Hi all,

I was a bit surprised to see that when I do a search for 'HIPAA' on the forums, no hits come up. I am reading in a number of places that LimeSurvey can be HIPAA compliant, but I need to know how to do this. I'd assume it is not HIPAA compliant right out of the box, and some settings need to toggled and it may need to be installed in a certain way.

Can anyone enlighten me? Any places out there which describe a best practices approach to implementing this tool in a HIPAA compliant way?

Thanks,
Colin

I am reading in a number of places that LimeSurvey can be HIPAA compliant...

HI, do you refer to the following resources ?

rc.partners.org

idash.ucsd.edu => (how to make an electronic informed consent...)

Yes, them as well as a couple of other sources.

Is this incorrect?

My opinion is that LimeSurvey allows the configuration of "HIPAA compliant" questionnaires (out of the box).

This said, the most important points for fully compliance are how your questionnaire is designed (including display of all necessary privacy notes) and how collected data are stored and used...

That is kind of what I was thinking.

If the Limesurvey end of things is secure, are there any tutorials on how to set up the rest?

In my situation, I'd be having patients take the survey once they were in my office, so it wouldn't seem too hard to host Limesurvey on a cheapie in-house server.

However, it would be nice if I could make it possible for someone outside of my office to do them ahead of time and maintain HIPAA compliance.

IF it is just going to be much simpler to keep it on a local server, does anyone have any recommendations on how to do this?

Thanks again.

Also, if the surveys are only going to be done locally, is there any way to do this with the local PC version of the software? There would never be more one person at a time taking a survey.

Thanks

In the case that the survey would be done locally (I assume on a tablet or a station where the patient can respond), the XAMPP version of Limesurvey should be enough. The only thing you need to know is the local (!!) IP of the computer / server where it is installed on.

For example, if you have a work station where people would respond, you could install Limesurvey (or the XAMPP/Limesurvey package) on this computer and use it also as server. Then you usually could access the survey also as "https://localhost/_folder-where-your-limesurvey-is-installed/"

I am not familiar with the requirements of that HIPAA thingy, so I can't tell you, if the data needs to be stored locally. But I highly doubt it, because this would exclude basically any thirdparty software offered as SAS. Most survey packages are only available as SAS though.

holch wrote: In the case that the survey would be done locally (I assume on a tablet or a station where the patient can respond), the XAMPP version of Limesurvey should be enough. The only thing you need to know is the local (!!) IP of the computer / server where it is installed on.

What holch means is that when running a local installation of Limesurvey via XAMPP you access the survey via the IP of the local computer. 127.0.0.1 works only from the local OC. If the PC is connected to a LAN the IP of the NIC (networkcard) can be used too. Even others from the LAN might be able to access the Limesurvey installation.

holch wrote: Most survey packages are only available as SAS though.

SAAS (Software as a Service). When first reading SAS I was irritated sine SAS is a company offering analytical software.

When hosting Limesurvey for HIPPA compliance you can start by looking for "HIPAA Compliant Hosting" since most of the compliance is the the same to any webapplication. A survey system can be sometimes easier protected than e.g. CRM or patients records database. Still waiting for a established HIPAA hosting requirements checklist. Keep data stored to a minimum is a good way to start.

When you have your local installation of Limesurvey on a single desktop computer I would first try to ensure that the PC cannot be stolen easliy. Or that the computer is fully encrypted and only will be booted into a kiosk mode when patients should fill out surveys.

Jelo is of course right, it should be SaaS (Software as a Service), not SAS. SAS stand for either the analytical software mentioned by Jelo, or for "Software as Service". So both (SaaS and SAS) are used for more or less the same thing, but SaaS would be definitely the better choice here, as it avoids confusion with the software.

testingsaas.blogspot.com.br/2008/12/saas...-thats-question.html

Holch,

Thanks for your thoughts...

I believe what you are describing is what I'm thinking. Let me elaborate.

HIPAA mandates a certain level of security that must be implemented for protected healthcare information while it is being stored and/or transmitted. I believe that if I did it on a local network that it is much easier to maintain HIPAA compliance. In this situation, the main issue is that the data are stored in a secure fashion. Storing locally seems relatively easy - storing and transmitting data in the cloud/over the internet is much more complex.

