As a Google Workspace administrator, ensuring your organization is HIPAA compliant is critical, especially if your company handles medical data in any capacity.
HIPAA (Health Insurance Portability and Accountability Act of 1996) is a U.S. federal law designed to protect sensitive patient health information (PHI). It establishes rules and standards to ensure the confidentiality, integrity, and availability of PHI while enabling the secure exchange of healthcare data. PHI includes any health-related information created, received, stored, or transmitted by healthcare providers or their business associates. This can include names, addresses, phone numbers, Social Security numbers, medical records, insurance details, and any other data that can identify an individual.
The primary goal of HIPAA compliance is to establish secure handling practices for patient data, preventing unauthorized access, data breaches, and misuse of sensitive information. Compliance not only protects patient privacy but also promotes trust between healthcare providers and patients, enhances transparency in healthcare operations, and reduces risks associated with fraud and data abuse.
When choosing digital tools, HIPAA compliance is a top priority for healthcare organizations. Google Workspace offers a powerful suite of collaboration and productivity tools, and when configured properly, its core services can meet HIPAA compliance requirements. In this guide, we’ll walk you through the essential steps to make your Google Workspace environment HIPAA-compliant, ensuring your organization maintains security, compliance, and trust.
Google Workspace can support HIPAA compliance, but it’s not inherently compliant out of the box (at least for most of the services). Compliance is a shared responsibility between Google and your organization. While Google provides the necessary infrastructure and security tools, you are responsible for configuring the platform correctly and ensuring your users follow HIPAA guidelines.
Key components of HIPAA compliance include implementing necessary security measures, signing a Business Associate Agreement (BAA) with Google, and maintaining policies that align with HIPAA’s Privacy, Security, and Breach Notification Rules.
Before using Google Workspace to store or process PHI, your organization must sign a BAA with Google. This agreement outlines Google’s responsibilities as a business associate, including how it handles and protects PHI. To sign a BAA, your organization must be on a paid Google Workspace plan (such as Business or Enterprise). The process includes the following steps:
1. Navigate to Google Admin Console, and go to Account > Account Settings:
Google Admin Console displaying account settings options, with key sections highlighted for easy access and management in Google Workspace.
2. Scroll down and select Legal and Compliance.
The Google Admin Console displays the Account Settings section, with the Legal and Compliance option highlighted for easy identification.
3. In the opened Legal and Compliance page, scroll down to the Security and Privacy Additional Terms section and select Google Workspace/Cloud Identity HIPAA Business Associate Amendment.
The Legal and Compliance section of the Google Admin Console displays various policy settings, with the Google Workspace/Cloud Identity HIPAA Business Associate Amendment option clearly highlighted for administrators managing compliance.
4. The document will open in a separate browser tab. Review it and involve your legal team if necessary.
5. Back in the Admin Console, select Review and Accept.
The Legal and Compliance section of the Google Admin Console is open, focusing on the "Review and Accept" option for the HIPAA Business Associate Amendment under Google Workspace/Cloud Identity.
6. HIPAA Compliance with Google Workspace/Cloud Identity window opens. Select Yes near all three questions and press OK.
The HIPAA Compliance window for Google Workspace/Cloud Identity shows three questions regarding compliance. All questions are answered "Yes," and the "OK" button is highlighted to confirm the settings.
7. In the Review HIPAA Business Associate Amendment window, select I Accept.
The HIPAA Business Associate Amendment window displays the terms for compliance, with the 'I Accept' option clearly highlighted to confirm the agreement in Google Workspace.
Detailed information about the Business Associate Agreement can be found on the official help page.
Google Workspace, designed for effective collaboration and data sharing, offers extensive tools for co-creation and teamwork. While these features enhance productivity, HIPAA compliance requires implementing strict controls to limit data sharing and protect sensitive information.
To ensure compliance, follow these steps to restrict sharing of PHI effectively:
1. In the Google Admin Console, navigate to Apps > Google Workspace > Drive and Docs.
The navigation path to configure Google Workspace settings for Drive and Docs in the Google Admin Console, with the relevant options clearly highlighted for easy access.
2. On the Drive and Docs page, select the Sharing setting option.
The Drive and Docs settings within the Google Workspace, showcasing the highlighted Sharing Settings option for configuring file-sharing permissions.
3. In the configuration menu, adjust the settings to align with your compliance policy. If you need to apply restrictions to a specific Organizational Unit (OU), select it from the Search for Organization Units field on the left side of the page.
