Access control systems in healthcare help combat unauthorized access, which accounted for 25% of email breaches in 2023. These systems ensure authorized users can access only the minimum necessary information and resources, such as medical records or medicine dispensaries, reducing the risk of disclosure.
The importance of access control in hospital security
Access control is a component of both physical and cybersecurity efforts in healthcare organizations. Knowing the location of critical data and systems, along with monitoring who accesses them, when, and how, is important.
Access control also prevents unauthorized access and privilege escalation, which are often the causes of breaches. Connecting physical and digital access controls simplifies administrative burdens and ensures security and compliance.
Read more: What is cybersecurity in healthcare?
Types of access control systems
Health IT teams should be aware of three main types of access control systems:
Role-based access control
Role-based access control is based on the resources needed to perform specific job roles. Rather than assigning permissions to individuals, permissions are assigned to roles, reducing administrative overhead.
Discretionary access control
Discretionary access control allows information to be shared on a need-to-know basis, decentralizing access control decisions. In this system, the data owner has control over who can access the information.
Mandatory access control
Mandatory access control is commonly used in government and military settings. Access rights are organized into tiers, such as restricted, confidential, and secret. The user's clearance level determines access to resources.
Read more: A guide to HIPAA and access controls
Challenges of access control in healthcare
Healthcare organizations face several challenges related to access control:
Privilege creep
Privilege creep occurs when access control teams grant privileges as one-off instances, without considering the long-term implications. To address this challenge, access control teams should resist granting privileges without a thorough evaluation.
Vendor management
Hospitals rely on numerous external vendors, and data breaches often involve third-party entities. Implementing a thorough vetting process for vendors before granting access to digital resources is necessary.
Contextual considerations
Context is important in access control decisions. For example, in a hospital setting where doctors and nurses wear masks and gloves, biometrics for secure authentication may not be feasible. Access control teams must consider the unique circumstances of the healthcare environment when implementing security measures.
Read also: Access control systems in healthcare
Improving access control measures in healthcare organizations
To enhance access control measures, healthcare organizations can take the following steps:
Internal audit
Conducting an internal audit is the first step towards enhancing access control. This knowledge enables the development of administrative policies that define and clarify IT's role in granting and revoking access.
Multifactor or passwordless authentication
Implementing multifactor or passwordless authentication systems adds an extra layer of protection to digital resources. These systems require users to provide multiple forms of authentication or remove the need for passwords altogether, reducing the risk of unauthorized access.
Mobile device key cards
Using key cards attached to an individual's mobile device can prevent physical breaches. This method ensures that only authorized personnel can access restricted areas or resources.
Deploying a combination of policies
Reducing administrative fatigue and increasing the effectiveness of security measures can be achieved by deploying a combination of policies. These policies should consider the unique needs and challenges of the healthcare environment, ensuring comprehensive access control.
Related: HIPAA Compliant Email: The Definitive Guide
HIPAA and access controls
The HIPAA security rule addresses access controls within its technical safeguards section. The access control standard (45 CFR § 164.312(a)(1)) outlines measures to restrict ePHI access to authorized individuals. These requirements include:
- Limiting ePHI access to authorized personnel only.
- Assigning unique user IDs for individuals accessing ePHI.
- Developing emergency access procedures.
- Enforcing automatic logoff to prevent unauthorized use.
- Securing ePHI through encryption and decryption during storage and transmission.
- Applying role-based restrictions to uphold the minimum necessary standard.
Related: HIPAA Compliant Email: The Definitive Guide
FAQs
How can healthcare organizations ensure the effectiveness of their access control systems?
Regular maintenance, updates, and testing of access control systems are ensure their effectiveness. Additionally, ongoing training for staff on access control policies and procedures can help reinforce security awareness and compliance.
What factors should healthcare organizations consider when implementing an access control system?
Factors to consider include compliance with regulatory requirements such as HIPAA, scalability to accommodate the organization's growth, interoperability with existing security systems, ease of use for staff, and the ability to customize access levels based on roles and responsibilities.
How can access control systems integrate with other security systems in healthcare facilities?
Access control systems can integrate with video surveillance systems, intrusion detection systems, alarm systems, and visitor management systems to provide a comprehensive security solution, allowing for centralized monitoring and management of security events.
What are the different types of access controls besides RBAC?
Besides Role-Based Access Control (RBAC), there are several other types including Discretionary Access Control (DAC), Mandatory Access Control (MAC), and Attribute-Based Access Control (ABAC). Each type has its own methodology for determining access rights based on different criteria such as user discretion, predefined policies, or attributes of users and resources.
How does one determine the appropriate access control model for their organization?
Determining the appropriate access control model depends on the organization's size, the sensitivity of the data handling, and the complexity of user roles and permissions.
Can access controls be bypassed, and how can organizations protect against this?
Like any security measure, access controls are not foolproof and can potentially be bypassed through social engineering, exploiting software vulnerabilities, or insider threats.
Farah Amod
