Proper forensic protocols dictate that each piece of evidence must be carefully documented, photographed, and labeled to maintain a chain of custody from collection to presentation in court or regulatory inquiry. A chapter from StatPearls based on Evidence Collection notes, “Evidence must be identified, collected, packaged, secured, and maintained correctly, then released to Law Enforcement following a strict chain of custody rules so that it can be analyzed appropriately and used later in legal proceedings” Every step, including who handled the evidence and where it was stored, is recorded precisely to preserve the evidence's integrity and admissibility in legal proceedings.
Forensic principles such as beneficence (doing the best for the evidence), non-maleficence (avoiding harm to the evidence), and justice are borrowed and adapted from medical bioethics to forensic bioethics, guiding forensic scientists to prioritize maximizing the probative value of evidence while ensuring its preservation for potential retesting. Analytical processes are conducted in a layered manner, from non-destructive to more consumptive tests, so that evidence remains available for defense examinations or further analysis if necessary.
What are forensic protocols?
Forensic protocols define the methods for handling various types of evidence like physical or digital while considering additional factors like chain of custody. In healthcare, the protocols assist in ensuring digital evidence like system logs, access records, and breach timelines are collected and analyzed without compromise.
According to a study published in IEEE Access, “The most significant objective of digital forensics is to gather evidence to respond to the 5Ws and How (5WH) questions: what occurred, who was involved, and when, where, why, and how an incident occurred.”
They outline the steps for identifying the breach’s source, assessing its scope, and avoiding further risk. The protocols also aid in creating an outward projection of accountability assuring those affected by a breach that actionable steps will be taken to strengthen their cybersecurity posture.
The steps involved in adapting forensic protocols to HIPAA compliant organizations
An example of the application of forensic principles in a healthcare setting is exhibited in the Journal of Education and Health Promotion study ‘A systematic literature review on the role of the forensic nursing’, “The collaboration among professionals in the field of nursing with regards to forensic investigation possesses the potential to avert the unnecessary loss or destruction of evidence.”
- Ensure all forensic evidence collection and handling strictly preserves the integrity and confidentiality of PHI to comply with HIPAA privacy and security rules.
- Maintain a clear and documented chain of custody for all evidence, especially digital logs and physical records containing PHI, to provide legal defensibility and compliance accountability.
- Isolate affected systems quickly after a breach to prevent additional unauthorized access or data loss, while securing evidence in a way that limits PHI exposure to only authorized personnel.
- Use secure methods for storing, transporting, and accessing forensic evidence, including encryption and access controls, consistent with HIPAA’s technical safeguards.
- Implement strict administrative safeguards by training staff on forensic procedures with an emphasis on HIPAA compliance requirements and confidentiality protections.
- Follow protocols for timely breach notification as required by HIPAA’s Breach Notification Rule, supported by accurate forensic analysis to determine breach scope and impact.
- Collaborate across organizational, legal, and technical teams with a shared understanding of HIPAA regulations and forensic best practices to maintain compliance throughout investigations.
Why forensic protocols matter for healthcare organizations and their business associates
Healthcare settings frequently involve data that has to be collected under a strict chain of custody. The integrity of evidence allows healthcare organizations to defend themselves in legal or regulatory investigations. For example, forensic nurses trained in evidence handling reduce errors and delays in managing cases involving potential abuse or malpractice, improving legal outcomes and patient safety. The preservation of evidentiary integrity prevents contamination, unauthorized disclosure, and loss of information.
An Elsevier Forensic Science International Synergy study notes how frameworks like the one provided by forensic protocols can be adapted to benefit decision making in high risk environments like healthcare. “The focus of the specified ethical principles is on scientists practicing forensic science with integrity, being true to data, use of appropriate science and providing proper testimony. Little is said in the ethical guidelines regarding how to approach ethical dilemmas in the crime laboratory and the use of ethical frameworks to resolve issues. Rather, accreditation and policy frameworks dictate use of quality systems as a means to identify and prevent ethical issues.”
The function of forensic protocols in safeguarding evidence also extends to digital forensic procedures in cybersecurity incidents involving protected health information (PHI). Protocols ensure that electronic evidence related to data breaches or cyberattacks is captured without alteration. Maintaining forensic protocols helps organizations to outwardly project forensic readiness, a state of preparedness to respond swiftly and correctly to forensic incidents. This readiness helps meet the requirements of the Security and Breach Notification Rule while it supports audits, investigations, and legal defenses.
Is a forensic protocol always necessary after a breach?
A forensic protocol is not always strictly necessary after every data breach but its voluntary application can be useful for breaches that are larger in scale. Breaches that result in the compromise of large volumes of data. The Change Healthcare breach involved unauthorized access to protected health information (PHI) with far reaching consequences. The breach resulted in millions of individuals being impacted and large scale disruptions to Change’s operations.
Through large scale reporting and the intervention of the HHS OCR, the breach resulted in a closer look at the legislative environment surrounding cybersecurity and data breaches. Forensic analysis is a necessary part of breaches like this assisting in the systematic uncovering of the breach's origin and the potential trickle down effect that ransomware attacks could present.
Suppose organizations perform a cost analysis and are determined to be able to afford the employment of a third party forensic firm (willing to sign a business associate agreement). In that case, organizations can also benefit from a PR standpoint. Those affected and viewing the breach from the outside would view reliable firms as upstanding third parties.
Once it is confirmed that the breach is mitigated and steps have been taken to secure the organization's cybersecurity, it is more likely to have credibility not otherwise provided by internal private investigations. This credibility is more likely to ensure individuals whose data is breached remain with the organization.
Related: HIPAA Compliant Email: The Definitive Guide
FAQs
What is the Breach Notification Rule?
The Breach Notification Rule is a standard by HIPAA requiring that covered entities and their business associates notify affected individuals the HHS, and sometimes the media when there is a breach of unsecured PHI.
When is a breach protocol enacted?
It is enacted when a breach of unsecured PHI is discovered. It means there has been unauthorized access, use, or disclosure of PHI.
Why are healthcare organizations often targeted in data breaches?
There are many reasons healthcare organizations are valuable to cybercriminals. These include:
- The value of data
- The operational pressure
- Potential security gaps
- The volume of data
Kirsten Peremore