On the right side, choose one of the two HIPAA-compliant options:
The Sharing options section in Google Admin Console, showing the selected Organization Unit field on the left and the available sharing settings: "Off" to disable external sharing and "Allowlisted Domains" to restrict sharing to trusted external organizations.
4. Press Save to apply the changes.
5. Back in the Drive and Docs settings, go to the General Access default section, and ensure that the default option Private to the owner is selected.
The 'General access default' setting in Drive and Docs is configured to 'Private to the owner,' ensuring that files are only accessible by the owner unless explicitly shared with others.
The above configuration will affect the sharing of files using Google Drive, Chat, and email attachments if the user inserts files using Google Drive.
Additionally, you should consider the restrictions for the following services:
If your Google Workspace license supports Data Loss Prevention (available for Enterprise-level subscriptions), you should enable this feature for email service, Drive and Chat.
More details about the restrictions recommended for HIPAA compliance can be found in Google’s HIPAA implementation Guide.
One of HIPAA’s key requirements is to restrict access to PHI to only those personnel who genuinely need it. Google Workspace supports this requirement by enabling granular access to data, customizable administrative roles, and separation of access through organizational units.
Granular access control should be enforced by assigning permissions carefully to both groups and individual users, particularly in Google Drive (including personal and Shared Drives). For Shared Drives, administrators may set restrictions to limit access to data by external users and limit the possibility of downloading, copying, or printing the content.
OUs allow administrators to enforce data access restrictions by applying different security settings and permissions based on user roles. For HIPAA compliance, users who need access to PHI should be placed in a separate OU, ensuring that only those individuals can access sensitive data. The OU should be configured with strict security policies and sharing restrictions. For example, external messaging in Google Chat can be disabled for departments handling PHI, and automatic session timeouts should be enforced to prevent unauthorized access if a device is left unattended.
Another critical access control measure is implementing the Principle of Least Privilege (PoLP) by customizing admin roles. While Google Workspace offers predefined admin roles, they may grant excessive permissions that auditors could flag as a security risk. Instead, organizations should create custom admin roles adjusted to specific responsibilities, ensuring each IT administrator has only the permissions necessary to perform their duties and nothing more. PoLP is a widely recognized industry best practice, recommended not only for HIPAA compliance but also for other cybersecurity standards.
Pro Tip: Even though HIPAA doesn’t explicitly require two-factor authentication and data encryption, the adoption of these features adds critical layers of security to protect PHI from unauthorized access and breaches. 2FA significantly reduces the risk of unauthorized access in case of credential compromise by requiring an additional verification step, while data encryption (such as S/MIME) ensures that PHI remains protected in the event of a successful hacker attack. Beyond compliance, enabling these security measures demonstrates a proactive approach to protecting patient data, which builds trust with the customers.
Even with the best technical configurations, human error remains a significant risk. Training employees on HIPAA compliance in Google Workspace combines education, hands-on practice, and continuous monitoring. Employees must understand the importance of protecting PHI and how Google Workspace tools should be used securely to maintain compliance.
A strong HIPAA training program should start with awareness sessions that cover HIPAA regulations, key security principles, and potential risks of mishandling PHI. Employees should be made aware of the consequences of non-compliance, including legal penalties and data breaches that can damage the organization's reputation.
Hands-on training with Google Workspace security features is essential as well. Employees should learn how to use Google Drive sharing settings to restrict access to data, avoid external sharing, and apply access controls such as View-Only permissions. Regular phishing simulations and security awareness programs help employees recognize social engineering attacks that could compromise PHI.
Continuous training through mandatory refresher courses, policy updates, and compliance check-ins should be used to reinforce best practices. Using real-world case studies and HIPAA violation scenarios makes training more engaging and impactful.
HIPAA’s Security Rule mandates that covered entities and business associates regularly evaluate their security measures to protect PHI from unauthorized access. Regular audits help organizations detect compliance gaps, misconfigured security settings, and unauthorized access before they become serious issues. By reviewing Google Workspace audit logs, access controls, and data-sharing settings, administrators can identify potential risks and take corrective actions accordingly.
For example, you can schedule a monthly review of the File exposure report. If you find data sharing incompliant, you may adjust the sharing policy and assign the necessary employee training.
As a healthcare organization, making Google Workspace HIPAA compliant may be mandatory for your business. By following the outlined steps, you can ensure compliance and reduce the risk of data breaches. While following all the requirements might look challenging, the involvement of third-party continuous compliance tools, such as Reco, will significantly simplify this process. To learn more about how we can help make your IT infrastructure compliant, request a demo.
