Is iCloud HIPAA compliant? Can healthcare organizations use iCloud for storing files containing electronic protected health information (ePHI) or sharing ePHI with third-parties? This article assesses whether iCloud is a HIPAA compliant cloud service.

Cloud storage services are a convenient way of sharing and storing data. Since files uploaded to the cloud can be accessed from multiple devices in any location with an Internet connection, information is always at hand when it is needed.

There are many cloud storage services to choose from, many of which are suitable for use by healthcare providers for storing and sharing ePHI. They include robust access and authentication controls and data uploaded to and stored in the cloud is encrypted. Logs are also maintained so it is possible to tell who accessed data, when access occurred, and what users did with the data once access was granted.

iCloud is a cloud storage service that owners of Apple devices can easily access through their iPhones, iPads, and Macs. iCloud has robust authentication and access controls, and data is encrypted in storage and during transfer. The level of encryption used by Apple certainly meets the minimum standard demanded by HIPAA. iCloud certainly appears to tick all the right boxes in terms of security, but is iCloud HIPAA compliant?

Will Apple Sign a Business Associate Agreement with HIPAA Covered Entities?

Cloud storage services are not covered by the HIPAA Conduit Exception Rule and are therefore classed as business associates. As a business associate, the service provider is required to enter into a contract with a HIPAA covered entity – in the form of a business associate agreement – before its service can be used in connection with any ePHI.

It is the responsibility of the covered entity to ensure a BAA is obtained prior to the use of any cloud service for sharing, storing, or transmitting ePHI.

That business associate agreement must explain the responsibilities the service provider has with respect to any ePHI uploaded to its cloud storage platform. The BAA should also explain the uses and disclosures of PHI, and the need to alert the covered entity of any breaches that expose data.

If a BAA is not obtained from Apple, its iCloud service cannot be used with any ePHI. So, will Apple sign a BAA with HIPAA covered entities?

Apple could not have made it any clearer in its iCloud terms and conditions that the use of iCloud by HIPAA-covered entities or their business associates for storing or sharing ePHI is not permitted, and that doing so would be a violation of HIPAA Rules.

“If you are a covered entity, business associate or representative of a covered entity or business associate (as those terms are defined at 45 C.F.R § 160.103), You agree that you will not use any component, function or other facility of iCloud to create, receive, maintain or transmit any “protected health information” (as such term is defined at 45 C.F.R § 160.103) or use iCloud in any manner that would make Apple (or any Apple Subsidiary) Your or any third party’s business associate.”

Is iCloud HIPAA Compliant?

It doesn’t matter what security controls are in place to ensure ePHI cannot be accessed by unauthorized individuals. If a communications channel is not covered by the conduit exception rule and the service provider will not enter into a contract with a HIPAA covered entity in the form of a business associate agreement, the service cannot be used with any ePHI. So, is iCloud HIPAA compliant? Until such point that Apple decides to sign a BAA, iCloud is not a HIPAA compliant cloud service and should not be used by healthcare organizations for sharing, storing, or transmitting ePHI.

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