Managing Protected Health Information (PHI) in Salesforce can be challenging for healthcare and nonprofit organizations. Compliance gaps often emerge, posing legal and financial risks. A HIPAA compliance audit helps address these risks by securing data, building trust with patients and donors, and ensuring your Salesforce setup supports your goals effectively.

This guide walks you through a clear process for auditing HIPAA compliance in your Salesforce environment. It covers key steps to tackle data quality issues, integration challenges, and internal team constraints. Whether you handle patient records or donor details, these steps will help you maintain compliance while optimizing your system.

Want to strengthen your compliance strategy? Book a consultation with Equals 11 to see how our Salesforce expertise can simplify your HIPAA audit and ongoing management.

Why Salesforce HIPAA Compliance Matters for Your Organization

HIPAA compliance is a legal necessity for any organization dealing with PHI. Fines for violations range from $100 to $50,000 per incident, with annual caps up to $1.5 million per category. Beyond penalties, violations can harm your reputation and erode trust from patients or donors, which can take years to recover.

Many organizations don’t realize how much regulated data exists in their Salesforce system. When CRM records combine personal identifiers with medical details, they fall under HIPAA rules. This applies to patient records, donor health information, and even volunteer medical clearances connected to external systems.

Key compliance challenges include:

• Incomplete or outdated PHI records creating hidden risks.
• Third-party apps or EHR systems lacking proper HIPAA safeguards.
• IT teams without deep HIPAA or Salesforce knowledge to handle changing rules.
• Difficulty keeping up with updated HIPAA guidelines and enforcement.
• User permissions that unintentionally allow unauthorized PHI access.

Keep in mind that HIPAA covers all systems handling PHI, including cloud platforms like Salesforce. With a Business Associate Agreement (BAA), Salesforce can meet compliance needs, but your organization must configure settings and maintain controls.

Get Ready for Your Salesforce HIPAA Compliance Audit

Starting a HIPAA audit without preparation often leads to missed issues. Taking time to set up properly helps you spot all gaps and build a strong foundation for the process.

Key Steps Before You Begin

Start with a Salesforce instance using HIPAA-eligible services. Only specific products like Health Cloud, Service Cloud, and Government Cloud support HIPAA compliance. Other versions or third-party apps may not qualify under HIPAA terms.

Ensure you have a signed Business Associate Agreement (BAA) with Salesforce. A BAA is required for any cloud provider handling PHI to define security responsibilities. Without it, storing PHI in Salesforce violates compliance rules.

Map out where PHI exists in your Salesforce setup, including custom fields, attachments, and connections to external systems like EHRs or payment tools. Understand how data moves between these systems.

Secure System Administrator access to Salesforce settings and logs. Work with IT, legal, and operations teams to review data practices and identify everyone who handles PHI.

Know the core HIPAA rules: Privacy Rule for PHI use, Security Rule for technical protections, and Breach Notification Rule for incident handling. This knowledge helps align your Salesforce setup with specific requirements.

Plan for the Audit Timeline

Expect a full HIPAA audit to take 2 to 4 weeks for mid-sized organizations, based on data complexity. Larger setups with custom features might need 6 to 8 weeks. The process includes reviewing configurations, user access, integrations, and policies, requiring input from your team and any external support.

Steps to Audit HIPAA Compliance in Salesforce

Step 1: Identify PHI and Set Audit Boundaries

First, locate all PHI in your Salesforce system and connected tools. Monitoring access to patient data starts with knowing exactly where it’s stored. Document every relevant object, field, and integration point.

Your inventory should cover:

• Standard objects like Contacts or Cases with health data.
• Custom objects for patient or volunteer records.
• Fields, including text areas, holding health details.
• Attachments or documents containing PHI.
• Email templates and communication logs.
• Connections to other apps or systems.
• Reports and dashboards showing PHI.

Rank data by sensitivity and access frequency. Medical records often need the highest protection, while other data like volunteer clearances may carry different risks.

