Zero Trust: Mitigating Cybersecurity Risks in Digital Medical Ecosystems

The first attempts to digitalise healthcare started almost sixty years ago and were primarily focused on the adoption of the Electronic Health Record (EHR) system. Although technologies were not that advanced to fully replace traditional medical records archives, it was the first step towards elegant automated systems for patient data storage and management, which modern hospitals can enjoy in 2024. 

The Covid-19 pandemic marked another milestone in the development of digital medical services. For instance, consider remote telehealth-based monitoring or special apps to verify the vaccination status – very convenient! However, alongside the convenience, patient databases have become primary targets for cyberattacks. 

According to IBM’s Cost of Data Breach report for 2024, healthcare organizations stand out as most severely impacted by data breaches, with the average data breach cost reaching an astonishing $9.77 million for the 14th consecutive year.

To protect healthcare organizations and minimize the risk of breaches, software development companies must stay vigilant regarding the biggest vulnerability of any digital system: the users. Let’s consider how the Zero Trust approach to users helps prevent the consequences of irresponsible digital behavior and what tools can assist software developers in enhancing the security of medical digital systems.

Zero Trust: Every user is a potential threat

Zero Trust is a security concept, based on the principle of not trusting any user by default. The system automatically authenticates and authorizes users before granting them access to any applications, databases, or resources within the healthcare organization. Furthermore, the authorization status of each user is continually re-evaluated as they interact with various applications and data.

To illustrate how this technology functions, consider the analogy of a person entering a hospital using a password. However, once inside, they must undergo re-authorization and present their password and access code each time they wish to enter a new room or perform any action.

Zero Trust in practice

One of the primary tools is multi-factor authentication (MFA), which adds an essential layer of security by requiring multiple forms of verification before granting access. Initially, users must enter their login credentials, password, SMS code, or CAPTCHA, along with a temporary access token that is verified by a key. Once authorized, the technology continues to monitor user behavior within the system continuously. 

Another handy tool is Microsoft Azure, which facilitates comprehensive user control during the authorization process on both websites and applications, as well as managing all data processing operations on cloud servers. Moreover, Microsoft Azure facilitates compliance with various healthcare regulations by offering tools that help organizations adhere to standards such as HIPAA, GDPR, and HITRUST.

Just-In-Time (JIT) access control further enhances cybersecurity for healthcare organizations by restricting incoming traffic to virtual machines. Access is granted only when it is required, which effectively reduces the potential attack surface.

Furthermore, data encryption is of utmost importance. All data stored or transmitted within Azure is encrypted utilizing industry-standard algorithms. This comprehensive encryption includes both data at rest and data in transit, ensuring that patient information is protected from unauthorized access.

By taking advantage of these advanced capabilities, healthcare organizations can bolster their overall security and better protect sensitive data while ensuring compliance with regulations such as HIPAA. 

Spring Security for internal access control regulation

In large healthcare organizations, managing access to sensitive information is crucial due to the varying degrees of access required by doctors and nurses. To determine the appropriate level of access for each type of information, Spring Security is employed. This robust framework is specifically designed for securing Java applications, especially those built using the Spring framework.

Spring Security is indispensable for its powerful features in both authentication and authorization, making it the de facto standard for securing Spring-based applications. Authorization dictates what authenticated users are permitted to do within the application, managing access based on roles and permissions. The framework is highly customizable, allowing developers to tailor security configurations to meet specific application requirements and supporting various authentication models and methods.

This role-based access control (RBAC) system enables administrators to grant users access according to their job responsibilities, ensuring that sensitive data is accessible only to authorized personnel. Each resource within the system has clearly defined security labels that indicate who can access it. The system automatically verifies the user’s compliance with these labels each time they attempt to gain access. For example, records of psychological consultations are accessible solely to users categorized under the ‘psychologist’ access bracket, while data pertaining to surgical operations can only be accessed by users classified as ‘surgeons.’

System administrators are tasked with setting up and managing access rights. In cases requiring the sharing of medical data, the super administrator can grant a doctor access to another doctor’s information. The super administrator possesses comprehensive rights within the system, including the capability to audit all actions related to data access. This auditing function allows for the tracking of any changes in access rights and helps in identifying potential security threats. 

Is it worth migrating from an old digital system to a new one?

Migrating to a new system often involves transferring vast amounts of data. Transferring millions of digital records is challenging and time consuming, particularly in the healthcare sector. But there are ways to minimize the risk, complete the transfer and adjust the data to new the new format.

Despite the challenges involved, the adoption of new digital systems offers a substantially higher level of cybersecurity compared to the older, outdated ones. As a result, the effort and time invested in transitioning to these advanced systems are well worth it. The Zero Trust approach, alongside the modern technologies that support it, reduces the risk of data leakage and damage to near-zero levels. 

Furthermore, these systems enable healthcare providers to access medical information in a more convenient format, efficiently plan and monitor disease progression, and ultimately enhance the quality of patient care.

Editor’s Note: The author has no financial relationship with any of the companies / products mentioned.

Photo: da-kuk, Getty Images

This post appears through the MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers. Click here to find out how.