HIPAA CONTINGENCY PLAN


 

 

 

HIPAA CONTINGENCY PLAN

Step 1 Upper Management Commitment - Contingency planning either commences here, or dies here.  This is often the most difficult obstacle to overcome.   However, if you are developing a contingency plan to become compliant with the HIPAA regulation, you should already have a commitment to the process.  If you dont, finish reading this article and discuss this with your management.   

Once the commitment is obtained, it is recommended that a Coordinator be appointed to act as a facilitator for the entire contingency planning process.

Step 1 is required before starting to work on any implementation specification

Step 2 - Risk Assessment Given a choice, disaster avoidance is a far more desirable option than attempting to recover from one.  To accomplish this, the simplest process is to perform a risk assessment, and subsequently remove the exposure(s).

Step 2 is not a direct requirement, however information gathered in this step will be helpful in completing Implementation Specification (iiC), emergency mode operation plan.

Step 3 - Business Impact Analysis and Recovery Strategy -  A business impact analysis (BIA) is a straightforward process designed to understand each business unit, and what each contributes.   What would happen if the unit could not function for 8 hours, a day, 2 days, a week, month or more?  What would it cost the business in lost revenue, both immediate and long term?  Would the inability of this unit to function impact other units?  Could you loose future customers?

BRProactives Introduction and Guide explains the process

Step 3 will meet the requirements of HIPAA Implementation Specification  (iiE) An Applications and Data Criticality Analysis.  It will also provide preliminary information required for HIPAA Implementation Specifications  - (iiB) disaster recovery plan, (iiC) emergency mode operations plan, and (iiE) applications and data criticality analysis.  

Step 4 - Offsite Storage of Critical Data   The identification and subsequent storage of both hardcopy and electronic information, OFFSITE, should be your number one priority.  At a minimum weekly, or preferably daily, full volume backups must be taken.  These backups, along with hard copy documentation, must be sent offsite to another location (another room or another floor is not an option).  Once you have established this process, ensure that it is documented and that you perform a quarterly review of the material you are sending. 

BRProactive’s Introduction and Guide explains the process and provides recommendations

If you rely on information technology to run your business,  offsite storage should not be considered an option.  Instead, this process should become a routine reality.

Step 4 will meet the requirements of HIPAA Implementation Specification:  (iiA) data backup plan. 

Step 5 - Disaster Recovery Plan A disaster recovery plan is a collection of specific recovery team plans.  Attempting a recovery without one is as much fun as a long walk down a short pier.   Each recovery team plan documents specific activities that each recovery team will perform in the event of a disaster.  Examples of recovery teams are: Crisis Management, Damage Assessment, Information Systems, Business Unit, Voice and Data, Corporate, etc.  Each recovery team plan, when fully developed, provides a detailed and systematic set of instructions that team leaders and members would follow in an emergency.  In essence, each recovery team plan documents:

To further control the recovery process, all recovery team plans are logically broken down into stages, sections and tasks.  Each stage (response, recovery, resumption, reconstruction and relocation), and section in a recovery team plan provides general direction.  Each task provides the detailed specific instructions on a required activity, and how to perform a function.

BRProactive provides the comprehensive templates for you to complete your plan

Remember, in a disaster, you cannot rely on key staff members being available. Therefore, the information contained within the recovery plan should allow others to understand the process, and step in.

Step 5 will meet the requirements of HIPAA Implementation Features:  (iiB) a disaster recovery plan and (iiC) emergency mode operation plan

Step 6 - A Recovery Location When your recovery plan is fully developed, you have positioned your business to recover in the event of a disaster.  At this point, you will want to consider an outside recovery service provider.  Generally, the services they provide can be two fold:

BRProactive’s Introduction and Guide explains the process and options

Step 6 will meet the requirements of HIPAA Implementation Specification: (iiC) emergency mode operation plan

Step 7 - A Tested Plan Finally, no recovery plan is ever completed.  It is a constantly changing and evolving document that is modified as your business changes.  One of the best ways to check the accuracy and logic of your recovery plan is to run an actual test, following the instructions outlined within, step-by-step.  Should any errors or omissions be uncovered, changes in the plan must be made.  This can be done at an offsite location, or with a table top desk exercise.  An annual test should be conducted at a minimum, with a twice a year test being ideal.

BRProactives Introduction and Guide explains the process and the required steps

Step 7 will meet the requirements of HIPAA Implementation Specification:  (iiD) testing and revision procedures

Contingency Plan Summary: Should a disaster impact your company, an up-to-date and fully functional contingency plan is priceless.  However, to get one requires a price to be paid as you go.  Commitment within Step 1 gets you going.  Step 2 identifies and reduces risk.  Steps 3 through 5 provide you with the recovery plan and the critical information and files needed for the recovery.  And finally, Steps 6 & 7 give your business a location to recovery at, and a place to test your recovery plan.

BRProactive provides you with the disaster recovery plan development software, and the necessary information to become HIPAA compliant in this section of the Security Standard.  It is a simple, straightforward and cost effective solution.

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