What is the difference between HIPAA and PCI DSS Compliance

What is the difference between HIPAA and PCI DSS Compliance?

Here we discussed the difference between HIPAA and PCI DSS Compliance. With the ongoing adoption of EHRs on a mass scale and multiple third-party integrations, several things have got included, such as secure access to patient records across various healthcare systems, interoperability between Primary Health care providers, specialists, and practitioners, and the latest, accurate, and up to date information on patients.

Since the healthcare industry has adopted all the healthcare data, it has also migrated into a digital format across private practices, clinics, hospitals, and other healthcare provider organizations. Naturally, even IT leaders are constantly upgrading and increasing information security simultaneously.

Much of these efforts are related to complying with the regulations and policies of the local authorities. BHI security and patient privacy are what HIPAA is all about. However, all this sensitive information is not protected by HIPAA alone.

Since many patients and consumers are before primary medical care or at least a portion of it with credit and debit cards, the PCI DSS is used by the healthcare industry as a precious tool that protects confidential patient files. Therefore, it is essential to know the difference between HIPAA vs. PCI DSS Compliance

Let us briefly understand these two and where they overlap to make the compliance process faster and more affordable.

Differences between HIPAA and PCI DSS

Both HIPAA and PCI DSS are vital to their respective industries. However, they are not interchangeable. Here are some differences to note between these two compliance standards:

1. Meaningful use

In the omnibus rule of HIPAA, meaningful use has been addressed to help the most severe threats to any ePHI. These may include unauthorized access, loss, and even the threat of theft. PCI DSS does not address the concept of meaningful use.

2. Compliance

Every covered entity and its business associates must comply with the HIPAA standards. Any business that processes credit card transactions must adhere to the PCI DSS standards.

3. Structure

While HIPAA has a looser and broader structure with fewer elaborate details, PCI DSS has more explicit information required to create a tighter and streamlined structure.

4. Implementation

PCI DSS has a far better structure and explains elaborately how to implement the structure. On the other hand, HIPAA leaves many of the implementation details to the provider to sort out, work out, and decide.


HIPAA features a broader range of concerns about patient safety, quality improvement, elimination of fraud, right to privacy, reduction in waste, and abuse. On the other hand, PCI DSS features a comprehensive and finite set of security requirements.

Similarities between HIPAA and PCI DSS

Some mentionable similarities between HIPAA and PCI DSS that are required to safeguard the sensitive data of consumers and patients are mentioned below:

  1. Controls. Many HIPAA and PCI DSS controls tend to overlap, making the standard compliance process more accessible and cost-effective.
  2. Infrastructure components. Various infrastructural features of HIPAA are also common to PCI DSS, such as active directories, log monitors, and even antivirus software.
  3. System components. There are many system components common to both the HIPAA and the PCI DSS standards, such as account data and personal health information.
  4. Non-compliance. In case of any non-compliance, be it with the HIPAA standards or even the PCI DSS standards, the consequences may include penalties, fines for violations, and even high-risk data breaches.
  5. Inclusions. Like PCI DSS compliance, HIPPA security compliance may entail periodic scans of vulnerability, remediation processes, risk analysis, and total maintenance and checks on various protocol standards.

While HIPAA and PCI DSS controls are primarily familiar to both, there are three controls that HIPAA includes. Still, PCI DSS does not have contingency plans, denial of service, or integrity protection.

Similarities between credit card and healthcare industries

  • In terms of the sheer number of data breaches targeted across the digital world. The second and third largest targets are the healthcare and credit card sectors. They have affected these two industries quite severely over the years.
  • The amount and nature of the information contained in cardholder data. And the EMR/HER systems are so valuable. Cyber attackers and hackers continually try to create breaches across various methods to access such information.
  • Hackers, especially those who pursue payment and Phi data, are highly innovative and relentless. This is the sole reason. That’s why various business entities and their associates need to constantly evolve, upgrade, and update their essential cyber security protocols.
  • Since data breaches are still happening on a large scale, implementation, and upgrades. Also, the maintenance and continuity of cyber security efforts have become a genuinely costly factor in both of these sectors.

What needs to be done?

From the discussion above, it is pretty evident why many organizations in today’s world are required to comply with both HIPAA and PCI DSS standards. Efforts to multiple standards can mean assessments, audits, documentation, and various processes.

This doubles and sometimes even triples the effort and time needed to reach complete compliance in it. However, it doesn’t necessarily need to.

When working with an experienced IT auditor, it is quite possible to take practical advantage of the regulatory overlaps in compliance with HIPAA and the PCI DSS protocols and standards. Mapping HIPAA and PCI DSS frameworks shows which tasks and evidence are genuinely redundant.

This will enable your team to cut out any extra work. When these two frameworks are joined in tandem, it will mean including both account data and PHI within the scope of a single assessment.

On top of that, PCI DSS can also serve as a robust framework. Also, a comprehensive prescriptive guide for every HIPAA requirement that is more often consider vague. The overall benefits of combining both the PCI DSS and HIPAA compliance fantastic management are:

  • The efficiency is far more increase when the strengths of both these frameworks are use together.
  • In the case of multiple engagements, oversight is highly decreasing.
  • The time required to test, assess, implement, and audit standard security measures are reduce significantly.


Since multiple sets of compliance requirements need to implement, the PCI DSS and the HIPAA teams in your organization can work together to streamline the entire process effectively.

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