8 ms·

Ask HN: HIPAA Hosting?

14 points by kgrin 16y ago

My consulting company is working with a client to make some changes to their webapp (it's a health-care-related app - details aren't super-relevant). One of the items on their wishlist is "make it HIPAA-compliant". We're working with the client's lawyer to determine exactly what that means in practice, but it's clear that one of the items will be "host it on infrastructure other than the $10/mo. WebFaction plan". The app itself is (relatively) simple systems-wise, so we don't really need a dedicated box and all the sysadmin and security headaches that come with it. But from my basic read of the HIPAA Security Rule, shared hosting (which abstracts away a lot of the sysadmin issues) won't cut it. We're primarily developers, not sysadmins, and certainly don't want to get into the server admin business on something with regulatory requirements. Does anyone here have suggestions for either a host that can make this less painful (not even sure what that would entail), or a firm that specializes in the sysadmin side of things? (Preferably with HIPAA experience).

notmyname 16y ago
No shared hosting seems to imply that VPS won't cut it either--depends on what "shared hosting" really means. So you are left with looking for a dedicated hosting plan. I'd say check out a company like Rackspace (disclosure: I work there).
- kgrin 16y ago
  Happy to use Rackspace or another dedicated server provider... the trick is that we don't want to be responsible for, say, security patches to the kernel. So really the question is: is there a company that'll manage the damn server(s) for us so that we get to deal with a nice, clean abstraction similar to shared hosting? Basically I want a HIPAA-compliant Heroku (though in this case not for Ruby).
- CWuestefeld 16y ago
  depends on what "shared hosting" really means I think that's the key. My employer hopes that a virtual machine on a private VLAN, with a fully-encrypted virtual disk, qualifies. This seems reasonable to me, but reasonableness isn't necessarily a part of any regulation.
  - thaumaturgy 16y ago
    FWIW, I think I recall the OpenBSD devs coming out pretty hard against considering a VPS to be "secure" in most senses of the word; they seem to have thought that there were theoretical ways for VPSs to on the same machine to break through their respective barriers. I can't find any links about this though and it's been months since I've kept up on OpenBSD-misc, so I might be full of shit. Personally, I would tend to choose a theoretically-insecure VPS over a vhost environment any day.
  - hmahncke 16y ago
    I don't know of a specific rule that prevents shared hosting - and if you do, I'd love to see it (as I mentioned, by company is in the middle of a similar process). What is clear is that you have to document access and changes, which could be trickier in a shared hosting environment. But if the host itself has processes in place, and documents them to you, you should be fine.
kls 16y ago
The first company that gets to a certified HIPAA and PCI hosting cloud is going to have to figure out what to do with the buckets of cash they have lying around. I think for the enterprise PCI certification will be the event that gets the big (non-tech) guys out of running their own infrastructure. I would imagine that it would be the same for medical. As for you immediate question, I am sorry I can't help I don't know who if anyone is doing this. I am still looking for a PCI certified cloud as a portion of my customers are Public companies and not having to work on all their different infrastructures and being able to provide them a hosted solution would be great for me, but there is no way I could get into managing a PCI certified hardware infrastructure just to achieve that goal.
- 16s 16y ago
  As a point of clarification... HIPPA is a federal law. PCI is an industry standard (VISA, Mastercard, etc). That does not mean one is better than the other, I just wanted to clarify.
  - kls 16y ago
    Yes, I am aware of the difference but thanks for the clarification. My point was more to the fact that a specialized cloud provider could really fill a needed void here on both counts.
- zorkerman 16y ago
  I agree it would be great, I've gotten letters from Amazon that it is hipaa compliant but not PCI, and from rackspace that it is pci compliant but not hipaa.
  - kls 16y ago
    I did not know that Rackspace is PCI compliant. Thanks for that info.
hmahncke 16y ago
HIPAA is more about documenting your intended process, and your actual actions, than it is about requiring any particular solutions provider. For example, it's entirely possible to build a HIPAA compliant web app on AWS: http://aws.typepad.com/aws/2009/04/white-paper-creating-hipaacompliant-medical-data-applications-with-amazon-web-services.html http://aws.typepad.com/aws/2009/04/white-paper-creating-hipa... My company is in the middle of this, and we haven't encountered any deal-breakers so far.
- Kadrith 16y ago
  A system built from scratch can meet HIPAA, and HITECH, without much more than good security. The issue is often with companies that give security an afterthought or have older software that needs to be "made secure." The key to that link is encryption; it gets Amazon off the hook for a lot of things.
