Framework: HITRUST

The r2 assessment is the highest level of assurance within the HITRUST framework, designed for organizations seeking comprehensive validation of security and compliance maturity. Candidates must understand that r2 builds on the principles of e1 and i1 but extends testing depth, evidence rigor, and control coverage. It evaluates the full PRISMA maturity model—from Policy through Managed—and includes sampling, interviews, and control validation across complex environments. The r2 program is often required by large healthcare entities, payers, and technology providers that handle substantial volumes of Protected Health Information (PHI).

In practice, achieving r2 certification demands a sustained governance program with formalized monitoring, measurement, and continuous improvement cycles. Assessors perform extensive evidence testing and require documentation that demonstrates consistent control operation over time. For exam preparation, candidates should recognize that r2 is not a one-time milestone—it represents an ongoing commitment to managed assurance. The depth of r2 testing provides external stakeholders with confidence that the organization not only maintains compliance but also operates a mature, risk-driven security program.
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