With regard to SAS, you are speaking well above my paygrade

*Damn it Jim, I'm a doctor, not a programmer*

Having said that, I believe you are referring to the less-important (to me) feature of being able to do these surveys from outside of my local network?

So, 2 questions:

1. If I were to have the XAMPP package running on desktop within my local network, I would just generate a token for each new patient and then point the browser on the tablet to an (internal) address that the token-generating process would provide me?

2. If I had a laptop with the XAMPP version running on it, I could just hand the laptop to the patient and they could take it on the laptop? They would take the survey through the web browser?

Thanks again and I'm sorry if my lack of understanding of how the world of computers works is complicating you understanding what I'm asking for.

In theory, you could even install Limesurvey on the tablet (if you manage to install a webserver that can run PHP and MySQL), so the tablet or the laptop could work as both, server and tool to apply the questionnaire, if there is only one person at the time doing the survey.

Now if more than one person at the same time might fill in the survey you should separate the server and the client (computer/browser where the questionnaire is filled in) physically. E.g. if your secretary has a computer that is always on, when the practice is open, then you could install it on this computer. Ideally this "server" is connected to the router via a cable and not Wifi, but it can also work with Wifi.

Then you need to find out, what the internal IP of this "server" is. Your office most probably has two kind of IPs. The public one, that is given to you by your ISP and that identify your office (or better your router) on the internet. But internally, the router needs also addresses for each computer/device that is connected to the local area network. That would be what I call the internal IP. They are not accessible from the internet (there are exceptions, but I assume that is not your case). These IPs are usually either static or dynamically assigned by the router (DHCP). For your survey to run properly, the IP of your "server" (device where limesurvey is installed) should be static, because otherwise it can happen that the IP changes over time (e.g. when you switch off the server overnight, the next day it might have a different IP).

So you should talk with the person that set up your network in the office. If it is you, you should have a look at the administration of your router. It usually gives you the option to assign static IPs to certain devices.

I am just noticing that I only read the last of 3 posts when I myself responded.

Jelo - what does "local OC" mean?

Holch - The distinction between SAS and SaaS is not something that I am understanding from the link. Sorry.

Also, I assume a tablet could be on the same wireless network as the host computer - it doesn't need to be connected via ethernet?

Also, I assume there would be something easily done to make an Ipad only allow the individual to access one program - i.e., the browser pointed at the survey?

Holch,

I think I'll skip running a server on the tablet itself. There is a Ubuntu Installer for Android, but I'd need to get the data off of there and back it up/look at and to do this I'd presumably need to use my network - probably with less robust encryption options that I'd have with a host computer and a tablet.

So, I think you answered all of my questions and connecting the "server" to the router directly is easy and I assume the tablet can access the server via wifi?


Thanks so much. I really appreciate everyone's time.

brainpsych wrote: Jelo - what does "local OC" mean?

Sorry, I hit O instead of the P key.
I meant local PC.

brainpsych wrote: Holch - The distinction between SAS and SaaS is not something that I am understanding from the link. Sorry.

You can safely ignore the content of the link for your problem.

brainpsych wrote: Also, I assume a tablet could be on the same wireless network as the host computer - it doesn't need to be connected via ethernet?

Yes, correct.

brainpsych wrote: Also, I assume there would be something easily done to make an Ipad only allow the individual to access one program - i.e., the browser pointed at the survey?

It depends on the App you will use as browser. Search and watch out for "kiosk mode" which describes a mode where everything is locked to a certain application so that the tablet or pc cannot be misused.

E.g. www.webascender.com/Blog/ID/447/How-to-S...iPad-to-Just-One-App
or support.apple.com/HT5509

As Jelo said: Ignore the differences between SAS and SaaS. Let's go for SaaS - Software as a service. This means that the provider doesn't sell you a software that you install on your computer or your server. Actually today you might associate this with "cloud".

Installing Limesurvey on a tablet: I have done it with an Android tablet already. There are apps that install the webserver and then you just need to install Limesurvey on that webserver, just as you would for a hosted service.

But I think the best solution is to have it running on a "server" (can be an ordinary computer) at your office. The tablet can access the "server" easily via WIFI through the router.

For the possibility to only allow one application (the browser) on the tablet, as Jelo said, search for kiosk mode.

Never used it, but you should find a solution there.