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Microsoft 365 HIPAA compliance

Office 365 HIPAA compliance is a pressing concern for an increasing number of healthcare companies. Microsoft’s robust cloud solution lets providers keep records and communicate with ease — but is it too easy? Can sensitive information really be protected if it’s stored in the cloud?
Cloud computing has been making inroads into the healthcare industry for several years. It offers numerous benefits as a strategy, enabling organizations and care providers to expand where and how they can use tech. By making it easier for providers to keep and reference patient records, even when they’re on the go, cloud computing improves and simplifies the patient experience.
This move to the cloud is positive for healthcare as a whole, but it places additional responsibility on compliance and security specialists. Fortunately, the task of finding HIPAA-compliant cloud software is becoming easier as more vendors and developers recognize the market demand. Many solution providers have now adapted their offerings to meet the HIPAA needs of healthcare organizations.
Microsoft 365, arguable the most widely used cloud service, is a standout example. It offers HIPAA compliance for all healthcare organizations that have and properly use a business associate agreement (BAA). In this article, you’ll learn more about what Microsoft has done to enable its 365 suite to meet HIPAA requirements and which aspects of data protection remain the responsibility of providers.

HIPAA BAA and Microsoft 365

The HIPAA compliance level of any cloud solution depends on the user organization’s BAA. One of the most convenient features of Microsoft 365 for the healthcare client is that it provides a BAA as a standard element of service.

What is a BAA?

A business associate agreement is a contract between a HIPAA-covered entity (such as a doctor’s office or hospital) and an associated business. As soon as any protected health information (PHI) gets uploaded to the cloud, both parties are automatically subject to HIPAA regulations. For that reason, you need to have a BAA in place with a cloud vendor before you implement any solution related to patient data.

How does Microsoft’s BAA work?

By default, Microsoft offers its BAA as part of its Online Services Terms to users who are covered entities or business associates as defined by HIPAA. The BAA covers Dynamics 365, Office 365 and some other cloud services.
If you’re considering Microsoft as a solution provider, review the BAA in detail to ensure that the covered services and terms of the BAA meet your needs. Microsoft does not modify its BAA by customer request, so the terms need to be sufficient as written.

Microsoft 365 Security Controls and HIPAA Requirements

To confirm that its security practices align with recommendations from HIPAA’s official publisher, the U.S. Department of Health and Human Services (HHS), Microsoft has undergone information security audits under the ISO 27001 standard . This standard evaluates multiple aspects of an organization’s IT security, including whether it follows HHS recommendations.
The results confirm that Office 365 includes all of the HIPAA security and privacy controls necessary for compliance. You can access these controls through the Microsoft 365 Compliance Center.

The Microsoft Compliance Center

The Microsoft Compliance Center gives customers access to the tools and information they need to manage compliance. It includes features like:
· Your Compliance Score, a risk-based metric that measures progress toward risk reduction
· An active alerts card, which lists your security notifications and points you toward more detailed information
· A data classification section to help you properly organize important data
· A reports section with information about third-party apps, shared files and more
· A permissions section that lets you manage access within your organization
· A solutions section with detailed information about your organization’s compliance strategies
· A data loss protection tool to let you track sensitive information
The Compliance Center is a robust resource. It’s available to all Microsoft business customers, but some features, like advanced threat management, sensitivity labels for data classification, some DLP functionality, may not be available unless you have a top-level license.

Microsoft 365 Security Features for HIPAA

Microsoft provides many security features to help enterprises maintain compliance with specific regulations. Those particularly relevant to HIPAA are:
· Least-privilege access: This feature limits the risk and impact of data breaches by granting elevated access to only those who require it.
· Privacy Readers: Microsoft recommends that customers with a BAA should designate representatives as HIPAA Privacy Readers, which gives them access to Message Center notifications about possible breaches involving electronic protected healthcare information (ePHI).
· End-to-end encryption: Microsoft encrypts all data when it is uploaded to or stored on the company’s servers. It is also encrypted when it is transferred outside of Microsoft facilities (encryption in transit); however, some information, including data in email subject lines and address fields, can’t be encrypted due to standard internet protocols. Therefore, Microsoft recommends that all users train personnel to never include ePHI in the To, From, or Subject lines of an email.
· Data Loss Prevention: ePHI is protected from sharing to unauthorized viewers.
· Multi-Factor Authentication: Users must provide information sent to another device or account before they are allowed to log in.
· Audit logs: Administrators can view who has seen, opened, shared or trashed documents.
· Data backups: This feature is required under HIPAA so that exact copies of ePHI can be restored when necessary.
· Security configuration: Microsoft allows customers to change their security settings on many services covered by the BAA. For HIPAA compliance, the safest strategy may be to set the strictest possible parameters. Detailed configuration instructions are available in Microsoft’s HIPAA implementation guide.

