Protecting patient information is vital for all healthcare organizations. This information—contained in electronic health record (EHR) systems, clinical decision support systems, radiology systems, and other environments—is critical for delivering quality care. Yet the rising number of cyberattacks puts this information at risk. Healthcare organizations face the very real possibility that patient information could be exposed, altered, or stolen—and that could have dire consequences for organizations and patients.
How can your healthcare organization strengthen information security? Understanding threats, responsibilities, and core elements of an information security program is a good start. You can then build your strategy around regulatory requirements to help ensure you protect sensitive information according to best practices while maintaining compliance.
What Is Healthcare Information Security?
Information security is the protection of information and information systems from unauthorized access, use, disruption, modification, and destruction. The overarching goal of information security is to ensure the confidentiality, integrity, and availability of information. For hospitals, individual providers, health plans, and any other organizations that handle patient data, information security is absolutely essential.
Protecting patient health information
Many healthcare organizations handle large volumes of electronic protected health information (ePHI), which can include names, home addresses, phone numbers, email addresses, social security numbers, account numbers, and more. Any unauthorized disclosure, theft, or alteration of this information—whether intentional or accidental—could lead to identity theft for individuals, and reputational damage and fines for organizations.
Addressing threats
There are numerous threats that can compromise ePHI. Cybercriminals can gain access to protected information through phishing, malware and ransomware attacks, exploitation of software vulnerabilities, and other tactics. At the same time, employees might expose information to unauthorized users, ultimately leading to similar consequences as external attacks. Healthcare organizations must protect ePHI from all these external and internal threats.
Complying with HIPAA and other regulations
Security and compliance go hand in hand. Healthcare organizations must not only defend against attacks but also maintain continuous compliance with HIPAA (the Health Insurance Portability and Accountability Act of 1996) and other regulations. HIPAA specifies in what circumstances and how patient information may be used or disclosed. It also establishes standards for protecting that information. If organizations fail to comply with HIPAA, they are risking not only data breaches but also fines.
Building patient trust and fostering engagement
Protecting the privacy and confidentiality of patient information is critical for maintaining patient trust. As healthcare organizations shift more patient interactions to digital channels, they need to assure patients that all personal information will be kept safe from misuse. Patients will only engage with organizations through online portals, AI-based chatbots, and other modes of communication when they are confident their information is well protected. For healthcare organizations, a single breach could rapidly erode that trust.
Main Threats to Healthcare Information Security
Healthcare organizations face a large and growing array of threats to information security. In many cases, attackers attempt to capitalize on common security vulnerabilities.
Ransomware and malware
Ransomware is the most prevalent form of attack facing healthcare organizations today. Ransomware is malicious software—or “malware”—designed to encrypt sensitive data or lock authorized users out of essential systems. Attackers demand a ransom in exchange for providing a decryption key or restoring system access. In recent years, many attackers have also threatened to steal and sell data, or to attack partner organizations.
Ransomware is not the only type of malware that can affect healthcare organizations. Trojans, viruses, rootkits, botnets, and spyware can allow attackers to steal information, destroy data, obtain credentials, and control systems. In some cases, these types of malware are used as part of ransomware schemes.
Phishing and social engineering
Many ransomware attacks begin with phishing. Attackers might send emails or text messages to employees, trying to trick them into clicking on a link to a spoofed website. If employees enter login credentials, attackers can steal those credentials and gain access to the enterprise network, where they can implant the ransomware.
Unsecured devices and systems
The rise of remote and hybrid work has expanded the attack surface for many healthcare organizations. In the past, IT teams had visibility into and control over nearly all the computers that employees used for work. But today employees are using both personal devices and company-owned systems from home and elsewhere. Keeping all those devices secured, patched, and up to date can be a major challenge for IT teams.
In addition, the increasing use of Internet-of-Things (IoT) devices and 5G wireless technologies in healthcare is spurring development of new cyber threats. Organizations have to ensure that medical devices using those technologies are not left vulnerable to hacking.
Legacy systems and outdated software
Continuing to use legacy systems and outdated software can also open healthcare organizations to attacks. Cyber criminals are constantly looking for vulnerabilities that they can exploit to gain access to or control over systems. Organizations must ensure systems are patched and updated, completely and promptly. And organizations should consider updating legacy systems or migrating to cloud environments to eliminate vulnerabilities.
Lack of staff training and awareness
Employees can be one of the best resources for blocking attacks—or they can be inadvertent vectors. If employees are unaware of current threats or lack training in identifying potential threats, they could accidentally fall for phishing schemes or mistakenly forward confidential information. Even IT staff members can create problems by misconfiguring systems or failing to adhere to security policies.
H2: Key Players in Healthcare Information Security
Healthcare information security must be a collaborative effort among internal teams, external vendors, government regulators, and even patients. All have roles to play in keeping data secure and maintaining compliance.
