Discussion: View Thread

solo statistical consultatnts and PHI

  • 1.  solo statistical consultatnts and PHI

    Posted 04-12-2023 09:06

    In my "conventional" employment, I work with a lot of protected health information (PHI). The computers I work with it on are part of various organizational IT systems, with the attendant firewalls, malware protection, etc. These are, of course, of variable effectiveness--we all read the news about data breaches and system intrusions in many places.

    I take data privacy and digital security very seriously. Even behind those organizational defenses, I tend to use hardware-encrypted thumb drives (when one is necessary), whole-disk encryption where possible, public-key encryption, etc. Even have an air-gapped computer in one office.

    If things go to plan, I'll potentially be working with PHI in my solo consulting business--on my own computer, probably from home. How have other solo consultants handled this?   Again, I try to be serious about this. I run Linux at home with whole-disc encryption, have a VPN, and measures similar to the above. The difference is that there is no "corporate" IT department to take the hit if things go awry.

    And what is your approach to Business Associate Agreements" vis-a-vis HIPAA?

    I plan to get a "cyber-insurance" policy, along with typical E&O.

    Thanks for any insights.



    ------------------------------
    Christopher Ryan
    Clinical Associate Professor of Family Medicine
    SUNY Upstate Clinical Campus
    ------------------------------


  • 2.  RE: solo statistical consultatnts and PHI

    Posted 04-12-2023 09:41

    There are "Virtual CISO" (Chief Information Security Officer) services available. I know of small companies and consultants that use such offerings. 



    ------------------------------
    Scott Nestler
    Principal Data Scientist & Optimization Lead
    Sumer Sports LLC
    ------------------------------



  • 3.  RE: solo statistical consultatnts and PHI

    Posted 04-12-2023 12:14

    Do you have an option to use a laptop, thumbdrives and vpn etc. provided by the client? That may be something to discuss directly with client IT engineers.   Do you need or have SOP's (standard operating procedures) in place in case a client wants to review your HIPAA procedures and complance? 



    ------------------------------
    Chris Barker, Ph.D.
    2023 Chair Statistical Consulting Section
    Consultant and
    Adjunct Associate Professor of Biostatistics
    www.barkerstats.com


    ---
    "In composition you have all the time you want to decide what to say in 15 seconds, in improvisation you have 15 seconds."
    -Steve Lacy
    ------------------------------



  • 4.  RE: solo statistical consultatnts and PHI

    Posted 04-12-2023 22:58

    Hi Christopher,

    Great question! I am in the works of starting my own consulting business and having the same question around encryption. I have not started to investigate options, but I see that my account uses https://www.encyro.com/, which may have some of the functional capabilities you mentioned.

    If you are interested in sharing findings in investigating tools, I would love to share my thoughts on what I find. I will be also looking for programs that allows for sending and e-signing for contracts.

    Thanks,
    Sarah



    ------------------------------
    Sarah Kalicin
    ------------------------------



  • 5.  RE: solo statistical consultatnts and PHI

    Posted 04-13-2023 13:19

    I have been working with PHI for decades from my consulting business and have observed significant increases in security requirements from both the client and their sources. If you can bring the data in-house, I recommend requesting de-identified records that still suit the analytical requirements of your client. Otherwise, I agree with Chris Barker's suggestion, let your client handle security requirements on their platform which you can use for the required analysis. 



    ------------------------------
    Timothy Kenney
    Kenney IS Consulting, Inc.
    ------------------------------



  • 6.  RE: solo statistical consultatnts and PHI

    Posted 04-13-2023 13:38
    Yes, that's an interesting point Tim and Chris B bring up: using the
    client's computer systems for the analysis to obviate many of the
    concerns about data security. However, doesn't this raise a different
    problem, potentially--what software do you need or want to do the work,
    and is the client able and willing to make it available on their machines?

    Thanks.