How Microsoft Handles Security Breaches

Microsoft’s BAA states that should a security breach occur, the company will notify all of your account’s global admins and all users who have the Privacy Reader designation within 30 days.
Microsoft does not notify your customers of a breach. That responsibility falls to you under HIPAA, which requires all covered entities to notify affected individuals if a breach involves unsecured ePHI. Microsoft also doesn’t submit any required notifications to the Secretary of HHS or the media.
In the case of a breach of a potential ePHI repository, Microsoft is not responsible for scanning stored data to determine whether any ePHI has actually been compromised. You will receive notification that a breach has occurred. You then have to assess whether any ePHI has been compromised and what the degree of the impact is if any.

Office 365 HIPAA Compliance Configuration: Best Practices

Microsoft is very clear that, in the end, the responsibility for HIPAA compliance lies with the customer. The vendor recommends that all companies establish a set of procedures and policies to help their personnel use Office 365 in a way that supports compliance. Here are some of the most important steps to follow during the setup process.
1. Check service details.
· Make sure that the products you plan to use are within the scope of Microsoft’s HIPAA Compliance Services.
· Review the BAA to make sure that the included security and privacy practices meet your needs.
2. Set up access control procedures.
· In your Microsoft 365 Message Center, specify your Privacy Readers.
· Turn on access tracking for your administrators so you can see when they access user accounts.
3. Provide training on PHI exclusion.
· Administrative personnel should not enter ePHI in any directories, address books or global address lists.
· No personnel should share ePHI in troubleshooting or support conversations with Microsoft.
· Users should not reference ePHI in any file names, email headers or publicly accessible SharePoint locations.
· Users should not send ePHI by email except to explicitly authorized users.
4. Establish procedures for access review.
· Regularly review user access to all ePHI storage repositories.
· Regularly examine user access permissions, password changes and additions to shared resources.
· Create a protocol for updating access rights in the event of personnel changes.

How Netwrix Helps Microsoft 365 Customers

Complying with HIPAA is no small task, and adding compliance related to cloud services can tax the resources of even the most robust organization. Netwrix can take much of that load off of your shoulders with its solution for HIPAA compliance.
Know exactly where you store ePHI
The Netwrix solution can identify the specific OneDrive for Business repositories, Exchange Online mailboxes and SharePoint Online sites in your account that contain ePHI. This is the first step towards protecting that ePHI from inside and outside threats.
Reduce your attack surface area by minimizing permissions
The Netwrix solution can also help you make sure that you have the correct privileges in place. It can automatically identify and remove excessive permissions to sensitive data. It also also simplifies the access review and privilege attestation process, thus improving your chances of passing compliance audits the first time around.
Identify and respond to threats
Thanks to detailed cross-system visibility, the Netwrix solution can spot red flags that could indicate insider threats, like failed access attempts, privilege escalation and unusually high numbers of reads, and detect signs of ransomware in progress. It enables you to easily drill deep into suspicious activities so you can block threats before they cause serious damage.
If there is a breach, whatever its source, Netwrix can help you determine the severity of the incident, enabling you to meet all requirements for notifying authorities and affected users.

