Is Firebase HIPAA Compliant?

Are you looking for a HIPAA compliant infrastructure? Here is an in-depth tutorial explaining the advantages and limitations of using Firebase to process PHI data.

The article will initially provide an overview of HIPAA, the legal documents required to comply with health regulations, and the type of data that must be protected.

Further, it will explore the advantages of using the Google Cloud Platform, Firestore, and Cloud Functions to comply with HIPAA requirements and the limitations of other Firebase services regarding processing PHI data.

Key Takeaways

• HIPAA mandates a Business Associate Agreement to process PHI data;
• Users can execute a Business Associate Agreement with Google Cloud Platform;
• The BAA does not cover all Firebase services but Firestore and Cloud Functions.​

What is HIPAA?

HIPAA stands for Health Insurance Portability and Accountability Act, and the United States instituted it in 1996. It provides data privacy and security requirements for safeguarding medical information. 

The act covers any organization that directly handles protected health information and includes healthcare providers, health plans, and health clearinghouses. 

The list of medical information protected is vast and includes the patient’s name, birth date, address, SSN, biometric identifiers, physical and mental conditions, etc.

According to Statista, healthcare data breaches have been increasing in recent years. They moved from 250 in 2015 to 712 in 2021. 

The HIPAA Notification Rule demands the covered entities and business associates to notify a breach of unsecured PHI data.

What is a BAA – Business Associate Agreement?

Entities covered by the HIPAA most often conduct business with non-regulated providers like accounting firms, cloud providers, consultants, etc.

A Business Associate Agreement is a legal contract between a covered entity and an organization (or individual) that will receive, transmit, or store PHI data. Here is an example of a BAA.

What are some examples of applications that may require to meet HIPAA regulations?

• Healthcare apps in general
• Hospital applications
• Patient portals
• Results Dashboard
• Symptoms tracker
• Patient intake forms
• Chat apps
• Etc

Is Firebase HIPAA compliant?

Firebase platform is part of the Google Cloud suite of services and provides an end-to-end application development platform. It offers products like databases, notifications, APIs, functions, analytics, etc.

A BAA is necessary between the covered entity and the cloud provider supporting healthcare-related applications as part of the HIPAA requirements. Firebase does not have a BAA directly but under the Google Cloud Platform.

Google Cloud’s business associate agreement covers all regions, network paths, and points of presence. The BAA does not cover all GCP’s products, and it’s limited to the products listed on the HIPAA Compliance Page.

As detailed below, services like Firestore and Cloud Functions are part of the GCP’s business associate agreement. The BAA does not cover other services like the Realtime Database, Messaging, Crashlytics, etc., on the date, I’m writing this article.

On top of storing data, another essential aspect of developing an application relates to authenticating users. Firebase provides the Firebase Authentication for multi-platform sign-in at no charge, but unfortunately, GCP’s BAA does not cover this product.

According to this Reddit post, users can achieve HIPAA compliant authentication using Google identity rather than Firebase’s authentication service.

According to this StackOverflow post, using Firestore with your own authentication method is an alternative way to meet HIPAA requirements.

Is Firebase chat covered by HIPAA? This is a common question asked by developers.

Virgil Security published an interesting that details how to build a HIPAA-compliant chat application using Firebase and an end-to-end encrypted SDK. The way it works is simple and elegant; it encrypts data on the user’s device and transfers only encrypted data. This way, no vendor will be able to access PHI data. To know more, please read the white paper.

Is there a Firebase HIPAA compliant alternative?

If you are looking for HIPAA compliant alternative to Firebase, please check out Back4App. It is a low-code platform with products including data storage, APIs, serverless functions, SDKs, file storage, etc. 

The company offers customers the ability to execute BAAs under their dedicated resources plans. For further information, please schedule a call.

Some examples of the security provisions available on Back4App are:

• HIPAA Compliant Infrastructure

Back4App uses AWS’s infrastructure to process, store, and transmit protected health information. As a SaaS provider, Back4App signs a BAA with AWS, and the covered entities using Back4App will execute an agreement directly with us.

• Data Encryption at rest

HIPAA mandates the encryption of the PHI of patients when the data is at rest. So, data stored on virtual machines, object storage systems, etc., demand encryption. Back4App accomplishes that by encrypting hard disks, S3 buckets, backups, etc.

• Data encryption in transit

HIPAA mandates the encryption of the PHI of patients when the data is in transit. Communication within Back4App’s infrastructure will happen using the appropriate SSL certificates to ensure no PHI data transits without proper encryption protocols.

• Data replication

To achieve high availability and reliable infrastructure, Back4App runs a fully-redundant environment for production applications that require signing a BAA.

The architecture covers a database cluster with two or more instances syncing data in real-time. It also supports an application cluster with two or more instances processing requests.

• Disaster & Recovery

Back4App allow customers to backup their data in multiple regions to ensure business continuity if an entire AWS region becomes inoperative.

• Multi-factor authentication

MFA or Multi-factor Authentication is an authentication procedure that mandates the user to deliver two or more validation elements to access an account.

Conclusion

HIPAA has delivered data privacy and security requirements for safeguarding medical information since 1996, and it applies to entities like healthcare providers, health plans, and clearinghouses.

It covers medical information like the patient’s name, birth date, address, SSN, biometric identifiers, physical and mental conditions, etc.

Entities covered by the HIPAA conducting business with non-regulated providers like cloud platforms must sign a BAA defining the rules that will govern the relationship and safeguards to protect health information.

The Google Cloud Platforms offers a suite of HIPAA-compliant products across all regions, network paths, and points of presence. The list includes Firestore and Cloud Functions which are two essential Firebase products.

Other Firebase products are not part of GCP’s business associate agreement, are unsuitable for handling protected health information, and are not HIPAA-compliant.

Back4App is a reliable Firebase HIPAA alternative and can sign BAAs with customers looking to store PHI data under their dedicated resources plans. To know more, please The company offers customers the ability to execute BAAs under their dedicated resources plans. To learn more, please schedule a call.

FAQ