I'm building an app that requires HIPAA compliance, which, to cut to the chase, means that I can't allow for certain connections to be freely viewable in the database (patients and recommendations for them).
These tables are connected through the patients_recommendations table in my app, which worked well until I added the encryption via attr_encrypted. In an effort to cut down on the amount of encrypting and decrypting (and associated overhead), I'd like to be able to simply encrypt the patient_id in the patients_recommendations table. However, upon changing the data type to string and the column name to encrypted_patient_id, the app breaks with the following error when I try to reseed my database:
can't write unknown attribute `patient_id'
I assume this is because the join is looking for the column directly and not by going through the model (makes sense, using the model is probably slower). Is there any way that I can make Rails go through the model (where attr_encrypted has added the necessary helper methods)?
Update:
In an effort to find a work-around, I've tried adding a before_save to the model like so:
before_save :encrypt_patient_id
...
private
def encrypt_patient_id
self.encrypted_patient_id = PatientRecommendation.encrypt(:patient_id, self.patient_id)
self.patient_id = nil
end
This doesn't work either, however, resulting in the same error of unknown attribute. Either solution would work for me (though the first would address the primary problem), any ideas why the before_save isn't being called when created through an association?
You should probably store the PII data and the PHI data in separate DBs. Encrypt the PII data (including any associations to a provider or provider location) and then hash out all of the PHI data to make it easier. As long as there are not direct associations between the two, it would be acceptable to not have the PHI data encrypted as it's anonymized.