Installable skillMIT

PHI Data Handling

Protected Health Information (PHI) data handling covering the 18 HIPAA identifiers, de-identification methods (Safe Harbor, Expert Determination), minimum necessary principle, access controls, audit logging, encryption, and secure disposal.

BY rnavarychUPDATED Oct 30, 2026
INTENDED FOR✳Claude Code>_Codex◈OpenClaw↗CursorInstall in a listed agent.

instructions.md

---
name: domain-healthcare-phi-data-handling-40111ebb5f90
description: Protected Health Information (PHI) data handling covering the 18 HIPAA identifiers, de-identification methods (Safe Harbor, Expert Determination), minimum necessary principle, access controls, audit logging, encryption, and secure disposal.
allowed-tools: Read, Grep, Glob, Bash
---

# PHI Data Handling

## When to use
- Determining whether a dataset or field constitutes PHI
- Implementing Safe Harbor or Expert Determination de-identification
- Designing role-based access controls for a clinical system
- Configuring audit logging for PHI access events
- Implementing encryption for PHI at rest or in transit
- Planning media sanitization or cryptographic erasure of PHI

## Core principles
1. **When in doubt it's PHI** — if a data element could identify an individual in combination with health information, treat it as PHI; the cost of over-protecting is low, the cost of a breach is not
2. **Minimum necessary is enforced at the API layer** — strip fields the caller's role doesn't need before the response leaves your service; don't rely on the client to ignore what it receives
3. **Every PHI access gets a log entry** — read access included, not just writes; audit trails without reads are half the story
4. **Cryptographic erasure beats secure delete** — destroying the encryption key is faster, more reliable, and more auditable than overwriting data in place
5. **Break-glass access is not a loophole** — it must be logged, time-limited, and reviewed post-access; emergency access that goes unreviewed is a compliance finding waiting to happen

## Reference Files
- `references/identifiers-deidentification.md` — the 18 HIPAA identifiers, Safe Harbor removal checklist, Expert Determination method and documentation requirements
- `references/access-controls-audit-logging.md` — minimum necessary principle, RBAC table by clinical role, break-glass implementation, required audit log fields, tamper-evident logging, high-risk access review cadence
- `references/encryption-disposal.md` — AES-256-GCM column encryption, TDE, key rotation with cloud KMS, mTLS for microservices, NIST SP 800-88 disposal methods, cryptographic erasure pattern
COMPATIBILITY & REFERENCES

Platform guidance

Imported from the listed AgentSkill.sh category. Complete supplied package files and notices are retained. Required external tools and credentials are not installed. No bundled code was executed during import. Individual agent task behavior has not been tested.