HIPAA Compliance Checklist for Austin Medical Practices: Technical Security Requirements

If you run a medical or dental practice in Austin, Round Rock, Cedar Park, or anywhere in Central Texas, you already know HIPAA compliance isn't optional. What you might not know is that the technical security requirements under the HIPAA Security Rule are specific, measurable, and enforceable.

This isn't about privacy policies and consent forms—that's the Privacy Rule. This is about the technical safeguards you're legally required to have protecting electronic protected health information (ePHI).

Let me break down exactly what HIPAA requires from a network security perspective, because this is where most small practices struggle.

Understanding the HIPAA Security Rule

The HIPAA Security Rule has three types of safeguards: Administrative, Physical, and Technical. As a network security professional, I'm focusing on the Technical Safeguards—the actual systems and configurations required to protect patient data.

These aren't suggestions. They're federal requirements with real penalties for non-compliance.

Required Technical Safeguards Under HIPAA

1. Access Control (Required)

You must implement technical policies and procedures that allow only authorized persons to access ePHI. This includes four implementation specifications:

2. Audit Controls (Required)

You must implement hardware, software, and procedural mechanisms that record and examine activity in systems containing ePHI.

What this means practically: Your EHR system needs to log who accessed what patient records and when. You need to review these logs periodically. Most modern EHR systems have this built-in, but you need to actually use it.

Audit logs should capture:

• User login and logout times
• Patient record access (who viewed which records)
• Data modifications or deletions
• Failed login attempts
• Administrative changes to user permissions

3. Integrity Controls (Required)

Implement policies and procedures to protect ePHI from improper alteration or destruction.

4. Person or Entity Authentication (Required)

Implement procedures to verify that a person or entity seeking access to ePHI is who they claim to be.

What this means practically: Strong passwords aren't enough anymore. Consider implementing multi-factor authentication (MFA) for remote access to your systems. While not explicitly required by HIPAA, MFA is increasingly expected as a reasonable security measure.

5. Transmission Security (Required)

Implement technical security measures to guard against unauthorized access to ePHI being transmitted over an electronic communications network.

Network Security Requirements for Austin Medical Practices

Beyond the specific HIPAA technical safeguards, there are network security basics that support compliance and protect patient data:

Firewall Protection

Your practice needs a properly configured firewall protecting your network from external threats. This isn't just "having a router"—it's actively managing what traffic is allowed in and out of your network.

Secure Wi-Fi Configuration

If you offer patient Wi-Fi, it must be completely separate from your internal network where ePHI is stored. Use WPA3 encryption for your staff network. Never use WEP or unsecured wireless networks.

Patch Management

Keep all systems updated with security patches. This includes your EHR server, workstations, network equipment, and any connected medical devices. Unpatched systems are one of the easiest ways attackers gain access.

Antivirus and Anti-Malware

Every computer accessing ePHI needs current antivirus software with automatic updates enabled. This is basic but critical protection against ransomware and other threats.

Backup and Disaster Recovery

HIPAA requires you to establish and implement procedures to create retrievable exact copies of ePHI. Your backup strategy needs to include:

• Regular automated backups (daily minimum)
• Encrypted backup data
• Off-site or cloud backup storage
• Tested restoration procedures
• Documentation of your backup schedule and verification

The Risk Analysis Requirement

Here's what trips up many practices: HIPAA requires you to conduct a risk analysis. Not once when you started—regularly and ongoing.

The risk analysis must:

• Identify where ePHI is stored, transmitted, and accessed
• Identify potential threats and vulnerabilities to that ePHI
• Assess current security measures
• Determine the likelihood and impact of potential risks
• Document findings and remediation plans

This is exactly what a professional security audit provides—documented evidence that you've met this requirement.

Common HIPAA Security Gaps in Small Practices

Based on industry data and OCR enforcement actions, these are the most common technical security failures in healthcare:

Outdated or Misconfigured Systems

Running old operating systems that no longer receive security updates (like Windows 7 or older Windows Server versions) is a significant violation. If your EHR vendor says you must use outdated software, you need to implement additional compensating controls or find a new vendor.

Lack of Encryption

Unencrypted laptops, portable hard drives, or USB drives containing patient data are frequent sources of HIPAA breaches. When these devices are lost or stolen, you're legally required to report it as a breach—which triggers notification requirements and potential penalties.

No Documentation

HIPAA requires documentation of your security measures, policies, and risk assessments. "We do security stuff" isn't compliance. You need written policies, procedures, and evidence you're following them.

Inadequate Access Controls

Giving every employee full access to all patient records violates the minimum necessary standard. Your systems should restrict access based on job function. Your front desk staff doesn't need the same access level as your physicians.

Poor Vendor Management

Your EHR vendor, billing company, IT support provider—anyone who handles ePHI on your behalf is a Business Associate. You need signed Business Associate Agreements (BAAs) with each one, and you need to verify they're actually implementing appropriate security measures.

What Austin Medical Practices Should Do Right Now

Here's your action plan for HIPAA technical security compliance:

Immediate Steps (This Week)

Verify you have Business Associate Agreements with every vendor who touches patient data. If you don't, get them signed immediately.

Check if you're backing up ePHI regularly. When was the last time you verified backups are actually working? Test a restore to be sure.

Review user access to your EHR. Does every employee still working for you have active accounts? Have you disabled accounts for former employees? Does everyone have appropriate access levels?

Short-Term Actions (This Month)

Document your security policies. You need written policies covering access control, password requirements, acceptable use, breach notification procedures, and incident response.

Implement automatic logoff on systems accessing ePHI. 15-30 minutes of inactivity is standard.

Enable audit logging in your EHR if it's not already active. Set up periodic review of these logs—quarterly at minimum.

Ensure all workstations have current antivirus and are receiving automatic updates.

Ongoing Requirements

Conduct annual risk assessments. HIPAA requires this. Document what you find and what you're doing about it.

Provide security awareness training to all employees. Document who attended and when. This should happen at hire and annually thereafter.

Review and update policies annually or when your practice changes significantly (new locations, new services, new technology).

Monitor for security incidents. Have a plan for how you'll detect, respond to, and report security incidents or breaches.

When to Get Professional Help

You don't need to be a cybersecurity expert to run a medical practice. But you do need to meet HIPAA requirements.

Consider getting a professional security assessment if:

• You've never had a formal risk analysis done
• It's been more than a year since your last assessment
• You've added new technology, locations, or services
• You're not confident your current security measures meet HIPAA standards
• You've received a HIPAA complaint or are under investigation
• You're preparing for a practice sale or merger

A proper security audit gives you documented evidence that you've met the HIPAA risk analysis requirement. More importantly, it identifies specific vulnerabilities before they become breaches.

The Bottom Line on HIPAA Security

HIPAA compliance isn't just about avoiding fines. It's about protecting the trust your patients place in you when they share their most private health information.

The technical requirements might seem overwhelming, but they're manageable when you break them down into specific, actionable steps. You don't need a massive IT department or unlimited budget—you need proper configuration of the systems you already have, good policies, and regular verification that everything's working as intended.

For Austin-area medical and dental practices, the risk of non-compliance keeps growing. OCR enforcement actions are increasing, and patients are more aware of their rights under HIPAA. The practices that get in trouble aren't usually the ones making good-faith efforts at compliance—they're the ones ignoring it entirely or assuming "our IT person handles that."

Take it seriously. Document what you're doing. Get professional help when needed. Your patients—and your practice—deserve that level of protection.