HIPAA can feel overwhelming, especially for smaller practices that do not have a full time compliance team. The good news is most HIPAA risk reduction comes from a clear set of security habits, the right technical controls, and documentation you can actually maintain.
This HIPAA IT compliance checklist is written for clinics, private practices, and healthcare offices that use modern tools like Microsoft 365, EHR platforms, and cloud based systems.
What HIPAA expects from your IT environment
HIPAA does not require one specific product. It expects you to protect electronic protected health information, often shortened to ePHI, by using reasonable safeguards. That usually includes:
Access controls and least privilege
Encryption for data in transit and at rest
Ongoing risk management
Audit logging and monitoring
Policies, training, and documentation
A plan for incidents and recovery
The goal is to reduce risk and prove that you take protection seriously.
HIPAA IT compliance checklist
1) Confirm where ePHI is stored and shared
You cannot protect what you cannot find.
Map ePHI locations such as:
EHR systems and patient portals
Email, file shares, and cloud storage
Scanned documents and PDFs
Mobile devices used by staff
Backups and archive locations
2) Access control, least privilege, and strong authentication
Minimum best practice:
Unique user accounts, no shared logins
MFA for email and cloud apps
Role based access to systems and folders
Separate admin accounts for IT tasks
3) Device security and endpoint protection
Endpoints are a major risk because staff use them all day.
Include:
Managed endpoint protection, ideally EDR
Automatic patching and restart policies
Full disk encryption on laptops
Screen lock policies and timeouts
Inventory of devices, including remote staff
4) Email and phishing protection
A large portion of HIPAA incidents start with phishing.
Reduce risk with:
Advanced email filtering and safe link scanning
Security awareness training
Phishing simulations to measure risk
Controls to prevent impersonation where possible
5) Encryption for data at rest and in transit
HIPAA expects safeguards for sensitive data.
Examples:
Full disk encryption on laptops and desktops
Secure email and encrypted transfer methods for files
Encrypted backups
TLS for web portals and cloud services
6) Backup and disaster recovery
Backups are part of availability, and availability matters for patient care.
Best practice:
Automated backups on a schedule
Immutable or offline backup copy
Regular restore tests
Documented recovery time expectations
Clear steps for restoring EHR access
7) Logging, monitoring, and audit readiness
HIPAA expects you to be able to investigate suspicious activity.
You should have:
Centralised logs for key systems where possible
Alerts for risky sign ins and admin changes
Visibility into email forwarding rules and mailbox access
Documentation of reviews and actions taken
8) Policies and required documentation
You need simple, current policies that match how your clinic actually works.
Common essentials:
Access control and password policy
Mobile device and remote work policy
Backup and recovery policy
Incident response policy
Vendor management and BAAs
9) Business Associate Agreements
If a vendor can access ePHI, you likely need a BAA.
Typical examples:
IT providers and cloud services
EHR vendors
Backup providers
Email and file sharing systems, depending on usage
10) Incident response steps
When something happens, speed and clarity matter.
Your response plan should include:
Who to contact, internal and external
How to isolate a compromised device
How to preserve evidence
Notification steps
Documentation for compliance and insurance
Quick self check, where most clinics fall short
If you are unsure about any of these, start here:
MFA is not enforced for all accounts
Staff devices are not centrally managed
Backups are not tested
Encryption is not confirmed on laptops
No documented risk assessment or review routine
Fixing these creates a big compliance and security improvement quickly.