You’ll end up with a complete list of PHI locations and a defined scope for what needs protection under HIPAA rules. Avoid missing PHI in custom fields, comments, or old imports, as these are common oversights.

Step 2: Review and Tighten User Access Controls

Check user profiles, roles, and sharing settings to limit PHI access to only those who need it. Salesforce offers detailed access controls and role-based permissions for compliance, but these must be set up correctly and reviewed often.

Focus on these areas:

• Confirm user access matches current job roles.
• Ensure role hierarchies don’t grant extra access.
• Limit permission sets to essential access only.
• Check sharing rules to prevent unauthorized exposure.
• Enable multi-factor authentication (MFA) for PHI users.
• Set IP restrictions for secure network access.

The goal is to control PHI access tightly while keeping work efficient for authorized staff. Equals 11 can help by spotting hidden gaps and refining permissions to balance security and usability.

Step 3: Confirm Encryption for Data Protection

Make sure PHI is encrypted both when stored and during transmission. Salesforce Shield encryption offers strong protection for sensitive fields, meeting compliance needs.

Verify these encryption points:

• Use Shield encryption for PHI fields.
• Manage encryption keys securely with rotation policies.
• Secure data transmission with TLS 1.2 or higher.
• Require encryption for mobile device access.
• Protect backups and archives with encryption.

Your PHI should stay safe from unauthorized access, whether stored or moving between systems. Double-check older integrations for outdated security settings that could create risks.

Step 4: Set Up Audit Logs and Monitoring

Track all PHI access and changes with detailed logging. Salesforce tools like Event Monitoring and Field Audit Trail support compliance tracking, providing necessary records.

Implement these features:

• Track logins, data exports, and admin changes.
• Log field-level changes for PHI records.
• Set alerts for odd access patterns or export attempts.
• Review user access quarterly for ongoing security.
• Monitor data exchanges with external systems.

You’ll have clear records for compliance reviews or investigations. HIPAA requires all PHI actions to be trackable. Automate reports to spot issues early and show diligence to auditors.

Step 5: Secure Integrations and Third-Party Tools

Assess all connected systems handling PHI for security. Only use HIPAA-covered Salesforce services for PHI, ensuring alignment with relevant policies.

Check these security aspects:

• Confirm BAAs with all connected systems like EHRs.
• Use secure APIs for data exchange.
• Encrypt all data transmissions.
• Validate HIPAA compliance of third-party apps.
• Audit custom integrations for weaknesses.

The result is safe data flow across systems without compliance risks. Equals 11 ensures integrations meet HIPAA standards, focusing on data accuracy and secure connections.

Step 6: Build and Test Recovery Plans

Create backup and recovery plans aligned with HIPAA for business continuity during disruptions. These plans keep PHI secure even in recovery scenarios.

Include these elements:

• Automate encrypted backups with retention rules.
• Set acceptable downtime and recovery targets.
• Define data loss limits and backup intervals.
• Plan for HIPAA breaches during outages.
• Outline communication steps for incidents.

You’ll be ready for data loss or outages, maintaining PHI access and compliance. Test recovery plans to meet targets while keeping security intact.

Sustain HIPAA Compliance in Salesforce Over Time

A single audit isn’t enough. Regulations shift, systems update, and new risks appear. Ongoing management keeps your organization protected as needs change.

Step 7: Record Audit Results and Monitor Continuously

Summarize audit findings, noting gaps and fixes with timelines. Set up a monitoring plan that fits your team’s capacity.

Document these details:

• Risk assessments and priority fixes.
• Clear steps and timelines for solutions.
• Regular compliance and security checks.
• Updated policies based on findings.
• Trackable compliance metrics.

This creates a path for improvement and prevents issues before they escalate to violations.

Step 8: Train Staff and Enforce Policies

Require ongoing HIPAA and Salesforce training for PHI handlers. Define clear policies for data access and incident response tied to your setup.

• Cover core HIPAA rules and breach protocols.
• Teach PHI handling specific to Salesforce.
• Detail steps for reporting issues.
• Tailor training to user roles.
• Update training with regulatory changes.

