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What is ePHI?

Last updated

5 September 2023


Dovetail Editorial Team

Technology has moved us past paper records, providing us with a much faster way to search for and retrieve patient information. 

But there’s a unique issue with digital records: New security challenges. Healthcare providers who use electronic protected health information (ePHI) owe it to patients to understand the security implications. 

In this article, we'll discuss what exactly ePHI is and steps to safeguard it.

Defining ePHI and its distinction from PHI

Let's start by taking a closer look at ePHI. 

You may already be familiar with PHI or protected health information. This information links to a patient's health condition, payment history, or treatment plans. 

PHI can come in any form, although it is traditionally paper-based. As you’d expect, ePHI is electronic protected health information.

ePHI arose when electronic records became advanced enough for the medical industry to use them securely. These records include:

  • Electronic medical records

  • Diagnostic images

  • Treatment plans

  • Patient history

  • Billing information

  • Any electronic communications to or about a patient

The cornerstones of ePHI protection

Safeguarding ePHI isn't just a nice thing to do; it's a requirement under HIPAA. 

This legislation breaks down the requirements for ePHI protection into three cornerstones: Confidentiality, integrity, and availability. 

Each of these strives to provide the same protections for ePHI that have long existed for other types of PHI.


This safeguards data from prying eyes. Only authorized personnel should view ePHI and never disclose it in violation of HIPAA rules.


Electronic storage methods bring different challenges to the integrity of files. Since they are easier to modify than paper forms, healthcare providers must take extra care to ensure data integrity.


One of the biggest advantages of electronic data is that it's much easier for authorized users to access. The availability cornerstone aims to ensure it stays that way.

HIPAA Security Rule requirements for ePHI

HIPAA Security Rule safeguards three separate areas: Administrative, technical, and physical. HIPAA provides a comprehensive framework with specific requirements for each. 

Failure to comply with regulations for any area can result in hefty fines or other legal action. Of course, it can also cause a loss of patient trust, which can be devastating.

Administrative safeguards

This section of the requirements concerns the organizational policies, practices, and procedures related to ePHI. Some of the major areas of this section are:

Appointing a security officer

This person is responsible for supervising and coordinating security efforts. They monitor compliance, stay up-to-date on security threats, and identify vulnerabilities.

Conduct risk assessments

This involves identifying potential threats or vulnerabilities to ePHI and evaluating their potential impact. Using this information enables better prioritization of security efforts and resources.

Provide awareness training

The human factor is one of the biggest threats to data integrity. Awareness training ensures everyone with access to ePHI understands common risks and how to mitigate them.

Create a contingency plan

Even the best security practices fail sometimes. When they do, a step-by-step contingency plan outlining the response will minimize the damage caused by a breach.

Technical safeguards

The digital nature of ePHI sets it apart from other types of PHI. They require strict technical safeguards to maintain the cornerstones of ePHI protection. Some of the major points include:

  • Access control: Implement measures to restrict unauthorized access to ePHI.

  • Encryption: Encrypt ePHI to protect it from unauthorized access.

  • Audit controls: Use systems to track and record access to ePHI.

  • Integrity controls: Use methods such as hashing and digital signatures to ensure ePHI integrity.

  • Automatic logoff: Automatically log off users after a period of inactivity.

  • Data backup and recovery: Regularly back up ePHI using secure methods.

  • Device and media controls: Control access to devices and media that contain ePHI.

Physical safeguards

Although digital threats usually come to mind when it comes to data security, many breaches occur from physical access to the data. The physical safeguards mimic those for other types of PHI with some ePHI-specific requirements. Major points include:  

  • Facility access controls: Limit physical access to areas storing ePHI with secure locks.

  • Disposal procedures: Develop secure disposal protocols for devices and media with ePHI.

  • Security cameras: Use cameras and security systems to monitor areas where ePHI is stored or accessed.

  • Visitor access controls: Create policies to keep ePHI secure when visitors need access to areas where it is stored.

While technological advances make our lives easier, we have to be extra careful with safeguarding data. That’s especially important with confidential, personal data, like PHI. HIPAA ensures healthcare facilities treat ePHI correctly, protecting patient data from breaches. 

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