HIPAA Printer Security: 10 Ways to Protect Patient Information

Are your office printers and copiers putting patient information at risk?

 

Healthcare organizations rely on printers, copiers, scanners, and fax machines every day. However, these devices can create security risks when patient records are left in output trays, stored on copier hard drives, or transmitted over unsecured networks.

How does HIPAA relate to printer and copier security? HIPAA requires covered healthcare organizations and their business associates to protect patient information using appropriate safeguards. Although HIPAA does not certify specific printers as compliant, organizations must account for the risks associated with printing, scanning, storing, transmitting, and disposing of protected health information (PHI).

For example, the HIPAA Privacy Rule protects patient information in paper and electronic forms, while the HIPAA Security Rule establishes safeguards for electronic protected health information (ePHI). Because modern multifunction printers often store and transmit electronic data, they should be included in an organization's broader security risk assessment.

Fortunately, there are practical ways to reduce these risks. The following 10 HIPAA printer security best practices can help healthcare organizations protect sensitive information while maintaining efficient document workflows.

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What Is HIPAA-Compliant Printing?

HIPAA-compliant printing is the use of policies, technology and employee procedures to protect patient information throughout the entire print and document lifecycle.

That lifecycle may include:

• Sending a document to a printer
• Holding the print job in a queue
• Authenticating the employee
• Releasing and collecting the document
• Scanning or faxing information
• Storing data on a printer hard drive
• Servicing or replacing the device
• Destroying printed documents

In practical terms, no single printer purchase can guarantee HIPAA compliance. The HIPAA Security Rule is flexible and technology neutral. Organizations must evaluate their own risks and select reasonable safeguards based on their size, capabilities, infrastructure and exposure to ePHI. A printer may offer features that support HIPAA compliance, but the organization remains responsible for configuring the equipment correctly and creating secure procedures around it.

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How Does HIPAA Apply to Copier and Printer Security?

Modern copiers and multifunction printers do more than produce paper documents. Many can store, process, or transmit electronic copies of patient records, insurance forms, prescriptions, and other sensitive information.

As a result, healthcare organizations should consider these devices when evaluating their HIPAA privacy and security risks.

Common copier security concerns include:

• Stored patient information: Some devices retain copies of documents on internal storage.
• Unauthorized printing: Confidential records can be left unattended in output trays.
• Network vulnerabilities: Outdated firmware, unsecured protocols, and weak access controls can expose connected printers to threats.
• Scanning and faxing: Documents sent to incorrect recipients can create privacy risks.
• Equipment disposal: Leased or retired copiers may contain sensitive information unless stored data is securely removed.

HIPAA does not require healthcare organizations to purchase a particular brand or model of printer. Instead, organizations must implement reasonable and appropriate safeguards based on their risks and the information their equipment handles.

For this reason, protecting patient information requires both secure printer technology and clear procedures for employees who use these devices.

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Why Printers and Copiers Can Create HIPAA Risks

Today’s multifunction printers perform many of the same functions as computers. They may store, process or transmit data when employees:

• Print patient records
• Scan documents to email
• Copy insurance cards
• Fax prescriptions or referrals
• Save documents to network folders
• Connect to cloud storage
• Access electronic health record systems
• Print remotely

Common healthcare printer security risks include:

• Patient documents left in output trays
• Shared usernames and passwords
• Default administrator credentials
• Outdated device firmware
• Unencrypted print traffic
• Unsecured scan-to-email functions
• Incorrect fax numbers
• Unrestricted access to device settings
• Stored files remaining on printer hard drives
• Copiers returned after a lease without verified data removal

The Federal Trade Commission warns that digital copier hard drives may store information from documents that were copied, printed, scanned, faxed or emailed. That stored information can be exposed through remote access or extracted from a removed hard drive when organizations do not protect it. Make printer and copier security an important part of a healthcare organization’s broader HIPAA risk-management strategy.

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HIPAA Printing Security Checklist

A healthcare print environment should address the following controls:

Security control	Risk it helps address	Information to document
Secure print release	Documents left in output trays	Print-release settings and procedures
Individual authentication	Unauthorized device access	User access and login records
Data encryption	Intercepted or exposed data	Encryption configurations
Automatic data overwrite	Recoverable hard-drive information	Overwrite and deletion settings
Firmware management	Known device vulnerabilities	Update and maintenance records
Audit logging	Untraceable print activity	Print, scan, fax and login logs
Physical access controls	Public access to devices	Printer locations and access procedures
Secure disposal	PHI placed in standard trash	Destruction policies and vendor records
Device retirement procedures	Data left on returned equipment	Data-erasure verification
Employee training	Mistakes and improper handling	Training dates and attendance records

 

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1. Use Secure Print Release

Secure print release, also known as pull printing, holds a document in a protected queue instead of printing it immediately.  The authorized employee must authenticate at the device before the document is released. Authentication methods may include:

• Employee ID cards
• Personal identification numbers
• Usernames and passwords
• Mobile authentication
• Single sign-on credentials

Secure print release helps prevent patient information from sitting unattended in an output tray. It can also reduce unnecessary printing because abandoned jobs may expire automatically instead of being printed.  When properly configured, the system may also create a record showing who released the document, when it was printed and which device processed it.