CIOs, CISOs, IT teams
CIOs and CISOs construct the information security strategies, define priorities, and set budgets. They work with IT managers to understand the operational challenges facing teams and select the most appropriate solutions. Those IT managers are also responsible for implementing security capabilities and configuring them correctly to maximize their value to the organization.
Software vendors, cloud providers, and other third parties
The vendors that supply healthcare organizations with security software must not only deliver effective solutions but also ensure that those solutions are free from flaws or vulnerabilities that could leave customers at risk. They must continuously update and patch their products to stay ahead of attackers.
Cloud providers such as AWS, Azure, and Google Cloud embrace a shared responsibility model for information security. While they secure the physical data centers and infrastructure, they generally leave the protection of apps, data, devices, and accounts to customers (depending on the cloud deployment model). At the same time, they provide customers with an array of services to address security needs.
Managed service providers (MSPs) can help reduce the burdens of selecting, configuring, and managing security solutions. They can also provide continuous, automated monitoring of environments to help healthcare organizations stay focused on more strategic tasks.
Regulators and policymakers
Government regulators and policymakers must keep up to date with a fast-changing environment. They might need to update regulations, provide clear guidance for compliance, or construct entirely new laws as threats and IT landscapes shift. The increasing use of AI in healthcare, for example, has driven lawmakers to create new bills and directives that enable healthcare organizations to capitalize on this new technology without putting patient data at risk.
Patients
Even patients can play a role in information security. They can choose strong passwords that are not easily guessed and use multi-factor authentication (MFA) policies to confirm their identities. Of course, healthcare organizations are responsible for establishing and enforcing security policies that affect patients without making digital experiences too cumbersome.
Core Elements of a Healthcare Information Security Program
Each organization will have some unique security requirements. But there are several core elements of a healthcare information security program that most organizations should have in place.
H3: Risk assessments
Before you invest in new cybersecurity solutions, you should understand your risks and vulnerabilities. You might start by inventorying your data and systems, identifying assets that are likely targets for attackers. You should also examine your existing security architecture and policies: Are there potential openings for network intrusions? If attackers were to steal a user’s credentials, what systems could they access? Evaluate your employees’ understanding of security best practices: Are you confident that users can identify threats and respond correctly?
Your risk and vulnerability assessment could be part of an established program, such as HITRUST certification. Working with an external assessor can help you determine which controls you need to comply with regulations, such as HIPAA, and enhance security.
Access controls
Once you have completed a risk assessment, you should start addressing vulnerabilities. Access control is an area that many organizations need to strengthen.
Robust access controls are critical for limiting access to data, apps, and systems to authorized individuals. Role-based access controls can help ensure that people access only those resources that they need for work. This granular approach to controlling access can help stop attackers from moving laterally across systems if they have already infiltrated the network.
Encryption
Encrypting data at rest and in motion is vital for ensuring data privacy and confidentiality. With encryption, you can help ensure that information will not be exposed or misused even if it is stolen. Encrypting data might not stop attempted attacks, but it should reduce damage.
Incident response plans
Having an incident response plan in place is crucial. In the event of an attack, you need to act fast to mitigate damage. At the first moment you detect an attack, you should isolate infected systems to prevent it from spreading. You can then start forensic analysis, work to restore data access, notify law enforcement and regulatory agencies, and contact patients who might be affected.
Staff training
Educating employees about security risks can go a long way toward bolstering security. Employees should learn how to spot potential threats and who to contact when those threats are identified.
At the same time, IT teams should make internal training a central component of the information security program. Staff members should learn how to properly configure systems, identify emerging threats, establish rigorous policies, and implement best practices.
Training should be a regular occurrence: Staff members should always have access to the latest information about threats and security capabilities. In addition, teams should make sure that policies and practices do not fall through the cracks when there is staff turnover.
Auditing and monitoring
Information security is not something you can set and forget. Whether you have an on-premises, hybrid, or public cloud IT environment, you need to audit and continuously monitor that environment to ensure you have addressed vulnerabilities and are complying with applicable regulations.
Working with an external partner, such as an MSP, can reduce the burdens of monitoring. You can establish a cadence for conducting audits and take advantage of the partner’s automated monitoring capabilities.
HIPAA Security Rule
To address the HIPAA requirement for protecting the security and privacy of ePHI, the U.S. Department of Health and Human Services (HHS) created Security and Privacy Rules. The Security Rule mandates that organizations must:
- Ensure the confidentiality, integrity, and availability of ePHI
- Identify and protect against threats to the security or integrity of information
- Protect against impermissible uses or disclosures of information
- Ensure workforce compliance
The rule also provides some guidance on how organizations can adhere to those requirements. By dividing guidance into physical, technical, and administrative safeguards, the rule can provide a good structure for an information security strategy.