Microsoft 365 and HIPAA Compliance FAQ

Are there any HIPAA concerns with using Office 365?
As long as you carefully review Microsoft’s BAA and understand the scope of its security and compliance protections, confirm that those protections meet your HIPAA compliance needs, and have all required security controls on your end, you should have few if any concerns about HIPAA compliance.
Office 365’s HIPAA protections are robust, but ultimately, compliance is your responsibility as the HIPAA covered entity.
Which Microsoft Office 365 plan is HIPAA compliant?
Microsoft offers its HIPAA compliance BAA to users of Office 365 Business, Office 365 US Government, and Office 365 US Government Defense. However, lower-level licenses of these services (Business Basic, Business Standard and Business Premium, for example) may not have all of the advanced security features you’ll want to use to maintain your compliance.
Microsoft recommends that users seeking HIPAA compliance enable top-level security protections. Some of these protections, including anti-phishing threat explorers and data loss prevention, are only available for holders of higher-tier Enterprise licenses.
Does having a BAA with Microsoft guarantee compliance with HIPAA and the HITECH Act?
No, a BAA doesn’t guarantee compliance. The BAA’s purpose is to clarify what compliance requirements are the responsibility of the HIPAA business associate. For example, if there is a breach in your Microsoft Office 365 account, Microsoft will notify you that it has occurred.
Under even the most robust BAA, you as the cloud service customer still have responsibilities for maintaining compliance. You need to establish and maintain an internal compliance program that addresses everything required of you as a HIPAA-covered organization. For example, you need to have internal policies, procedures and processes in place to ensure that your personnel act in a way that doesn’t violate HIPAA regulations.
Microsoft’s BAA helps you adhere to HIPAA principles when using the company’s services, but it won’t do everything for you. You still need to make sure that your team uses Office 365 in a way that aligns with each rule of HIPAA and the HITECH Act.
Original Article - Is Microsoft 365 HIPAA Compliant?
Related content:
· Data Security in Healthcare: Key HIPAA Requirements
· Keep Your SharePoint HIPAA Compliant
· [Free Download] Compliance Demystified
submitted by Jeff-Netwrix to Netwrix

Google Cloud vs AWS vs Azure: Which Cloud Vendor to Choose in 2020

When migrating from on-premises IT infrastructure to the cloud, one of the first questions businesses need to tackle is which cloud vendor to choose. For the most part, it’s not a simple decision. For instance, three global cloud vendors available in 2020: Google Cloud, AWS, and Microsoft Azure share a surprisingly large number of similarities. Furthermore, businesses will also take into consideration something called “vendor lock-in”. Once a business has migrated to a cloud, changing vendors will require another migration which costs additional time and money, albeit, less so than the original migration.
To help you figure which cloud service provider is the best for you, we’ve worked with our cloud-certified engineers and developers to create this in-depth guide that compares Google Cloud, AWS, and Microsoft Azure on the basis of 4 major factors: storage, compute, cloud tools and pricing.
Editor’s Note: D3V Tech is a Google Cloud Partner. However, this is a bias-free guide and we’ve looked at each cloud vendor objectively to help you make the best decision.

Overview: Google Cloud

Google offers other businesses to run their software on the same infrastructure as its own services such as Google Search, Mail, and Youtube - which is very confidence-inspiring, to say the least. Google Cloud or Google Cloud Platform (GCP) was launched just two years (2008) after the launch of Amazon Web Services (2006) and two years before Microsoft Azure (2010) but despite its early launch, Google Cloud has been able to corner the smallest market share (hence, why it’s called the underdog of the industry). As of now 2020, the top three cloud vendors had the following market share:
  • AWS (63%)
  • Azure (29%)
  • GCP (8%).
However, it’s important to note that the lower market share isn’t a reflection of Google’s cloud services, rather a testament to the power of early bird advantage and Microsoft’s existing corporate clientele, almost all of whom choose Azure due to its integration capabilities with Microsoft tools (Office, Outlook, etc.) Another thing to note is that Google Cloud’s market share has been slowly increasing year-on-year.

Key Strengths

In a nutshell, why would a business choose Google Cloud over the other vendors? One of the things Google Cloud beats others at is pricing. Google Cloud has very aggressive pricing along with a large number of discounts that make it far, far more affordable than the other either AWS or Azure.
Google also has less experience in dealing directly with businesses and has always been a B2C company. But this is also an advantage. Google Cloud has done everything to make cloud services more approachable and easy to get started with. For instance, Google Cloud has made conventionally challenging technologies like Machine Learning and Artificial Intelligence extremely accessible with a wide range of innovative products in these fields. As a result, GCP is a more user-friendly option. It also promotes DevOps and agile development, open-source support, and multi-cloud. Google Cloud also has less of a vendor-lock with services like BigQuery Omni that analyzes your data even if it's on different clouds, including AWS and Azure.

