mukul975/privacy-data-protection-skills

hipaa-phi-inventory

- Conducts comprehensive inventory of protected health information across the enterprise per HIPAA Security Rule requirements at 45 CFR §164.308(a)(1)(ii)(A) and §164.310(d).

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Verwendung

  1. Installationsbefehl kopieren und das Quellpaket vor der Installation in der eigenen Agentenumgebung prüfen.
  2. Benötigte Werkzeuge, Zugangsdaten und Hosts im Original prüfen.
  3. Eingabe und gewünschtes Ergebnis beschreiben und die Ausgabe mit den Quellen abgleichen.
npx skills add https://github.com/mukul975/privacy-data-protection-skills --skill hipaa-phi-inventory

Vor dem Start

  • Die Installation umfasst weder Modellabo noch API-Kontingent oder Dateizugriffsrechte.
  • Sterne und Installationen zeigen Aktivität, keine unabhängige Qualitäts- oder Sicherheitsprüfung.
Originales Skill-Dokument

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HIPAA PHI Inventory — ePHI Asset Identification and Data Flow Mapping

Overview

The HIPAA Security Rule at 45 CFR §164.308(a)(1)(ii)(A) requires covered entities and business associates to conduct an accurate and thorough assessment of potential risks and vulnerabilities to the confidentiality, integrity, and availability of ePHI held by the entity. This risk analysis is impossible without first knowing where ePHI resides, how it flows, and who has access. The PHI inventory is the foundational step of HIPAA compliance, supporting risk analysis (§164.308(a)(1)), access management (§164.312(a)), device and media controls (§164.310(d)), and business associate management (§164.502(e)).

Regulatory Framework

Security Rule — Risk Analysis Foundation

  • §164.308(a)(1)(ii)(A): Conduct an accurate and thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of ePHI held by the covered entity or business associate
  • §164.310(d)(1): Implement policies and procedures that govern the receipt and removal of hardware and electronic media that contain ePHI into and out of a facility, and the movement of these items within the facility
  • §164.312(a)(1): Implement technical policies and procedures for electronic information systems that maintain ePHI to allow access only to persons or software programs that have been granted access rights

OCR Risk Analysis Guidance

OCR guidance identifies the first step of risk analysis as: "Identify where ePHI is created, received, maintained, or transmitted." This requires a comprehensive inventory covering:

  1. All electronic media and systems that create, receive, maintain, or transmit ePHI
  2. All locations where ePHI is stored (on-premises, cloud, mobile, removable media)
  3. All network paths over which ePHI is transmitted
  4. All workforce members and roles with access to ePHI
  5. All business associates that create, receive, maintain, or transmit ePHI

PHI Identifiers — 45 CFR §160.103

PHI includes individually identifiable health information transmitted or maintained in any form that relates to past, present, or future physical or mental health condition, provision of healthcare, or payment for healthcare. The 18 HIPAA identifiers are:

#IdentifierExamples
1NamesFull name, maiden name
2Geographic data smaller than stateStreet address, city, ZIP code
3Dates related to individualBirth date, admission date, discharge date, date of death
4Phone numbersHome, mobile, work
5Fax numbersAll fax numbers
6Email addressesPersonal and work email
7Social Security numbersSSN
8Medical record numbersMRN, chart number
9Health plan beneficiary numbersInsurance ID, member ID
10Account numbersPatient account, billing account
11Certificate/license numbersProfessional license, birth certificate
12Vehicle identifiers and serial numbersVIN, license plate
13Device identifiers and serial numbersImplant serial, medical device ID
14Web URLsPatient portal URLs, personal websites
15IP addressesDevice IP addresses
16Biometric identifiersFingerprints, retinal scans, voiceprints
17Full-face photographsPhotos, images
18Any other unique identifying numberAny code or characteristic that could identify an individual

PHI Inventory Categories

System Inventory

System CategoryExamplesTypical PHI Content
Electronic Health Record (EHR)Epic, Cerner, MEDITECHComplete clinical records, demographics, diagnoses, medications, lab results
Practice Management SystemAthenahealth, eClinicalWorksScheduling, demographics, insurance, billing
Laboratory Information System (LIS)Sunquest, OrchardLab orders, results, specimen data
Radiology (PACS/RIS)Change Healthcare, SectraImaging studies, radiology reports, patient demographics
Pharmacy SystemPyxis, OmnicellMedication orders, dispensing records, patient allergies
Billing/Revenue CycleWaystar, R1 RCMClaims, EOBs, patient financial data, demographics
Patient PortalMyChart, Cerner HealthPatient-accessible clinical data, messages, appointments
Telehealth PlatformZoom for Healthcare, AmwellSession recordings, clinical notes, patient identity
Email SystemMicrosoft 365, Google WorkspaceePHI in attachments and message body
File SharesNetwork drives, SharePointUnstructured clinical documents, reports
Mobile DevicesSmartphones, tabletsEHR access, clinical photos, messaging
Medical DevicesInfusion pumps, monitorsPatient vitals, device-patient association
Backup SystemsCommvault, VeeamComplete copies of all source system ePHI

Data Flow Categories

Flow TypeSourceDestinationMethodEncryption
Clinical documentationProvider workstationEHR databaseHTTPSTLS 1.2+
Lab orders/resultsEHRLISHL7v2 / FHIRTLS 1.2+
Claims submissionBilling systemClearinghouse/payerEDI 837TLS 1.2+
Patient portal accessPatient devicePortal serverHTTPSTLS 1.2+
HIE exchangeEHRHIE/HINFHIR / DirectTLS 1.2+
BA data sharingCE systemBA systemSFTP/APITLS 1.2+
BackupProduction systemsBackup storageBackup agentAES-256
Mobile accessMobile deviceEHR (Citrix/VPN)VPN + HTTPSTLS 1.2+

Integration Points

  • hipaa-risk-analysis: PHI inventory is the required first step of risk analysis per §164.308(a)(1)
  • hipaa-security-rule: Inventory supports access control, audit, and device/media controls
  • hipaa-minimum-necessary: Inventory informs role-based access to specific PHI categories
  • hipaa-baa-management: Inventory identifies all BAs that create, receive, maintain, or transmit PHI
  • hipaa-breach-notification: Inventory determines scope of breach impact assessment

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