PHI in Print: What Healthcare Organizations Need to Know About Physical Safeguards

While many healthcare organizations focus on securing digital systems, printed Protected Health Information (PHI) remains one of the most vulnerable and overlooked sources of data breaches. Let’s take a closer look at why physical safeguards matter and what your organization needs to do to protect member data and remain compliant.

What Are Physical Safeguards?

Under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule, healthcare organizations are required to implement administrative, technical, and physical safeguards to protect PHI. Physical safeguards refer specifically to the protection of physical access to systems, equipment, and facilities where PHI is stored, handled, or printed. This includes not only computer servers and data centers but also file cabinets, fax machines, printers, and even desks where printed PHI may be left temporarily.

Why Do Physical Safeguards Matter?

Even in an era of electronic health records (EHR), many healthcare organizations still generate, store, or transmit PHI in printed form, including:

• Patient charts
• Insurance claims
• Lab results
• Appointment reminders
• Explanation of benefits (EOBs)
• Billing statements
• Prescription slips
• Internal QA reports

If not properly protected, these documents can be easily seen, copied, misplaced, or stolen . Without strict controls in place, your organization may be at risk of HIPAA violations, financial penalties, and loss of patient trust.

Common Print-Related PHI Vulnerabilities

You may already have digital safeguards in place, but are your printed materials equally secure? Some of the most common oversights include:

• Unsecured printers or fax machines in shared spaces
• PHI left in output trays or on desks
• Improper disposal of paper documents (e.g. using a regular trash can instead of shredding)
• Inadequate access control for storage rooms (e.g. unlocked doors, no restrictions)
• Viewing of screens or documents by unauthorized personnel
• Movement of media without logging or tracking

Physical Safeguards: What Your Organization Must Address

There are several key physical safeguards your organization must take to mitigate risks associated with PHI in printed or electronic formats.

Facility Access Controls

• Limit physical access to areas where PHI is stored or processed
• Lock doors and use security systems, access badges, or visitor logs
• Develop contingency access plans for emergencies and disasters
• Escort visitors in sensitive areas

Workstation Use and Security

• Ensure desks, printers, and screens that handle PHI are in restricted areas
• Don’t leave documents unattended, especially in public or shared zones
• Use privacy screens and auto-lock settings on workstations
• Positioning reception desks to prevent public viewing of patient information

Device Controls

• Create policies for the secure disposal or reuse of documents and storage devices
• Log the movement of printed PHI and storage media within or outside the facility
• Require secure backup before moving equipment with stored PHI

Document Handling Procedures

• Shred documents before disposal rather than putting them in the regular trash
• Use confidential waste bins with locks for PHI disposal
• Train staff to verify recipient identity before faxing PHI
• Require face-down placement of documents containing PHI

Environmental Controls

• Install surveillance cameras in areas where PHI is stored
• Use opaque filing systems instead of clear containers
• Create separate areas for discussing sensitive patient matters

Printed PHI is still PHI, and it must be protected accordingly. Healthcare organizations can’t afford to overlook the physical side of data security. With the right policies, training, and partners in place, you can maintain compliance, safeguard your members’ privacy, and protect your reputation.

Why a HIPAA-Certified Vendor Matters

Outsourcing print and mail services? Your responsibility for HIPAA compliance doesn’t stop there.

You must ensure that any business associate—such as a print or fulfillment vendor—is also HIPAA-compliant and follows strict physical security protocols. That includes secure production facilities, chain-of-custody procedures, and proper staff training.

At Graphcom, we are HIPAA-certified and SOC 2 Type II compliant. We specialize in secure healthcare communications, offering everything from compliant print production to secure mail handling—all backed by decades of experience and rigorous physical safeguards.