Cloud solutions for healthcare bring in a myriad of features and conveniences for healthcare organizations. However, as health care providers look to move their data storage to the cloud, cloud security concerns should not be underestimated when handling ePHI. In a time when ePHI is becoming increasingly cloud-based, it’s important to ensure ePHI remains secure. ePHI refers to electronic personal health information that can be used to identify an individual or that relates in some way to their health care. Healthcare ePHI is the most sensitive data that a company has to deal with. This data must be protected at all costs because it could lead to identity theft, medical fraud, and other serious complications..  

But what exactly is ePHI and how can we keep it safe in the cloud? This article will explain the definition of PHI and ePHI, HIPAA ePHI requirements, ePHI guidelines, and the best practices for keeping ePHI secure on your cloud storage system so you don’t have any security breaches! 

ePHI definition- What does ePHI stand for?

ePHI stands for Electronic Protected Health Information. ePHI refers to electronic personal health information that can be used to identify an individual or relate in some way to their health care. Examples of EPHI are patient records, prescription orders, billing information, and medical imaging reports that are stored electronically.


Protected Health Information or PHI is identifiable health information that a covered entity (organizations that directly handles sensitive patient data) or a business associate uses, maintains, stores or transmits as a part of healthcare services. PHI refers to medical records and any other information that can be used to identify the patient. ePHI or Electronic Protected Health refers to the PHI which is held or transferred in electronic form. 

HIPAA ePHI Requirements

All organizations that directly handle ePHI, including hospitals, doctors’ offices, and health insurance providers must abide by HIPAA Security Rule guidelines when handling ePHI. Under HIPAA, any information that can be used to identify a patient is considered protected health information. It states that ePHI includes any of the 18 distinct demographics- name, address, dates, telephone number, fax number, email address, social security number, medical record number, health plan beneficiary number, account number, certificate number, license plate numbers, device identifiers, web URLs, IP address, biometric identifiers, full-face photos, and other unique identifying numbers that can be used to identify a patient.

HIPAA privacy rules state that PHI can generally only be used to furnish medical services and process payments. Only in special circumstances, such as under a court-ordered warrant, these details can be released to the authorized persons. It also sets standards for the storage and transmission of ePHI. This includes providing a unique account for each user, enabling multi-factor authentication, recording all access and changes to ePHI. The only way that EPHI is allowed by law to be transferred electronically is through secure messaging. EPHI can’t be sent by text message, email, or any other type of electronic communication that doesn’t have encryption to protect the data from being accessed without authorization. HIPAA sets specific standards for the confidentiality, integrity, and availability of ePHI: 

  • Confidentiality: Not disclosing ePHI without proper patient authorization.
  • Integrity: Ensuring that ePHI is only accessed by appropriate and authorized parties.
  • Availability: Allowing patients to access their ePHI in accordance with the HIPAA security standards.

Best Practices to Keep ePHI Secure in Cloud

  1. End-to-End Encryption

The first step in ensuring ePHI stays intact on your storage system would involve encryption options such as AES 128-bit encrypted file systems where each user has an account with only the necessary ePHI to do their job. True end-to-end encryption is crucial for keeping ePHI secure in the cloud. ePHI should never be stored or transmitted in unencrypted form. Encrypting data at rest and using key management to protect encryption keys is an important step for securely storing ePHI in the cloud.

  1. Ensuring Network Security

Ensuring network security by setting up firewalls on the organization’s website and systems increases network security and prevents intrusion. Install anti-virus software and malware detection tools on computer systems across the organization. Moreover, healthcare applications need to be fast, accurate, and reliable to save lives. So, poor network security and performance in the cloud can be a barrier for healthcare organizations to provide remarkable services. So, building network security in your organization helps keep ePHI secure in the Cloud.

  1. Choose a reliable cloud service provider

In most cases, while healthcare organizations are responsible for the basic security, configuration, and other aspects of cloud services, the cloud service provider is responsible for managing the infrastructure components and physical security of the cloud data centers. So, choosing a reliable cloud service provider must be your top priority. A reliable cloud service provider will provide you with an agreement that outlines what security they provide and what security is configurable by the organization. 

  1. Business Associate Agreement

As a healthcare provider, a Business Associate Agreement (BAA) must be one of the most important things in your checklist if you’re entering into a partnership with a cloud-based data company. In fact, BAA is the first line of defense should a healthcare organization ever face a data breach problem. HIPAA requires a Business Associate Addendum between the covered entity (healthcare provider) and a business associate such as a cloud service provider.

  1. Always Backup data

Although building a solid in-house cloud architecture or choosing a reliable cloud service provider is sufficient to keep your ePHI secure in the cloud, you can never be too safe. With all the important and sensitive files being shared and transferred in the cloud, having a backup storage solution guarantees its safety in the event of a system crash or attack. So, backing up your cloud data offers even more protection for your files in the cloud.  

If ePHI is not secured on your cloud storage system, it can lead to data breaches which would result in a company’s reputation being tarnished and could even incur fines or penalties by the state attorney general. So, for a healthcare organization, making sure ePHI is as safe as possible in the cloud must be a top priority. This is where we can help. At Intone, we collaborate and win with our clients to deliver exceptional cyber risks strategies and execution capabilities. We will help you deliver the best defense by developing the best offense.