2. Require Individual User Authentication

Shared printer accounts make it difficult to determine who accessed a device or completed a specific action.  Require individual credentials for employees who print, scan, copy or fax sensitive information.

In addition, use role-based permissions to limit features according to job responsibilities.  For example, a medical billing employee may need access to secure scanning and faxing functions, while another employee may only need basic printing access.  Consider restricting:

• Scan-to-email
• Scan-to-cloud services
• External faxing
• Address-book changes
• USB storage
• Device configuration
• Administrative settings

Individual authentication improves accountability and helps prevent employees from accessing functions they do not need.

3. Encrypt Data in Transit and at Rest

Healthcare organizations should protect information both while it travels through the network and while it remains stored on a device.  Encryption considerations may include:

• Print jobs traveling from computers to printers
• Files stored temporarily in a print queue
• Data stored on printer or copier hard drives
• Documents sent through scan-to-email
• Information transferred to network folders
• Files sent to cloud-printing platforms
• Fax documents processed by multifunction devices

Review the device’s available security settings and confirm that encryption is enabled where appropriate. In addition, replace outdated protocols with more secure alternatives and disable communication methods your organization does not use.  Cloud providers that create, receive, maintain or transmit ePHI on behalf of a covered entity or business associate may also have HIPAA business-associate responsibilities. Restrict Physical Access to Print Devices.  Technology controls cannot prevent every exposure. Healthcare organizations must also consider where printers, copiers and fax machines are located.

Avoid placing devices that regularly process patient information in:

• Waiting rooms
• Public hallways
• Reception areas accessible to visitors
• Shared building spaces
• Unmonitored storage rooms
• Areas visible from public counters

Whenever possible, place these devices in staff-only areas. High-risk departments may need additional access controls, such as badge-restricted doors or dedicated devices. Organizations should also consider whether unauthorized individuals could view documents, remove printouts, photograph information or access the device’s control panel. Physical safeguards work together with technical controls to reduce unnecessary access to patient information.

5. Secure Printer and Copier Hard Drives

Many multifunction printers and copiers contain storage drives that temporarily or permanently retain document information. Create written procedures for managing stored device data throughout the equipment lifecycle.

Recommended practices include:

• Automatically deleting completed jobs
• Enabling data-overwrite features
• Encrypting device storage
• Limiting saved-document functions
• Scheduling secure data deletion
• Removing stored address books when appropriate
• Erasing data before equipment service
• Verifying data destruction before returning leased devices
• Documenting how retired equipment is handled

The risks are not theoretical. HHS reached a settlement of more than $1.2 million with Affinity Health Plan after an investigation found that the organization returned photocopiers without erasing data from their hard drives. The drives contained ePHI associated with as many as 344,579 individuals. When a printer or copier leaves your organization, obtain written confirmation that stored information has been securely removed or destroyed.

6. Keep Firmware and Security Settings Updated

Printers are network-connected devices, which means outdated software and weak configurations can create cybersecurity vulnerabilities.  Include printers and copiers in your organization’s patching and vulnerability-management process.

Your IT team or managed IT service provider should:

• Inventory every network-connected print device
• Change default administrator passwords
• Install approved firmware and security updates
• Review manufacturer security advisories
• Disable unused ports and protocols
• Restrict printer administration to authorized employees
• Remove inactive user accounts
• Review device configurations after major updates
• Replace equipment that no longer receives security support

HHS guidance states that risk analysis should include risks and vulnerabilities associated with unpatched software. This principle should extend to multifunction printers and other devices that create, receive, maintain or transmit ePHI.

Create audit trails and review activity. Logging helps healthcare organizations detect unusual activity, investigate incidents and demonstrate that security controls are being monitored.  Depending on the capabilities of your equipment and print-management system, consider tracking:

• User login attempts
• Failed authentication attempts
• Print-job releases
• Scan activity
• Fax activity
• Administrative changes
• Address-book updates
• Use of external storage devices
• Device errors
• Data-deletion events

Collecting logs is only the first step. Assign responsibility for reviewing them and define what types of activity require investigation.  For example, repeated failed logins, large print volumes outside business hours or unexpected changes to scan destinations may warrant attention. The level of logging and review should reflect your organization’s risk analysis, infrastructure and operational needs.