Overview: AWS

Amazon Web Services is undoubtedly the current king of cloud services, in terms of market share, at least. Thanks to the early bird advantage and the fact that it had more experience serving businesses cloud services than anyone else, AWS managed to secure a contract with the CIA to help improve collaboration and communication between the 17 intelligence agencies. However, is it still the best or has the competition caught up?
The truth is, AWS has developed a very strong product with a large collection of cloud services. It’s reliable, enterprise-friendly, and global in every sense of the word. In short, AWS is an easy recommendation for most businesses. However, this mature offering isn’t cheap. AWS will cost smaller businesses more than either Azure or GCP for the same services and some may find it less than ideal for smaller development teams.

Key Strengths

AWS is a mature, enterprise-ready cloud service provider with the largest network of data centres providing excellent global reach and performance. As a result, it’s often the obvious choice for larger businesses. It’s also been around for the longest time meaning it’s easier to find AWS-proficient developers and plenty of case studies for you to use during your cloud migration. AWS also has the largest cloud ecosystem with over 175 services that aid businesses across a variety of fields.

Overview: Microsoft Azure

Microsoft Azure launched relatively late but quickly amassed a large market share by leveraging its other products related to the Windows and Office line. It also gave discounts to entice existing customers to use Azure. Since then, Azure has integrated a large number of Microsoft services into Azure, automatically onboarding new customers.
Azure is an enterprise-ready cloud solution but has caught criticism in the past for lack of refinement. Many customers found that Azure wasn’t on the same level as other Microsoft products and even competing cloud vendors when it came to pricing, customer support, documentation, or services. However, Azure is quickly changing all of that and has also seen constant growth in the past few years (only AWS has been losing market share).

Key Strengths

Azure’s biggest strength is the seamless integration with the Windows ecosystem. For instance, since .Net framework is one of the on-premises software that is now on Azure, your existing .Net code can be used on Azure as well. Some other Microsoft services ported to Azure include Windows Server, Office, SQL Server, Sharepoint, and Dynamics Active Directory. Azure is also considered a safe alternative to AWS due to its global reach, a wide range of tools, and hybrid cloud capabilities.

Differences: Which cloud vendor does it best?


Each cloud vendor has separate compute services. In most cases, Amazon’s Elastic Compute Cloud or EC2 is considered the best overall. It has a wide variety of options and configurability.
Azure’s offering is called Virtual Machines and it is comparative to EC2 in most areas but it has fewer related services and versatility.
Google Compute or Compute Engine also offers a lot of customizability and sits between EC2 and Virtual Machines in terms of versatility as it has a large assortment of compute related services including the popular Kubernetes Engine.
Both AWS and Azure offer a free tier that offers 750 hours of compute per month for 12 hours while Compute Engine’s free tier allows one f1-micro instance per month for up to 12 months.



Once again, AWS is the most mature option here with a long list of storage and database options. Again, Azure is comparable to AWS in both storage and database options but actually offers more options when it comes to backup, and so does Google. Speaking of which, Google has the least number of storage and database options.

Cloud Tools and Services

Additional tools and services should be an important factor in your decision since a larger ecosystem of cloud services allow you to break free from third-party services and ensure all of your business needs can be fulfilled through one platform.
In terms of cloud tools, AWS has the largest ecosystem, Google has the second-largest ecosystem, and Azure has the least amount of additional cloud tools and services.


AWS is undoubtedly the most mature cloud service provider in the market right now. However, this versatility also commands a high price. More importantly, though, AWS’ cloud services are highly intertwined and this makes the pricing structure more complex. But the general consensus is that AWS is one of the pricier options. To get more clarity on the actual cloud spend you can expect, we recommend using a third-party price calculator AWS as the in-built calculator isn’t very functional.
Since Azure is targeting a similar demographic as AWS (large enterprises), it also has a similar pricing structure, that is, it’s not very cost-effective for smaller operations. However, the free trial in both AWS and Azure is a good method to try their situational pricing before actually paying out of pocket.
As we previously mentioned, Google Cloud is more tailored towards startups and small-medium enterprises which means it is more affordable. It also offers deep discounts which, in most cases, makes Google Cloud the best option from a strictly cost perspective.

Wrapping up…

Vendor lock-in is a concern that can be put to rest with proper research and expert guidance. For instance, it’s easier to judge these vendors on the basis of pricing, app ecosystem, datacentres, and performance when you have your cloud requirements clear. This can be a challenge for a company that is still in the planning stage. If you are one such company, feel free to reach out to our certified cloud engineers for guidance on choosing the right cloud services provider and a complete cloud migration roadmap .
submitted by D3Vtech to Cloud

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