keyist 16y ago
Had to research this before. Firehost is one of the names that came up often: http://www.firehost.com/secure-hosting/hipaa http://www.firehost.com/secure-hosting/hipaa Their plans start from $845 monthly. No affiliation, just passing info along. You can't just rely on the provider though. All the server hardening in the world wouldn't help with apps that don't comply fully. Some of the audit requirements are bound to be very specific to the nature of your app.
- thaumaturgy 16y ago
  I was curious what $845/month got you, so just for fun I looked. From the features part of that page: 1. Log Monitoring and Management: Not sure what they mean by this; surely it's something more complex than logrotate. Maybe rsyslog or something? 2. Continuous Vulnerability Monitoring: So, they follow the usual script sites & mailing lists. 3. Managed Anti-Virus Protection: I hope they aren't running on a Windows platform, and if they aren't, I'm not aware of very many current in-the-wild viruses for the various Linux distros. 4. 1 Gigabit Networking Infrastructure (Public and Private): Heh. 5. Two-Factor Authentication: I see this a bit, and it's usually mis-used. Unless they require you to physically submit a fingerprint, DNA sample, retinal image, or some other such thing, then it's not two-factor authentication. 6. Application and Database Server Isolation: They're running the application and the SQL instances on different servers, but if the application server gets compromised, then so does the SQL server, since the application needs automated credentials for the SQL server. 7. Managed SSL Service: Once a year they make sure your certificate is up-to-date. 8. Business Associate Agreement Friendly: What? 9. Managed Redundant Firewall Protection: Not sure what they mean by this. Either your firewall works, or it doesn't. Layering them doesn't do squat. If they mean that they have a hot spare ready to go in case of an outage, then that's a little better -- but still not that helpful if the app server or db server falls over for any reason. 10. Managed Redundant Web Application Protection (Port 80/443): What? 11. Managed Redundant DoS/DDoS Mitigation: This is nice, at least, since it requires a bit of infrastructure to do it right -- assuming that they can stand up to a multi-terabit-per-second hit, since that's what the botnets are packing these days. 12. Managed and Monitored Intrusion Detection: So, run-of-the-mill IDS + Nagios + remote logging. 13. Managed Proactive Operating System Security Patches: This is a lie unless they're personally writing and submitting patches. The most "proactive" you're likely to get otherwise is running a nightly update. 14. Managed Weekly Full Backups + Daily Differentials (Encrypted): I want to take just a moment here and toot our own horn: we do weekly fulls + daily differentials for our regular web hosting customers, for a heck of a lot less than $845 a month. They aren't currently encrypted, but that wouldn't be all that challenging to add on. 15: Highly Secure Data Center Environment: You can probably get the same "highly secure data center environment" from Rackspace, Hurricane Electric, or any of a number of other really big hosting providers. 16: VPN/SSL Provided for Server Management (RDP/SSH/FTP/SQL): Nice, but again, really not that hard to set up, especially for a turn-key environment. TL;DR: I'm really surprised both at what qualifies as "HIPAA compliant hosting" as well as at the price charged for it. I wonder if the bulk of the cost goes towards paperwork or some other kind of administrative overhead? I certainly don't see the price reflected in their technical offering.
16s 16y ago
One other issue to consider is that just because your hosting provider's infrastructure is HIPPA compliant doesn't mean your application is. There are still a ton of privacy issues within the application, plain text HTTP, user authentication, etc.
- kgrin 16y ago
  Yep - we're aware of all that, and we can handle the various app-level changes... we just don't want to be in the "ongoing server maintenance" business.
justlearning 16y ago
Depending on your fit/needs, it may be worthwhile to check out if the end client would like to maintain this box. That way, you are on their network. The disadvantage is of course the administration. We did this on a pilot project with one of our clients with hipaa requirements. We asked for box with the minimum requirements with admin/firewall setup and used this server as our end point for our app. hope this helps.
lightcrest 16y ago
Lightcrest is a complex managed hosting provider that works with clients to ensure HIPAA compliance. We build fully managed environments (servers, storage, network, physical security) and work with application developers and management on a variety of compliance issues. http://www.lightcrest.com http://www.lightcrest.com
zfierstadt 16y ago
I work for a managed infrastructure firm that specializes in scaling out secure platforms for customers that require HIPAA compliance - might want to check it out. http://www.lightcrest.com/security/hipaa http://www.lightcrest.com/security/hipaa Ex Myspace/Microsoft folks - lots of in house experience building high-volume sites that get pounded with malicious traffic. Cheers