The COVID-19 pandemic accelerated the digital transformation of healthcare services, leading to the widespread adoption of electronic medical records and reports. While this transition to digital technologies has significantly improved the quality of care provided by doctors, it has also exposed the healthcare sector to increased cybersecurity risks. 

In recent years, the healthcare sector has emerged as a primary target for cyberattacks, which is mainly due to the highly sensitive nature of medical information. According to IBM’s Cost of Data Breach report for 2024, organizations within critical infrastructure sectors face the highest costs associated with data breaches. Among these sectors, healthcare stands out as the most severely impacted, with the average breach cost of a data breach reaching an astonishing $9.77 million for the 14th consecutive year. 

Such breaches result in significant financial losses and violate patient privacy. They disrupt medical services, delay the initiation of treatment and can even jeopardize patients’ lives.

Recognizing these challenges, the World Health Organization (WHO) has emphasized the urgent need to enhance cybersecurity within healthcare. The WHO European Regional Action Plan on Digital Health 2023–2030 aims to secure health data while raising awareness of associated risks and promoting technologies that enhance privacy. 

How can healthcare organizations improve their security measures to minimize the risk of breaches and data leaks without compromising the benefits that digital technologies offer? The zero-trust model presents a robust solution for safeguarding the healthcare sector. 

Zero-Trust: Every User is a Potential Threat 

Zero-trust is a security concept that fundamentally redefines workflows based on the principle of not trusting any user by default. Under this model, 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. 

The zero-trust model has demonstrated its effectiveness in addressing numerous challenges associated with cloud or hybrid environments. By adopting this approach, the risk of medical data leakage is significantly reduced, making it much lower than in traditional or older systems. 

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

To effectively implement the zero-trust approach within the healthcare sector, developers employ a variety of advanced technologies. One of the primary tools 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.

Multi-factor authentication (MFA) is another critical component, adding 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.

The zero-trust model in Azure operates on the principle that every request could be a potential threat, which necessitates continuous verification of both users and devices. This approach significantly minimizes the risk of unauthorized access by implementing ongoing authentication processes and ensuring that users are validated at every access point. As a result, the technology can promptly detect potential threats in real time, assess system vulnerabilities and neutralize them efficiently.

Additionally, 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 about 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, particularly in the healthcare sector. The process of transferring all medical information can be time-consuming and complex, often taking months to complete. Ensuring the safety and security of all data throughout this transition is of paramount importance. 

For example, when working with a large hospital, we encountered the significant challenge of transferring 20 million digital records of doctor visits. To minimize the risk of data loss, our developers devised a specialized verification system. This system continuously monitored the status of the information transfer, indicating which data had already been successfully transferred and which had not. The entire operation required two months of intensive work to complete the transfer and adjust the data to 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. 

By integrating these advanced functions into their daily operations, healthcare organizations can significantly bolster their cybersecurity posture. This not only protects sensitive patient data but also cultivates patient trust by ensuring that their information is safeguarded against breaches and unauthorized access.