Most MSPs can handle a medical office's day-to-day IT. Fewer can navigate the compliance requirements that come with handling PHI.
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Business Associate Agreement
Any vendor who accesses, stores, or transmits PHI must sign a BAA before touching your systems. This includes your MSP, your cloud backup vendor, your email provider, and any platform where patient data flows. No BAA = HIPAA violation, even without a breach.
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PHI Encryption
HIPAA requires PHI to be encrypted at rest (on devices, servers, and backups) and in transit (email, file transfer, remote access). Device encryption (BitLocker/FileVault), encrypted email gateways, and TLS on all communications are baseline — not optional add-ons.
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Annual Risk Assessment
HIPAA's Security Rule requires a documented risk analysis at least annually and after significant changes to your environment. The risk assessment must identify all PHI locations, evaluate threats and vulnerabilities, and document remediation plans. It's also your primary defense in an HHS audit.
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Audit Logging
HIPAA requires audit controls — the ability to track who accessed what PHI, when, and from where. This means audit logging on your EHR, on your network, and on any system that touches patient data. Logs must be retained for 6 years and reviewed regularly for suspicious access patterns.
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Breach Notification
If PHI is breached, HIPAA requires notification to affected individuals within 60 days, to HHS, and (for breaches of 500+ records in a state) to major media. Your MSP needs a documented incident response plan and experience executing breach notifications — including what to send HHS and how.
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EHR Integration
Your EHR platform — Epic, Athenahealth, Dentrix, Kareo, or others — has specific IT infrastructure requirements, support channels, and integration dependencies. An MSP who has worked with your EHR before will know what questions to ask and what not to touch. One who hasn't may break something they can't fix.