The new and enhanced HIPAA omnibus standard brings an interesting question with regards to cloud security and the shared responsibility model in IaaS clouds. Since the release of the HIPAA omnibus, we’ve received many questions around “BAA” agreements, and how the responsibility split actually happens between (for example) the cloud provider and an ISV providing a healthcare application in an IaaS environment.
Without getting to the details of what a “Business Associate Agreement” means, I’ll simply say that the updated regulation makes business associates (Healthcare ISVs’, and potentially the cloud providers themselves) of covered entities (i.e. clinics or hospitals) directly liable for compliance with certain requirements of the HIPAA privacy and security rules (read more about it in this excellent HIPAA survival guide post). In other words, the entire “food chain” (The cloud provider, the ISV, and any other business associates in the logical flow to the covered entity), should ideally sign a business associate agreement. But what is the practical meaning of such requirement in an IaaS cloud environment? As one should expect – full compliance can be achieved only if all parties (business associates) will enforce compliance where they can actually do so. The IaaS cloud provider for example, will prove compliance on the physical and hypervisor level, while the Healthcare ISV will prove compliance on the guest OS, the healthcare application, and PHI data stored in the cloud.