HIPAA & Context-Aware Access: How Pomerium Aligns with HIPAA

Healthcare organizations handle some of the most sensitive data in existence: electronic protected health information (ePHI). HIPAA’s Security Rule was designed to safeguard this data, but its requirements often feel abstract when applied to modern IT systems.

Pomerium bridges this gap. By enforcing identity-aware, context-driven access, Pomerium helps healthcare organizations align with HIPAA’s Technical Safeguards and reduce compliance risk. Below, we examine how Pomerium maps directly to the safeguards defined in 45 CFR § 164.312.

Access Control (§ 164.312(a)(1))

HIPAA Requirement: “Implement technical policies and procedures for electronic information systems that maintain electronic protected health information to allow access only to those persons or software programs that have been granted access rights.” — 45 CFR § 164.312(a)(1)

How Pomerium Aligns:
Pomerium enforces access control by tying requests to user identity, role, and context. This ensures that only authorized individuals or applications can interact with ePHI.

In Practice: Clinician Access with Context-Aware Rules

This example restricts clinicians to hospital-managed devices, enforces business hours, and blocks unauthorized certificates.

Audit Controls (§ 164.312(b))

HIPAA Requirement: “Implement hardware, software, and/or procedural mechanisms that record and examine activity in information systems that contain or use electronic protected health information.” — 45 CFR § 164.312(b)

How Pomerium Aligns:
Pomerium generates detailed logs for every access request, capturing who accessed what, when, and under what conditions. This provides a compliance-grade audit trail.

In Practice: Pomerium Logs for HIPAA Audit Trail

This log shows exactly who accessed which patient record, when, and why access was granted.

Integrity (§ 164.312(c)(2))

HIPAA Requirement: “Implement electronic mechanisms to corroborate that electronic protected health information has not been altered or destroyed in an unauthorized manner.” — 45 CFR § 164.312(c)(2)

How Pomerium Aligns:
By enforcing role- and context-based access, Pomerium helps ensure that only authorized users can modify sensitive data. Logs also provide a record that supports integrity verification.

In Practice: Read-Only Access for Non-Physician Staff

This policy enforces read-only access for nurses, preventing unauthorized modifications to treatment records.

Person or Entity Authentication (§ 164.312(d))

HIPAA Requirement: “Implement procedures to verify that a person or entity seeking access to electronic protected health information is the one claimed.” — 45 CFR § 164.312(d)

How Pomerium Aligns:
Pomerium integrates with identity providers to verify user identity. It supports MFA, certificate validation, and device posture enforcement to strengthen authentication.

In Practice: MFA and Certificate-Based Authentication

This example enforces MFA and certificate validation before granting access to physicians.

Transmission Security (§ 164.312(e)(1))

HIPAA Requirement: “Implement technical security measures to guard against unauthorized access to electronic protected health information that is being transmitted over an electronic communications network.” — 45 CFR § 164.312(e)(1)

How Pomerium Aligns:
All traffic routed through Pomerium is encrypted with TLS by default. Pomerium also supports mutual TLS and can delay certificate validation until policy evaluation. This allows administrators to explicitly enforce certificate trust in policy, deny access when certificates are invalid, and generate auditable logs showing why a connection was blocked.

In Practice: Enforcing Encrypted Connections Only

This prevents access to ePHI unless the connection is authorized.

Why This Matters

HIPAA does not prescribe specific tools, but it requires safeguards that restrict, monitor, and secure access to ePHI. Pomerium provides these capabilities directly through context-aware access control, audit logging, authentication enforcement, and encrypted connections.

Healthcare organizations using Pomerium can strengthen their compliance posture while also modernizing their security model with Zero Trust principles.

Conclusion

The HIPAA Security Rule defines technical safeguards that every healthcare organization must meet. Pomerium aligns directly with these safeguards, providing identity-aware, context-driven access that protects ePHI, supports compliance, and reduces the risk of costly violations.

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