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HIPAA challenges: top roadblocks to compliance
The Health Insurance Portability and Accountability Act (HIPAA) affects thousands of companies around the U.S., including many that support health care providers instead of delivering care directly themselves.
Many organizations find HIPAA compliance challenging. The U.S. Department of Health and Human Services has found organizations non-compliant with HIPAA in 67 percent of its investigations, and large-scale breaches, such as at Anthem and Premera Blue Cross, have made headlines and clearly demonstrated the severity of the threat posed by hackers.
The difference between the data handling practices of the compliant 33 percent and the non-compliant 67 percent frequently comes down to a single change or set of changes. In data collection, storage, and transmission, the details are important, and a small adjustment can be the difference between a hefty fine and a sterling reputation.
HealthITSecurity.com polled its readers about HIPAA compliance and audit challenges in 2016 and found that external data security threats are the top concern for 32 percent of healthcare IT professionals, slightly ahead of both employee training and evolving technology, each the top concern for 28 percent of respondents.
The Office of Civil Rights (OCR), which enforces HIPAA compliance for the Department of Health and Human Services, reviewed over 100 healthcare institutions in 2017 and found the vast majority struggling with information security risk planning, performing security risks analysis, providing patient’s access to their personal health information (PHI), as well as providing notifications of privacy practices and breach notifications. For small and medium-sized businesses, there are many potentially challenging requirements of HIPAA. Start with some of the most common issues, like those below, because one or more of them seem to apply to most HIPAA covered entities or business associates.
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HIPAA challenges
HIPAA challenges center on balancing patient privacy with operational efficiency, securing PHI across multiple systems, and ensuring staff and vendors follow strict compliance rules. Healthcare providers, payers, and business associates often struggle with technical safeguards, staff training, and evolving cyberthreats.
Common HIPAA challenges include improper disclosure of PHI, inadequate staff training, weak access controls, unsecured devices, and failure to conduct regular risk assessments.
Even small oversights, like mishandling records or failing to secure devices, can put an organization at risk of violations.
Top 10 HIPAA compliance concerns and challenges
Organizations face many compliance hurdles, but some come up more often than others. These are the ten most common HIPAA challenges:
- Improper disclosure of PHI – Unauthorized sharing of patient data, whether intentional or accidental, is one of the most frequent violations. This includes talking about patients in public areas, sharing information with the wrong recipient, or releasing records without proper authorization.
- Insufficient staff training – Employees who aren’t fully trained on HIPAA rules may mishandle data, fall for phishing scams, or improperly use communication tools. Consistent training is crucial to compliance.
- Unsecured electronic devices – Laptops, mobile phones, and tablets often store or access PHI. Without encryption, passwords, or remote wipe capabilities, stolen or lost devices can quickly become a liability.
- Weak access controls – Allowing too many people access to PHI or failing to limit access by job role creates unnecessary risk. Role-based access control is a HIPAA requirement often overlooked.
- Inadequate data encryption – PHI transmitted via email, stored in databases, or moved across networks must be encrypted. Failure to implement strong encryption leaves sensitive data vulnerable to interception.
- Poor audit trails and monitoring – HIPAA requires audit controls to track who accesses PHI and when. Many organizations don’t have proper logging systems, making it difficult to detect unauthorized access.
- Third-party risks – Business associates such as billing companies, cloud providers, and contractors also handle PHI. Without proper agreements and oversight, their practices may put your compliance at risk.
- Physical security gaps – Unauthorized access to paper records, unlocked file cabinets, or unmonitored storage areas can be just as damaging as a digital breach. Physical safeguards are often overlooked in favor of digital ones.
- Failure to conduct risk assessments – Regular risk assessments help organizations identify vulnerabilities and compliance gaps. Many fail to perform them consistently or document them properly, leading to exposure.
- Delayed breach response – HIPAA requires timely breach notification. Organizations that hesitate to report or fail to follow the breach notification rule face greater penalties and reputational damage.
HIPAA violation consequences
When organizations fail to comply with HIPAA, the consequences can be severe. Financial penalties range from thousands to millions of dollars, depending on the severity and frequency of violations. Beyond fines, organizations may face lawsuits, reputational damage, loss of patient trust, and even criminal charges for willful neglect.
For more details about specific types of violations and the four penalty tiers, see our dedicated article on HIPAA Violations →.
Addressing HIPAA challenges head-on
Compliance is possible with proactive planning and continuous improvement. Organizations can minimize risks by adopting these best practices:
- Conduct regular training – Keep staff updated on HIPAA requirements, phishing threats, and secure communication practices.
- Implement strong access controls – Use role-based access, multi-factor authentication, and strict user provisioning policies.
- Encrypt all PHI – Ensure data is encrypted both at rest and in transit to protect against breaches.
- Audit and monitor activity – Maintain detailed logs of PHI access and regularly review them for unusual activity.
- Strengthen vendor oversight – Require signed business associate agreements and evaluate third-party compliance efforts.
- Perform risk assessments – Document and act on vulnerabilities identified during assessments to maintain ongoing compliance.
- Establish a breach response plan – Prepare clear procedures for breach reporting, patient notification, and mitigation.
HIPAA compliant hosting challenges
When PHI is stored or transmitted through hosted environments such as web applications, databases, or patient portals, compliance becomes more complex. Organizations must ensure that every layer of hosting—servers, networks, and applications—meets HIPAA security requirements.
Common HIPAA hosting challenges include:
- Shared environments – Traditional shared hosting often lacks the isolation required for HIPAA compliance, leaving PHI exposed to cross-tenant risks.
- Encryption gaps – Data at rest in databases or in transit over web apps must be encrypted. Misconfigured SSL/TLS certificates or unencrypted backups can create compliance violations.
- Improper access controls – Hosting platforms must limit database and application access through role-based permissions, secure authentication, and monitoring. Without this, unauthorized staff or vendors may access PHI.
- Insufficient logging and monitoring – HIPAA requires audit trails of who accessed PHI and when. Many hosting setups lack adequate monitoring tools, making it difficult to track suspicious behavior or breaches.
- Third-party dependencies – Using third-party plugins, APIs, or cloud services introduces risk if those vendors don’t follow HIPAA standards or sign Business Associate Agreements (BAAs).
- Disaster recovery and backups – Backups must also comply with HIPAA. Unsecured or improperly stored backups are a frequent point of failure in hosted environments.
These challenges highlight why healthcare organizations often turn to HIPAA-compliant hosting providers that offer secure infrastructure, signed BAAs, and built-in compliance safeguards.
FAQs on HIPAA challenges
Getting started on HIPAA compliance
HIPAA compliance is straightforward, but not necessarily easy. There are several crucial considerations to stay on top of.
One way to simplify compliance is to work with a hosting provider who understands the unique needs of the healthcare industry.
That’s why Liquid Web offers HIPAA-audited hosting solutions with superior physical and technical security. A thorough review by third-party auditors confirms that Liquid Web solutions align with HIPAA security and privacy guidelines, allowing customers to more easily maintain compliance.
Click below to explore options or start a chat with one of our hosting experts now.
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Additional resources
What is HIPAA-compliant hosting? →
A complete beginner’s guide
Scaling a compliant cloud →
How to scale up without compromising security
HIPAA guide for small business →
A complete resources for medical SMBs
Jerry Vasquez brings decades of leadership experience to his role as Product Manager at Liquid Web, focusing on networking and security products. When not working or sleeping, Jerry can usually be found eating and having a good conversation with good people.