Identity management in healthcare involves the enactment of policies and practices that restrict the access of protected healthcare information to authorized individuals only. These security measures typically are components of broader identity and access management (IAM) frameworks.
Protecting digital information can be very challenging, especially for healthcare organizations. The healthcare industry is one of the most frequently targeted sectors for cyber criminals, alongside finance, due to the sensitive nature of the data involved. Hacking is the leading cause of healthcare data breaches.
In this guide, we'll provide an overview of IAM and discuss how identity security measures help facilities maintain compliance. We'll cover examples of identity management procedures, and then give you five best practices for building on the IAM policies and procedures you already have in place.
What Is Identity and Access Management (IAM) in Healthcare?
The term identity and access management refers to the safeguards put in place to ensure that the right people can access data at the right time, under the correct circumstances, and that all other access attempts are prevented. In healthcare, identity and access management typically consists of tools and policies that help institutions protect electronic protected health information (ePHI).
What Is the Importance of Identity Management in Healthcare?
Limiting access to certain types of healthcare information to authorized personnel is not only best practice, it's also the law. Data security measures are required under the Health Insurance Portability and Accountability Act (HIPPA), which mandates the use of the following three types of security procedures:
- Administrative safeguards
- Physical safeguards
- Technical safeguards
It's important that IAM policies and practices address all three aspects of data security in order to be effective and compliant with federal and state laws.
Identity Management in Healthcare: Examples
Healthcare identity management policies and procedures restrict access to ePHI within a broader framework of security measures. Facilities may work with multiple vendors and specialists to establish layered security systems. Here are two examples of healthcare identity management practices that would contribute to an organization's broader IAM framework.
Example 1: During onboarding, a nurse receives a secure username and password that will allow her to access the facility's EHR system. The system tracks when and where she accesses the EHR from that point until offboarding, at which point her access is revoked.
Example 2: A hospital's compliance officer performs an audit of access logs and notices multiple, systematic failed login attempts involving a physician's username, well after normal working hours. She freezes the compromised account and alerts the IT department of a potential cybersecurity threat.
IAM Incident Response and Remediation Activities
The HIPAA Security Rule does more than define the types of safeguards that healthcare facilities must have in place. It also establishes a requirement for an incident response (IR) plan that can be initiated if and when a threat arises, including the following "response and reporting" requirements:
- Identify the suspected (or known) incident and respond to the threat.
- Mitigate the harmful effects on the protected entity (or entities) to the extent possible.
- Document the incident and its outcome.
In addition, healthcare organizations must perform remedial activities to fix the offense or breach. IAM incident response and remediation activities depend on the nature of the infraction. The National Institute of Standards and Technology (NIST) provides resources to guide facilities through remediation involving the analysis of weaknesses and implementation of stronger security.
5 Best Practices for Healthcare Identity Management
It's important that only authorized personnel have access to protected healthcare data and resources. Here are five best practices for establishing strong IAM policies and procedures at your facility.
1. Monitor and Audit Internal Users
The individuals within your organization should access ePHI only on an as-needed basis. When an employee looks at a patient's health information for any reason other than to perform their job, this is considered unauthorized access and should be tracked as a data breach. Detection systems that monitor users' behavior on the system, such as User and Entity Behavior Analytics (UEBA) software, can cut down on this type of breach.
2. Protect Against External and Unauthorized Users
Use administrative, physical, and technical safeguards to ensure that those who aren't authorized can't access sensitive material. Restrict access to areas where information is displayed, such as provider workstations that have visible computer screens. Instruct staff to log off in-patient computer workstations before leaving the room. These workstations should be set to automatically log off after a period of inactivity.
3. Establish Strict Onboarding and Offboarding Procedures Related to Digital Identity Management
Healthcare has notoriously high turnover rates, which can make it challenging to manage the digital identities of current staff members. In addition, temporary staff such as traveling nurses often require relatively swift onboarding into a health system so that they can quickly begin providing care. Establishing thorough, standardized onboarding and offboarding procedures for assigning usernames, passwords, badges, and other facets of a digital identity can help mitigate risk in this area.
4. Hire IAM Experts for Your Team
Healthcare identity and access management procedures involve a blend of clinical care, technology, and infrastructure. Strong IAM depends on a collaboration between:
- Hospital leadership
- Legal departments
- Human Resources (HR)
- Information Technology (IT)
- Clinicians
- Security
Hiring personnel with IAM expertise in key positions can help to solidify these collaborations and oversee your program. Examples of job titles for this position include:
- IAM Program Manager
- Compliance Officer or Manager
- Chief Information Security Officer
5. Follow Industry Standards for Incidence Response Procedures
Prevention is crucial, but the way your facility responds to an identity-related security issue is equally important. NIST provides recommendations for IAM incident response and remediation activities. The Cybersecurity and Infrastructure Security Agency (CISA) also offers recommended best practices for IAM incident response.
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