    --Chris Ryan

    Timothy Kenney via American Statistical Association wrote:
    > I have been working with PHI for decades from my consulting business and
    > have observed significant increases in security requirements from
    > both... -posted to the "Statistical Consulting Section" community
    > Please note that using your email client's "Reply" option will send your
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  • 7.  RE: solo statistical consultatnts and PHI

    Posted 04-13-2023 14:28

    Permit me to mention, one of my several section chair (soon to be announced) initiatives  is "data privacy'.  I had posted a link to my article in amstat news about a data privacy issue I discovered and the motivation for my initiative .

    https://magazine.amstat.org/blog/2022/09/01/seerhaystack/ I will have more details about the initiative to share when  Sarah Kalicin our incoming new section communications /social media expert takes over the role. Sarah was most recently on COSGB (council of sections governing board)
    Its important  to mention  that CENSUS bureau and the corresponding ASA Census committee have done a considerable amount of work, including publications , on data privacy issues

    Based on the discussion here I will ensure that the  initiative to include recommendations for Statistical  consultants handling of HIPAA related privacy issues in their consulting work.  I work (worked ) in Pharma and there is always an executive, reporting to the CEO with responsibility for HIPAA compliance. Every pharma company has procedures about protecting privacy /HIPAA.  Simplest example is discovering that a patients name and/or SSN has been inadvertently written into comments on the data collection instruments. And Pharma has many vendors, such as CRO's who also must have HIPAA compliance procedures in place as a condition for contracting with the vendor.  a topic included in the data privacy initiative are the well known limitations of de-anonymization  - the NETFLIX/IMDB is one example. Thank you




    ------------------------------
    Chris Barker, Ph.D.
    2023 Chair Statistical Consulting Section
    Consultant and
    Adjunct Associate Professor of Biostatistics
    www.barkerstats.com


    ---
    "In composition you have all the time you want to decide what to say in 15 seconds, in improvisation you have 15 seconds."
    -Steve Lacy
    ------------------------------



  • 8.  RE: solo statistical consultatnts and PHI

    Posted 04-13-2023 13:52
    I agree that de-identification is always preferrable if possible. The
    "minimum necessary" principle. However, this puts some burdens on the
    client to prepare a suitable dataset. Do they know how to do it
    properly? I have not infrequently seen something like, "Oh, we omitted
    the addresses; we just used the zip codes," which doesn't cut it with
    HIPAA regs. (Besides which, outside of dense urban areas, zip codes are
    mostly an administrative convenience with little sociodemographic value
    in an analysis.)

    So de-identification itself can be a statistical job. Have you been in
    the position of helping the client to prepare the de-identified dataset
    in the first place, to enable it to be taken off-site for analysis?
    Perhaps that's a tenable middle ground.

    Thanks.

    --Chris Ryan

    Timothy Kenney via American Statistical Association wrote:
    > I have been working with PHI for decades from my consulting business and
    > have observed significant increases in security requirements from
    > both... -posted to the "Statistical Consulting Section" community
    > Please note that using your email client's "Reply" option will send your
    > response to all members of the discussion group. To send a private
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    > upper right of their post.
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    > Apr 13, 2023 1:19 PM
    > Timothy Kenney
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    >
    > I have been working with PHI for decades from my consulting business and
    > have observed significant increases in security requirements from both
    > the client and their sources. If you can bring the data in-house, I
    > recommend requesting de-identified records that still suit the
    > analytical requirements of your client. Otherwise, I agree with Chris
    > Barker's suggestion, let your client handle security requirements on
    > their platform which you can use for the required analysis.??
    >
    >
    >
    > ------------------------------
    > Timothy Kenney
    > Kenney IS Consulting, Inc.
    > ------------------------------
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    > -------------------------------------------
    > Original Message:
    > Sent: 04-12-2023 09:05
    > From: Christopher Ryan
    > Subject: solo statistical consultatnts and PHI
    >
    > In my "conventional" employment, I work with a lot of protected health
    > information (PHI). The computers I work with it on are part of various
    > organizational IT systems, with the attendant firewalls, malware
    > protection, etc. These are, of course, of variable effectiveness--we all
    > read the news about data breaches and system intrusions in many places.
    >
    > I take data privacy and digital security very seriously. Even behind
    > those organizational defenses, I tend to use hardware-encrypted thumb
    > drives (when one is necessary), whole-disk encryption where possible,
    > public-key encryption, etc. Even have an air-gapped computer in one office.
    >
    > If things go to plan, I'll potentially be working with PHI in my solo
    > consulting business--on my own computer, probably from home. How have
    > other solo consultants handled this????? Again, I try to be serious about
    > this. I run Linux at home with whole-disc encryption, have a VPN, and
    > measures similar to the above. The difference is that there is no
    > "corporate" IT department to take the hit if things go awry.
    >
    > And what is your approach to Business Associate Agreements" vis-a-vis HIPAA?
    >
    > I plan to get a "cyber-insurance" policy, along with typical E&O.
    >
    > Thanks for any insights.
    >
    >
    >
    > ------------------------------
    > Christopher Ryan
    > Clinical Associate Professor of Family Medicine
    > SUNY Upstate Clinical Campus
    > ------------------------------
    >
    >
    >
    >
    > ??
    >
    > You are subscribed to "Statistical Consulting Section" as
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    >
    >




