Cybersecurity Challenges

Cybersecurity Challenges

Solving healthcare issues while improving efficiency and patient care

Healthcare institutions face a variety of cybersecurity challenges, and the threats continue to grow and evolve. Hospitals are particularly vulnerable to data breaches and ransomware attacks because of the high value of healthcare data. In addition, most doctors and hospitals now use electronic prescribing, which is vulnerable to theft and fraud. Clearly, patient safety and data privacy come first, but at the same time, administrators are under intense cost pressures that can only be alleviated by improving operational security and the efficiency of clinical workflows.

Trusted identities offer the means to accomplish these objectives through a holistic, end-to-end approach to identity and authentication that spans multi-factor authentication, credential management, digital certificates and physical identity and access management (PIAM). Today’s comprehensive solutions strengthen security while making it easier for healthcare organizations to comply with regulatory mandates aimed at protecting patient information and the integrity of healthcare delivery in an increasingly digital world.

They also enable administrators embrace a more connected and efficient hospital in the Internet of Trusted Things (IoTT), and they open the door to using big data and machine learning in ways that will fundamentally change how healthcare institutions operate, manage risk and deliver care and other services.

The Compliance Challenge and Opportunity

Trusted identities are integral to regulatory compliance in two key ways. First, they are used when physicians complete an authentication process to comply with the HIPAA Security Rule aimed at protecting patient health information. Additionally, they are used to comply with the Drug Enforcement Administration (DEA) mandate for a separate two-factor authentication when using electronic prescribing for controlled substances (EPCS) solutions—a key weapon in the opioids battle.

Rather than addressing these two authentication requirements separately, administrators can realize significant cost efficiencies by moving to integrated systems that extend multi-factor authentication across the entire identity and access management lifecycle. Integrated systems can also be designed to elevate trust through the use of digital certificates and signatures and signing, all backed by public key infrastructure (PKI) security. They can incorporate One Time Password (OTP) tokens and biometrics to comply with the DEA and HIPAA for Electronic Prescription of Controlled Substances (EPCS), and the same systems can also be used to protect patient records and data, implement secure access to facilities, and authenticate remotely to VPNs using mobile devices.

Indeed, unified platforms offer the opportunity to tie everything together and automate other manual workflows. The result is an end-to-end physical identity and access management solution that integrates with access control systems, logical identity and other internal applications so healthcare organizations can manage all types of physical identities and their details.

Truly converged access control will ultimately consist of a single security policy, one credential, and one audit log. The goal is a fully interoperable, multi-layered security infrastructure that is based on a flexible and adaptable platform. Such a platform will enable hospital administrators to preserve their investments as they grow, evolve, and continually improve their security capabilities in the face of ever-changing threats. The healthcare industry will deliver an improved patient experience, more comprehensive security view, and more coordinated approach for protecting privacy while controlling access to patient data, electronic prescriptions, equipment and facilities.

The Power of Convergence

One of the first places where this convergence is happening is with the combination of physical and data security onto a single credential. In much the same way that users are gravitating to mobile solutions, in part, because they like how it interconnects their digital world, so too are healthcare institutions embracing converged credentials. Users want to do far more with their trusted identity credentials than just open doors, especially when they also must access healthcare records, electronic prescriptions for controlled substance (EPCS) systems and other hospital systems many times each day.

Healthcare institutions are among the first to harness the power of converged credentials. Many are using a cloud-based model to provision IDs and perform authentication for physical and logical access control, and for managing EPCS. The next step is to migrate to convergence solutions that pull everything related to identity management into a unified system capable of granting and managing access rights.

The convergence trend will drive the adoption of PIAM software to unify identity lifecycle management by connecting the enterprise’s multiple and disparate physical access control systems (PACS) and IT security systems to other parts of the IT ecosystem such as user directories and HR systems. PIAM software works with existing hardware and infrastructure to collect, collate, store, process and analyze identity and other data from multiple security and non-security solutions, becoming the hub for all these systems while also tying in key external services for running background checks or verifying the identities of visitors and others.

