Security is not just important; it's paramount in healthcare
applications. With the extensive digitization of medical records and
information, applications play a crucial role in safeguarding this
medical information. Patient information, personal health records, and
treatment details- all of this data must be kept confidential. The
privacy of each patient and the integrity of the healthcare system
must be protected at all costs. It's not just a requirement; it's a
responsibility we all share.
It’s crucial to safeguard patient
data. The high-profile Wall Street Journal report traces the aftermath
of a 2013 data breach involving 85 local and federal government
agencies across the US, including state bureaus of vital records, to a
single compromised terminal in a fertility doctor’s office at the
University of California Los Angeles, where much of that data was
first collected. Data breaches can result in costly fines, liability
cases, bad publicity, cash theft, and much more. However, the stakes
for the privacy and safety of patients could be much higher. As these
institutions increasingly rely on technology to improve care, it's
important to recognize that the same technology that connects millions
of people and processes trillions of dollars also secures thousands of
lives every second. Embracing technological advancements is not just a
choice but a necessity in the healthcare sector.
We will address
best practices for creating secure healthcare applications. The
security of healthcare applications is of vital importance for
protecting the sensitive medical information, such as treatment
records and bank data, of all patients. However, it's equally
important to ensure that this security does not compromise the user
experience. We will discuss some of the best practices that will make
applications more secure against data theft and unauthorized access by
cyber attackers. These best practices, if strictly followed, can make
healthcare applications more secure for us as they are expected to
follow regulatory compliance and are responsible for providing a
secure application with a superior user experience, ensuring that the
end-users feel safe and reassured.
The cybersecurity environment for healthcare is rife with multiple sources of threats, as detailed below:
Secure Application Design starts with secure coding practices.
Adopting security coding practices is crucial in mitigating the risk
of vulnerabilities introduced at the application development phase. By
following well-established secure coding guidelines and frameworks
(e.g., OWASP), we can design and develop applications that avoid
common coding vulnerabilities that could lead to attacks. Security
flaws must be prevented early rather than reactively addressed. By
implementing secure coding practices in software development, primary
care organizations can curb the risk of security vulnerabilities
introduced during application development.
Additional features of
secure application design involve regular security audits and code
reviews. These security audits happen regularly and involve
documenting and validating the security posture of an application
during its lifecycle. Specifically, security audits help you to
identify vulnerabilities in your application before they can be
exploited. Meanwhile, code reviews happen periodically during
development and post-deployment. Human security experts can perform
reviews or be automated using automated testing tools.
Second,
since patient data is subject to many copies and transfers around a
complex healthcare ecosystem, encryption should always be used for
data at rest and in motion. This applies to all electronically
protected health information (ePHI) instances found within a HIPAA
(Health Insurance Portability and Accountability Act) enterprise and
its business associates. Cryptography stores data in an unreadable
form to limit the accessibility of information to unauthorized
parties; this is called encryption. For data at rest, encryption
should be used to help mitigate unauthorized access to stored
information through protocols such as the NIST’s Advanced Encryption
Standard (AES). For data in motion, encryption to protocols such as
TLS (Transport Layer Security), formerly known as SSL or Secure
Sockets Layer, is used to secure and hide data moving between systems,
thereby mitigating access through interception and alteration within
the network.
Access controls and authentication serve as vital checkpoints in
healthcare apps; indeed, stringent user authentication might be the
first line of defense against an adversary who wants to access your
application. Perhaps the best way to achieve this is by leveraging
multi-factor authentication (MFA), or ‘2 factor’, which prompts the
user to validate their identity using a combination of authentication
‘factors’. For example, a password constitutes a ‘something you know’
factor, while a fingerprint or retina scan, as well as one-time
passcodes transmitted to a mobile device, can be categorized into
‘something you are’ and ‘something you have’ respectively.
Role-based
access control (RBAC) is another essential practice for data security.
Concretely, an RBAC system ties users’ access permissions with their
roles and restricts data access to only include information about jobs
for which the user is responsible. For example, a medical technician
will be able to see and process test results from a patient but not
administrative or billing data. This approach reduces the odds of data
espionage because only as many users as necessary can see or handle
any piece of information, considering the principle of least
privilege.
Access controls rely on timely maintenance,
particularly keeping user accounts and associated access rights up to
date. In this regard, it is important to update the actual information
in user accounts when an employee changes role, leaves your
organization, or a new member of staff is hired. Furthermore, it is
useful to carry out periodical reviews of user accounts. During such
reviews, wrongly set access rights can be corrected to align with your
staff's current access rights. As a consequence, this reduces the
number of inappropriate permissions and also ensures that incorrectly
set permissions from the past will be revoked. This ongoing management
of access rights, therefore, reduces the risk that an unauthorized
party will gain access to your patient's records, thereby preventing a
data breach.