Expect a knowledgeable team that minimizes errors while maintaining efficiency. Success shows in high training completion rates and fewer human-error incidents.

Ready to shift to a proactive compliance approach? Book a consultation with Equals 11 for a tailored HIPAA strategy.

How Equals 11 Strengthens Your Salesforce HIPAA Compliance

Navigating HIPAA rules and Salesforce features can be complex. Without focused expertise, critical gaps may go unnoticed despite significant effort.

Equals 11 makes the audit process straightforward and strategic. We address specific challenges healthcare and nonprofits face with tailored support.

Specialized Salesforce and AI Knowledge

Our team goes beyond compliance to enhance your Salesforce setup for security and efficiency. We use AI tools like Einstein Prediction Builder to spot risks early and automate secure workflows without slowing down your operations.

Focus on Reducing Real Risks

Equals 11 prioritizes practical risk reduction over mere checklist compliance. We ensure solutions support both regulatory needs and your goals, like better patient care or donor outreach, while maximizing your Salesforce value.

Improved Data Quality for Compliance

Inaccurate data often creates compliance risks. Equals 11 tackles data issues, ensuring PHI is secure, correct, and useful for your mission through better integration and enrichment.

Clear Coordination and Updates

Compliance projects need careful planning. Equals 11 manages timelines and budgets effectively, keeping everyone informed with regular updates throughout the process.

Support for Stretched Teams

If your staff is overwhelmed or lacks specific HIPAA skills, Equals 11 offers flexible expert support. This lets your team focus on daily tasks while we handle compliance details.

Our clients often find that working with Equals 11 not only secures compliance but also boosts Salesforce usage and delivers actionable insights for better results.

Ready to protect your Salesforce environment? Contact Equals 11 for a personalized consultation.

Common Questions About Salesforce HIPAA Compliance

Does Salesforce Automatically Meet HIPAA Standards?

Services like Health Cloud and Service Cloud can support HIPAA compliance if configured correctly with a Business Associate Agreement (BAA). Salesforce provides the necessary infrastructure, but your organization must apply the right settings and practices to maintain compliance.

Why Is a Business Associate Agreement (BAA) Necessary?

A BAA is a legal document outlining responsibilities for protecting PHI between your organization and Salesforce. It’s critical because without one, storing PHI in Salesforce breaks HIPAA rules. The agreement details covered services and breach notification duties.

How Does Salesforce Shield Encryption Help?

Shield Platform Encryption secures PHI at rest with field-level protection. It keeps data safe even if someone accesses the database, using separate encryption keys. This meets HIPAA Security Rule needs for protecting data against unauthorized access.

Can Equals 11 Assist With Continuous Compliance?

Yes, Equals 11 provides ongoing services to monitor HIPAA compliance in Salesforce. We conduct regular checks, track configuration changes, and offer automated reports and guidance to adapt to updates in rules or business needs.

What Should You Do If Violations Are Found?

Finding issues during an audit lets you fix them before penalties or breaches occur. Document the scope, assess impact, and apply fixes, from adjusting settings to broader plans. If PHI exposure happened, follow breach protocols. Equals 11 supports with technical and strategic help.

Final Thoughts: Protect Your Mission With Strong Compliance

Effective HIPAA compliance in Salesforce builds trust with stakeholders and improves operations. It’s more than a requirement; it’s a way to enhance data quality and confidence among patients and donors.

This audit guide offers a practical path to identify and fix compliance issues while optimizing Salesforce. Yet, the depth of HIPAA and Salesforce features means ongoing expertise is vital for lasting success.

Organizations that view compliance as a strategic focus see benefits like lower risks, better efficiency, and stronger relationships. Investing in compliance pays off by avoiding fines and boosting resilience.

While these steps improve your standing, working with experts ensures every detail is covered. The most effective organizations know compliance is too critical to handle alone.

Secure your Salesforce setup with confidence. Contact Equals 11 today for a tailored HIPAA compliance consultation to protect your mission and enhance your capabilities.