7. Train Employees on Secure Printing

Even well-configured technology cannot prevent every human mistake.  Employees should understand how everyday print habits may expose patient information. Incorporate print security into HIPAA training, onboarding and periodic security reminders.

Training should cover:

• Picking up printed documents immediately
• Using secure print release
• Confirming the correct printer before sending a job
• Verifying fax numbers
• Confirming scan-to-email recipients
• Avoiding shared credentials
• Reporting lost or misdirected documents
• Protecting documents while working remotely
• Placing PHI in approved disposal containers
• Reporting suspected device tampering

Use realistic examples that reflect employees’ daily responsibilities. A short scenario involving an abandoned lab report or misdirected fax may be more memorable than a general policy statement.  Employees should also know exactly whom to contact when a print, scan or fax mistake occurs.

8. Dispose of Printed PHI Securely

Printed patient information should not be placed in an ordinary trash or recycling bin where unauthorized individuals could retrieve it.  Healthcare organizations should create clear procedures for disposing of paper records and other materials containing PHI.

Depending on the organization’s circumstances, safeguards may include:

• Locked shredding containers
• Cross-cut shredding
• Pulping
• Burning
• Pulverizing
• Approved document-destruction services
• Certificates of destruction
• Written retention and disposal schedules

HHS does not require one specific disposal method in every situation. Instead, covered entities must review their circumstances and use reasonable safeguards to prevent improper access to PHI during disposal. s should also know how to handle printer test pages, fax confirmations, misprints, labels, cover sheets and handwritten notes that contain patient information.

9. Include Printers in HIPAA Risk Assessments

Healthcare organizations often focus their security assessments on computers, servers, electronic health record systems and email. However, risk analysis should include all systems that create, receive, maintain or transmit ePHI.

HHS describes risk analysis as a foundational step in HIPAA Security Rule compliance. Organizations must accurately and thoroughly assess potential risks and vulnerabilities to the confidentiality, integrity and availability of their ePHI. An environment risk review should examine:

• Device inventory and age
• Printer firmware
• Network exposure
• Default passwords
• User access
• Secure print release
• Encryption
• Scan-to-email workflows
• Fax procedures
• Remote printing
• Cloud integrations
• Hard-drive storage
• Device maintenance
• Vendor access
• Audit logging
• Disposal procedures
• Lease-return requirements

Document any identified risks, assign responsibility for corrective action and establish a timeline for addressing them.

10.  Evaluate Your Print and Copier Vendors

Finally, do print and copier vendor need Business Associate Agreements (BAA)?  Not every company that sells, delivers or repairs a printer automatically becomes a HIPAA business associate.  A vendor may be a business associate when it performs functions or services for a covered entity that involve access to PHI. HHS generally defines a business associate as a person or entity that performs certain activities or services involving the use or disclosure of PHI on behalf of a covered entity or whether a vendor may:

• Access stored patient data
• View documents during service
• Maintain cloud print queues
• Remotely monitor devices containing ePHI
• Manage scanning or document workflows
• Dispose of devices or hard drives
• Process or transmit PHI

When the relationship qualifies, the parties generally need a Business Associate Agreement that defines permitted uses of PHI, required safeguards, incident-reporting obligations and data-handling responsibilities.  Consult your HIPAA compliance or legal advisor when determining whether a specific vendor relationship requires a BAA.

Other HIPAA security risks healthcare practices overlook.

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Questions to Ask a Healthcare Print Provider

Before choosing a printer, copier or managed print provider, ask:

1. How does the device protect stored data?
2. Does it support secure print release?
3. Can employees authenticate with badges or individual credentials?
4. Can access be limited according to employee roles?
5. Does the device support encryption?
6. How are firmware and security updates managed?
7. Can unused ports and protocols be disabled?
8. What activity can the device log?
9. Can scan and fax functions be restricted?
10. How is stored data removed before a device is returned?
11. Will the provider document data destruction?
12. Under what circumstances will technicians access stored information?
13. Is the provider prepared to sign a BAA when the relationship requires one?
14. How quickly can the provider respond to device or security problems?

Choose a provider that can explain both the available technology and the procedures required to use it securely.

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Is Your Healthcare Print Environment Secure?

Your printers and copiers may handle sensitive patient information every day. But are the right safeguards in place?

DDL Business Systems helps healthcare organizations across Winchester, Northern Virginia, and the Shenandoah Valley evaluate their print environments, identify potential security risks, and select equipment that supports safer document workflows.

Schedule Your Free Healthcare Print-Security Assessment

Learn where your current printing and scanning processes may be exposing sensitive information.