  • 9.  RE: solo statistical consultatnts and PHI

    Posted 04-13-2023 15:03

    My most recent client, IBM, was tasked with providing national healthcare data (HCUP US) that was both public facing and for internal use only. The available public data was carefully de-identified, but even then there was concern  over the use of "vulnerability analysis or penetration testing" (from the data use agreement that users must complete). I was not involved in the process to de-identify the records, so I cannot comment on this.  To complicate the security issues further, each state that submits their data has specific data security requirements. To access the data for analysis I used an IBM laptop connected to the IBM secure network from my office. I also license the SAS product, but was not using it for this work.. For an other client I ran SAS on their system using their client's data, which satisfied their security agreement with the client.. For all this work I needed business specific security training. As any breech must be reported and documented, anyone  with access to the data must be certified as having been trained on procedure and process. It is a rigorous  process due to the potential  liabilities.



    ------------------------------
    Timothy Kenney
    Kenney IS Consulting, Inc.
    ------------------------------



  • 10.  RE: solo statistical consultatnts and PHI

    Posted 04-13-2023 15:51

    The requirement for Penetration testing "PEN testing"- in the EU/ (GDPR)  seems to arise from
    Regulation (EC) No 45/2001 (the Regulation)
    and this falls under the jurisdiction of the European Data Protection Supervisor (EDPS)
    https://edps.europa.eu/sites/edp/files/publication/it_governance_management_en.pdf

    There is a census bureau document that refers to penetration testing

    https://www2.census.gov/programs-surveys/decennial/2020/program-management/pmr-materials/08-03-2018/pmr-cybersecurity-08-03-2018.pdf 

    And one of the types of pen testing is "white box Pen testing" using ethical hackers

    https://www.makeuseof.com/what-is-whitebox-penetration-testing/
    A white-box penetration test is a type of test whereby the ethical hackers have full privileges and knowledge about the system or application they are carrying the simulated attack on. In a white-box penetration test, the pentester has complete information about the target, the system, the network architecture, the source codes, and login credentials. They have root or administrative privileges of the system. They carry out this using penetration testing tools and various cybersecurity strategies.

    There appear to be certification standards for ethical hackers 
    https://en.wikipedia.org/wiki/Certified_Ethical_Hacker

    there are types of ethical hackers, White Hat, Black Hat and Grey hat
    and some definitions (not clear to me if this is a peer reviewed article ) 
    https://www.sciencedirect.com/topics/computer-science/white-hat-hacker
    and a (for sale $) book chapter
    https://www.sciencedirect.com/science/article/pii/B9781597494250000063

    Rene Carmille may have been the "first" ethical hacker 
    Not clear to me why this references "statisticians"
    https://www.facebook.com/80000Hours/posts/1562286777186388/
    the ethical hack was not punching column 11 for religion on the Hollerith card 

    The IEEE newspaper, The Institute, describes Carmille as being an early ethical hacker: "Over the course of two years, Carmille and his group purposely delayed the process by mishandling the punch cards. He also hacked his own machines, reprogramming them so that they'd never punch information from Column 11 [which indicated religion] onto any census card." His work to identify and build in this exploit saved thousands of Jews from being rounded up and deported to death camps.



    ------------------------------
    Chris Barker, Ph.D.
    2023 Chair Statistical Consulting Section
    Consultant and
    Adjunct Associate Professor of Biostatistics
    www.barkerstats.com


    ---
    "In composition you have all the time you want to decide what to say in 15 seconds, in improvisation you have 15 seconds."
    -Steve Lacy
    ------------------------------



  • 11.  RE: solo statistical consultatnts and PHI

    Posted 04-13-2023 13:59

    an idea to explore: Dropbox has a paid option of HIPAA Compliance 



    ------------------------------
    Zhanna Galochkina
    Statistician
    ------------------------------