Physical Safeguards for Healthcare Information
Even as more organizations migrate apps to the cloud and support remote work, there is still a need for physical safeguards to protect healthcare information. In fact, the Security Rule defines several physical safeguards that healthcare organizations must have in place.
Facility access and control
Healthcare organizations that handle ePHI must limit physical access to facilities that contain that information. For organizations using cloud environments, cloud providers assume responsibility for controlling access to facilities.
Workstation and device security
Organizations must also control access to workstations and other devices that can view or use ePHI. So, for example, if providers use workstations for telehealth visits, those workstations should be located in private areas.
Proper disposal of PHI records
Organizations must have processes for securely transferring, removing, reusing, and disposing of electronic media to protect ePHI. For example, organizations should make sure that when they dispose of media, ePHI is erased or otherwise completely inaccessible.
Technical Safeguards for Healthcare Information
The Security Rule defines several technical safeguards for protecting healthcare information. These controls might be available as services from cloud providers or MSPs.
Access controls
Organizations must allow only authorized people to access ePHI. MFA—while not specified by HIPAA—offers a strong approach to meeting access control rules. With MFA, you require not only usernames and passwords but also additional means of authentication, such as a USB key or facial recognition. MFA can work with single sign-on (SSO) capabilities to tighten security without making user experiences too complicated.
Audit controls
Organizations need to record and examine access activity, and other activity, relating to information systems with ePHI. The HIPAA Security Rule doesn’t specify the type of solution that should be used—or even the kinds of data that must be collected. But organizations can often configure reporting tools to capture relevant data.
Integrity controls
To maintain the integrity of data, organizations must ensure that ePHI is not improperly altered or destroyed. You might implement encryption, data validation processes, and logging services to meet that requirement.
Transmission security
Organizations need to protect sensitive data transmitted over networks, as it is when multiple clinicians collaborate on care. Cloud providers offer encryption and decryption services that use network protocols to protect data when it is transmitted. Rotating access keys on a regular basis can help enhance security.
Administrative Safeguards for Healthcare Information
There are multiple administrative safeguard standards specified in the Security Rule. These standards refer to the various administrative actions, policies, and procedures that organizations should implement to protect ePHI.
Security management process
Organizations must conduct a risk assessment, identifying potential risks to ePHI and then implementing security measures to reduce those risks. These measures are not just technology solutions but also processes that help ensure data remains protected.
Security personnel
Healthcare organizations must designate someone to develop and implement security policies and procedures. In fact, most organizations have a team of people who work collaboratively to create and continuously fine-tune those policies and procedures.
Information access management
The Security Rule requires organizations to implement role-based access management. This approach can reduce the risk of insider threats and limit the potential damage caused if an individual’s credentials are compromised.
Workforce training and management
Organizations must train employees who work with ePHI on security policies and procedures. They should periodically assess the level of training and consider sanctioning team members who violate policies.
Penalties for Noncompliance
Complying with HIPAA is non-negotiable. If organizations fail to meet HIPAA requirements, they leave themselves vulnerable to regulatory fines, erosion of patient trust, and data breaches.
Fines and penalties
The HHS Office for Civil Rights (OCR) enforces HIPAA rules by investigating complaints, reviewing compliance, and conducting outreach with healthcare organizations. If the HHS OCR discovers violations, and the organization does not remedy them in a timely manner, that organization could be subject to fines ranging from a few hundred dollars to more than a million.
Organizations also face fines if they suffer a data breach. Even if organizations settle civil cases with the HHS OCR, those organizations could wind up paying millions of dollars for large-scale breaches.
Reputational damage and loss of patient trust
Breaches and fines for non-compliance can also impact the reputation of healthcare organizations. Patients might be less likely to use particular healthcare services or employ digital channels if they do not trust organizations to keep their personal information secure. Similarly, healthcare providers might be less likely to work with partner organizations if those partners have failed compliance audits or suffered breaches.
H3: Increased risk of data breaches
Importantly, compliance issues can signal serious security gaps—and those gaps can leave organizations at increased risk for data breaches and other security events. Though working to comply with HIPAA and other regulations can be a time-consuming and costly endeavor, that work can ultimately protect organizations from much greater losses and damage than non-compliance.
Moving Forward with an Information Security Strategy
Information security must remain a top priority for healthcare organizations. Constructing a strategy around HIPAA rules can help ensure your organization addresses key areas for protecting sensitive data and maintaining data privacy. Many organizations will benefit from working with outside firms that have deep expertise in enhancing security and achieving compliance. With the right partner, your organization can better protect patient data and address threats while focusing more of your resources on innovation.
Ready to start building your information security strategy? Cloudticity can help. Contact us to set up a free consultation.
