliant VoIP system isn’t as simple as picking a certified provider and calling it a day. You need to train staff on HIPAA regulations, keep track of your compliance efforts, self-audit to identify any potential non-compliance issues, and establish a solid Business Associate Agreement (BAA) with your VoIP provider. 

We’ll help you understand HIPAA requirements and how to have a compliant VoIP system so you can operate your business confidently and securely.

A Bird’s Eye View of HIPAA Requirements

Understanding the ins and outs of HIPAA is critical before delving into the technical and administrative measures required for compliance, especially for VoIP communications.

Here are the core tenets of modern HIPAA requirements:

  • Privacy Rule—The Privacy Rule protects the confidentiality of Protected Health Information (PHI) in any form, whether it’s electronic, paper, or oral. It identifies who can access PHI and when you can disclose it, and it gives individuals the right to access their own health information. It also requires organizations to notify individuals about their privacy practices and ensure adequate measures are in place to prevent unauthorized access to PHI.
  • Security Rule—This rule zeroes in on electronic protected health information (ePHI). It requires administrative, physical, and technical safeguards to protect ePHI from unauthorized access. These safeguards include access, audit, and integrity controls and transmission security.
  • Breach Notification Rule—This rule kicks in when a breach involves unsecured PHI. It requires that your company and business associates provide notification of the breach to affected individuals, the Secretary of Health and Human Services, and, in certain cases, the media. You must make these notifications within 60 days of discovering the breach.
  • Omnibus Rule—Enacted in 2013, this rule enhances patient privacy protections, provides individuals with new rights regarding their genetic information, and strengthens the government’s ability to enforce the law. It extends the requirements of HIPAA to business associates of covered entities and contains modifications to the breach notification rule, among other provisions.

The Intersection of Unified Communications and HIPAA-Compliant VoIP

When you’re thinking about HIPAA-compliant VoIP, you need to approach it from all angles: the technology itself, any legal agreements that are in place, and your organization’s policies.

Each facet, from the encryption protocols to the legal agreements, plays a crucial role in ensuring PHI remains protected, no matter which means of communication you’re using.

Here’s how HIPAA rules affect your business communications:

  • Multi-channel communications—SMS, fax, video, and voice are common communication channels in modern business settings through which PHI can be shared. These all fall under the purview of HIPAA, and each channel needs to be properly secured.
  • Authentication and access control—Every user in your VoIP system should have a unique user ID. This ensures that every action taken within the system can be tracked to a specific individual, which is crucial for accountability and auditing purposes.
  • Encryption—Data must be encrypted while in transit (being shared) and at rest (being stored). This ensures the data is safe from interception and unauthorized access, whether it’s being transmitted through a video call or stored in the cloud.
  • Call recording and storage—VoIP systems often have call recording features. Any call recordings containing PHI must be securely stored and encrypted to ensure the information stays confidential. Secure storage solutions should have access controls to ensure only authorized personnel can retrieve these recordings.
  • Business Associate Agreement (BAA)—HIPAA requires that you have an official BAA between your company and your VoIP provider. This agreement lays out the responsibilities of both parties regarding the handling and safeguarding of PHI. It’s a crucial document that forms the legal foundation for ensuring that the VoIP provider will comply with HIPAA requirements.

Seven Steps to a HIPAA-Compliant VoIP System

To ensure HIPAA compliance within your VoIP system, you need to pay close attention to both technical and administrative details within each step of the process. Start with choosing the right platform, then make sure you’re following all compliance requirements, training your employees, and performing regular audits.

Step 1: Choose a secure and reliable VoIP platform

Chart showing three plans offered by Nextiva for HIPAA compliant business communication plans.

Opt for a platform that supports essential features like voicemail recording, encrypted SMS and messaging, secure storage, call recording, disaster recovery, interactive voice response (IVR), and live call monitoring. Research the best VoIP providers and evaluate them based on their abilities to meet HIPAA requirements and overall VoIP quality

Step 2: Configure the VoIP platform to meet HIPAA requirements

VoIP platforms may not be HIPAA compliant out of the box. Work with your provider to turn certain features on or off to ensure compliance. Set up automatic call recording, configure secure storage and backups, establish unique user IDs and access controls, and ensure voicemail recordings are secure.

Step 3: Sign a BAA with your VoIP provider

Establish a Business Associate Agreement with your VoIP provider. This legal document lays out the responsibilities of both parties to ensure your patients’ health information is protected.

Step 4: Update your documentation

Make sure you’re documenting procedures to ensure the confidentiality, integrity, and availability of ePHI. Create a comprehensive plan to respond to breaches, perform assessments and audits, manage disaster recovery and backups, and handle access controls.

Step 5: Train your employees

Implement annual educational programs focusing on HIPAA regulations and cybersecurity norms to ensure staff members are well-versed in the correct procedures for handling PHI, such as avoiding unauthorized sharing.

Step 6: Conduct annual self-audits

Regular self-audits are crucial for identifying potential problem areas and making necessary adjustments to maintain compliance. While you should be performing annual self-audits at a minimum, you may want to consider more regular audits, especially if you have new staff members.

Step 7: Report incidents and notify impacted users promptly

In the event of a breach or unauthorized disclosure of PHI, follow HIPAA’s Breach Notification Rule for letting people know about a breach.

What Happens if You Don’t Meet HIPAA Requirements?

Non-compliance can lead to hefty fines ranging from $100 to $50,000 per violation, with a maximum penalty of $1.5 million per year. It can also cause irreversible damage to your company’s reputation and, in extreme cases, result in criminal charges.

If you discover any potential compliance issues, take immediate corrective action and consult with legal experts to minimize consequences.

Examples of Non-Compliant VoIP Communications

Navigating HIPAA compliance can be challenging when using VoIP, as unintentional violations often occur due to gaps in security measures or employee training.

To show you what we mean, here are some VoIP communication examples that might seem okay at first glance but actually aren’t.

  • Texting patient information without encryption—A nurse texts another healthcare provider details about a patient’s medication, but the platform doesn’t have encryption security. This violates HIPAA’s transmission security requirements because it exposes PHI to potential unauthorized access.
  • Recording a call without consent—A healthcare provider uses a VoIP system with call recording features to record a conversation with a patient but fails to obtain the patient’s consent beforehand. Recording a conversation that includes sensitive patient information without obtaining explicit consent violates the patient’s privacy rights under HIPAA.

Unauthorized sharing on conference calls—During a conference call, a doctor mentions details about a specific patient’s x-ray results, but not everyone on the call is authorized to hear this information. This violates HIPAA’s minimum necessary rule, which stipulates that only those directly involved in a patient’s care should have access to their medical information.