Data confidentiality is essential to protect sensitive healthcare data
in applications. Encryption of the information during rest and in
motion is needed to comply with regulations and prevent the theft of
confidential data. During the rest phase, the confidential data is
stored in servers, databases, and devices. Encrypting such information
at rest protects it in the event of physical access to these storage
devices. In the in-motion scenario, an end-to-end encryption scheme is
needed so that confidential data can be protected when it’s in flight
between users, systems, or networks. It’s common to exchange sensitive
information such as medical records or personal identifiers between
mobile devices and servers, but for security purposes, one doesn’t
want such information to be intercepted or tampered with in flight.
Data protection, in turn, entails the use of secure encryption
protocols, such as the Advanced Encryption Standard (AES) protocol,
for encrypting data at rest, providing strong confidentiality and
security against brute-force attacks, which remains essentially secure
for a very long time when properly implemented. When deploying
encrypted channels for data-in-transit, TLS is the protocol of choice,
providing confidentiality and integrity of communication between two
parties across a network, securing the channels against eavesdropping
and man-in-the-middle attacks. Indeed, these well-known and rigorously
tested encryption protocols should be used to build healthcare
applications to ensure that patient information remains confidential
and secure throughout its lifetime.
Ensuring regulation compliance is important to ensure that the patient
data received, stored, and transmitted by a healthcare application is
respectful of legal and moral standards. Healthcare patient data is
particularly sensitive, so compliance with laws such as the Health
Insurance Portability and Accountability Act (HIPAA) in the United
States and the General Data Protection Regulation (GDPR) in the
European Union is especially important to protect the privacy of the
patients and the security of the information. These laws often contain
specific requirements regarding the treatment and exchange of patient
data describing the nature of the protection measures to be taken, for
example, including encryption, access controls, audit trails, and so
on. Not only is this type of law compliance legally required, but it
is integral to maintaining trust with the patients providing the
highly sensitive information.
Regular compliance assessments of
healthcare applications are instrumental in keeping them compliant
with regulatory protocols on an ongoing basis. A compliance assessment
requires a review of an application’s security measures, policies, and
procedures to identify possible gaps in compliance and provide
suggestions for how to address them. Knowing exactly where they stand
on a regular basis when properly audited gives organizations the
advantage of working to remedy any possible security vulnerabilities
and to keep their security practices in line with regulatory updates.
Regular assessment of compliance will also prepare organizations for
audits by a regulatory body and lower the likelihood that they will be
subject to penalties or fines by that body for non-compliance.
Finally,
keeping track of changes to regulations, especially those such as
HIPAA and GDPR that butt against the fraying seams of changing
technologies will help maintain ongoing compliance as such laws
undergo periodic amendments to address emerging challenges. What’s
more, abreast knowledge about new industry standards and trends will
also enable organizations to keep their information security defenses
at the cutting edge, going well beyond the strict legal mandates
imposed by regulators to effectively protect patient data and keep
their information systems thoroughly secure over the long run.
This need for uncompromised third-party integrations becomes more
important with every passing day as healthcare applications
increasingly rely on third-party APIs and services for the additional
functionality they add to an app. It is crucial to perform a security
assessment of all third-party components before integrating them into
a healthcare system. This includes looking at the provider’s security
practices, whether they comply with regulations such as HIPAA or GDPR,
and how they handle and protect sensitive data. A thorough security
assessment helps to identify security pitfalls and mitigate the risks
of choosing a third-party service that might expose the healthcare
application to security vulnerabilities through compromise.
Another
critical step in securing healthcare data sharing with third-party
services is implementing secure API gateways. API gateways are the
single secure entry and exit point for all interactions between the
healthcare application and the third-party services and can manage and
control all the traffic between all the various APIs from these
services. They can also enforce authentication, encryption, and rate
limiting of all inbound and outbound data, thus ensuring that data is
transferred to and from authorized users and applications and no
unauthorized access can occur since the third-party services cannot
interact directly with the healthcare application.
Once a
successful integration has been completed, throttling third-party
access to healthcare data and managing it prudently is an ongoing
dynamic process. Third-party access into production environments needs
to be audited on a regular cadence, data usage needs to be tracked,
and the third-party service provider stays active on a daily basis to
ensure that services are continually delivered in a secure manner.
In summary, securing healthcare applications plays a crucial role in protecting patient data and ensuring the credibility of healthcare services. When healthcare technology companies adopt best practices such as designing secure applications, enforcing strong access controls, encrypting data, complying with legal and regulatory requirements, and wisely managing the use of third-party integrations, healthcare organizations will be able to mitigate the risk of hacking and data breaches. This goes a long way towards ensuring that any patient and doctor data is protected and that healthcare applications continue to serve their purpose for years to come. Achieving best practices for protecting our data in healthcare technology is paramount in delivering safe, reliable, and compliant care in today’s digital world.