{"id":488,"date":"2009-01-22T18:10:28","date_gmt":"2009-01-23T02:10:28","guid":{"rendered":"http:\/\/cubist.cs.washington.edu\/Security\/?p=488"},"modified":"2009-01-22T21:28:30","modified_gmt":"2009-01-23T05:28:30","slug":"security-review-electronic-medical-records","status":"publish","type":"post","link":"https:\/\/secblog.cs.washington.edu\/Security\/2009\/01\/22\/security-review-electronic-medical-records\/","title":{"rendered":"Security Review: Electronic Medical Records"},"content":{"rendered":"<p>Now that computers have reached the mainstream, demand for online services is increasing. Recently, this has come to include access to medical records over the Internet. The existence of products such as Microsoft&#8217;s HealthVault and Google&#8217;s Google Health demonstrates the demand for this type of service. Even though such services can be used to improve the quality of health care, care must be taken to ensure they don&#8217;t create new problems.<\/p>\n<p><!--more--><\/p>\n<p>A recent <a href=\"http:\/\/www.msnbc.msn.com\/id\/28655104\/\">Associated Press article<\/a> discussed some of the risks associated with such a system. In this particular case, the software used by the Veterans Association in their hospitals had a bug, and as a result &#8220;patients &#8230; were given incorrect doses of drugs, had needed treatments delayed and may have been exposed to other medical errors.&#8221; This example shows that even though these types of systems are designed to help eliminate errors in treatment, they can sometimes introduce problems of their own.<\/p>\n<p>The threat of medical mistakes isn&#8217;t the only shortcoming of electronic medical records, however. Patient privacy is also a serious concern. Access to these databases must be carefully controlled to protect patient confidentiality.<\/p>\n<h2>Assets<\/h2>\n<ul>\n<li> The first asset is patient privacy. Medical records often contain sensitive information that individuals would rather not disclose to other people. This can include diseases or conditions that usually carry a negative connotations.<\/li>\n<li> Another rather important asset is the safety of the patient. The electronic medical records should contain up-to-date and accurate information that can be quickly accessed by authorized personnel. Inaccurate information could lead to improper medical care, as illustrated by the VA incident mentioned above.<\/li>\n<\/ul>\n<h2>Threats<\/h2>\n<p>Placing medical records in an electronic database increases the accessibility of the information for both authorized and unauthorized individuals. This can lead to difficulty in detecting illegitimate access to medical information; it is much easier to detect an unauthorized user in a locked room than it is to detect an unauthorized user remotely accessing a database.<\/p>\n<ul>\n<li> One class of unauthorized user is someone seeking information about a particular individual for malicious use. This can be used for personal gain (such as through blackmail) or to harm the individual (by modifying the paitent&#8217;s records).<\/li>\n<li> A second class of threat arises because of the consolidation of medical records in a centralized location. This enables someone to &#8220;harvest&#8221; the database for a specific subset of patients (all patients affected by a certain type of disease, for instance).<\/li>\n<\/ul>\n<h2>Weaknesses<\/h2>\n<ul>\n<li> With an electronic system, technical problems (such as power outages or equipment malfunction) present a serious weakness. If the system loses power, the records will be inaccessible. This can result in delay of medical treatment.<\/li>\n<li> Humans present another weakness in the system. HIPAA requires that medical records are stored in an encrypted format, but this does nothing to prevent legitimate users from copying the information to unencrypted secondary storage devices, or protecting the information with a poorly chosen password.<\/li>\n<li> A third potential weakness in the system comes from implementation errors in the software. The article discussed above demonstrated how a bug in the software could pose a threat to a patients health.<\/li>\n<\/ul>\n<h2>Defenses<\/h2>\n<ul>\n<li> To help combat the threat of power outages or equipment failures, implementers could utilize redundancy to help mitigate the effects of these failures. This includes using backup-generators or uninterpretable power supplies, and back-up servers to prevent data loss.<\/li>\n<li> Stronger access control policies could reduce the likelihood of unauthorized access by users. This includes a stricter password policy, and enforcing the principle of least privilege.<\/li>\n<\/ul>\n<p>Transitioning from paper based medical records to electronic databases could be very beneficial to patients and doctors alike. Quicker access to critical information could help save lives in medical emergencies. Furthermore, electronic copies of medical information would allow doctors at any hospital to acquire the necessary information to treat the patient. This transition must be done carefully, however. Proper steps must be taken to ensure the confidentiality of this information, as well as its integrity. Not only should access to the information be limited to authorized personnel, but should also be verifiable and accurate.<\/p>\n<p>Written by: Nick Hunt and Jon Andes<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Now that computers have reached the mainstream, demand for online services is increasing. Recently, this has come to include access to medical records over the Internet. The existence of products such as Microsoft&#8217;s HealthVault and Google&#8217;s Google Health demonstrates the &hellip; <a href=\"https:\/\/secblog.cs.washington.edu\/Security\/2009\/01\/22\/security-review-electronic-medical-records\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":78,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-488","post","type-post","status-publish","format-standard","hentry","category-security-reviews"],"_links":{"self":[{"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/posts\/488","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/users\/78"}],"replies":[{"embeddable":true,"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/comments?post=488"}],"version-history":[{"count":8,"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/posts\/488\/revisions"}],"predecessor-version":[{"id":493,"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/posts\/488\/revisions\/493"}],"wp:attachment":[{"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/media?parent=488"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/categories?post=488"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/secblog.cs.washington.edu\/Security\/wp-json\/wp\/v2\/tags?post=488"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}