A single PIAM solution standardizes identity management for employees, contractors, visitors, suppliers, tenants and vendors, enabling organizations to manage all identities and issue credential across all buildings, systems, permissions and associated workflows, regardless of the underlying access-control system at any given location. Visitor management is a particularly important element to consider when assessing hospital security— ideally, hospitals should integrate visitor management software with real-time patient feeds, preregistration information and the hospital’s access control system, and then use PIAM software to standardize identity management while tying in external services.

PIAM software also enables PACS to connect to cloudbased card issuance systems and wireless locks, and to locationbased services that enable healthcare institutions to know where people and assets are in the building. Unifying identity management in this way improves efficiency and security while facilitating new IoT use cases that connect the world of people with the world of things.

Protecting the Connected Hospital

When healthcare administrators deploy new IoT capabilities they must be confident patients will be safe. Today’s real-time and proximity-based location technologies create a trusted environment for connecting, monitoring and managing patients, mobile clinicians and staff. They include a cloud service, portals and Bluetooth beacons in the form of smart cards and provide a onecard solution for both indoor positioning services and physical access control. Their cloud-based model and minimal hardware requirements also eliminate the expensive infrastructure setup of antennas, servers and wired infrastructure to further reduce total cost of ownership. Installation simply entails plugging in AC-powered BLE/WiFi gateways and then providing staff with the smart card beacon.

A big benefit of location-based services is the deeper analytics they provide around the movement of personnel in a hospital building. This provides better insights for optimizing usage of facilities, common areas and individual exam and other rooms, as well as workflows in emergency departments and clinical operations. The proximity-based services verify when personnel are nearby a given area for use cases such as monitoring staff check in and check out. They also help organizations meet health and safety regulations by monitoring room occupancy.

Location-based services also can include visitor awareness capabilities to achieve a complete solution for checking in visitors, running background checks, managing identities and issuing credentials. The services also provide wayfinding for patients and visitors navigating the hospital, and historical information about where visitors and other people have been in the building in the event of an emergency, security breach or theft. Additionally, they can help staff to more efficiently manage physical assets, including quickly locating critical medical equipment, beds, crash carts and other medical devices by providing the missing link between these assets and a trusted ecosystem.

Another emerging IoT trend in healthcare is the use of digital certificates to secure hospital assets such as IP-based video surveillance cameras so they are not vulnerable to cyberattacks. Until now, these security cameras connected to the IoT were vulnerable to hackers who could compromise them and gain access to an organization’s IT infrastructure. Now, they can be turned into trusted edge devices in the IoT through the use of digital certificates. Embedding certificates into these items provides a way to authenticate them and to encrypt the data traffic flowing between them.

The future of connected health may be even brighter in the home. The combination of NFC tags, mobile apps, cloud authentication services and web applications simplifies “proof of presence” by making it easier to document the time, location and accurate delivery of prescribed care. This is helping to drive growing adoption of electronic visit verification (EVV), which helps streamline in-home patient visits, ensure security and patient privacy, and eliminate billing fraud.

Reducing Risk

One of the most promising weapons in the fight against healthcare fraud, malware and data breaches is real-time risk profiling technology that protects against both established and recent threats that target users both on-line and on mobile devices. Today’s risk management solutions protect a wide variety of transaction systems and sensitive applications, providing a combination of evidencebased capabilities and behavioral biometrics supported by machine learning. They offer a highly promising way for hospitals to detect phishing, malware and fraudulent medical or financial transactions, and prevent medical account takeovers and session stealing.

There is a revolution underway in healthcare that is spurring active investment in the security infrastructure. Administrators are prioritizing their expenditures to fuel key initiatives including adopting a seamless trusted identity management experience that fights cybersecurity threats while streamlining compliance and ushering in exciting new connected health capabilities, from the hospital to the home.

This article originally appeared in the September 2018 issue of Security Today.


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