Healthcare organizations and the cloud: Benefits, risks, and security best practices

Healthcare organizations are moving their business-critical applications and workloads to the cloud, and while there are many benefits (lower costs, added flexibility and greater scalability), there are also inherent risks that cannot be overlooked.

Ensuring organizations’ sensitive data is being monitored and protected (24/7) is key and having analysts who clearly understand security in the cloud is critical. Hiring and staffing these roles can be quite difficult because of the skillset required. Outsourcing cybersecurity to a managed security service provider (MSSP) is one viable solution for healthcare organizations that are in the process of migrating to the cloud and are concerned with protecting patient information, sensitive data, and applications.

Why healthcare organizations are moving to the cloud

HIMSS Analytics conducted a survey of healthcare IT professionals about their views of cloud usage, with nearly two-thirds of respondents saying they are currently using the cloud or cloud services.

Why are healthcare organizations finally making the move? Many have started to look at the cloud as a disaster recovery and backup option in the event of a ransomware attack, which affected the healthcare sector in 2017. The cloud also enables increased operational and storage flexibility as more healthcare companies use applications like precision medicine and population health.

Who’s responsible for keeping the cloud secured?

With so much critical information being accessed and stored in the cloud, it’s important to know who is responsible for monitoring authentication, communication, and client access to devices as well as how they’re securing it. Cloud application vendors are motivated to secure their infrastructure against denial of service attacks, disruption to service delivery, and large backend infrastructure breaches to protect their business. However, control over data access, user credentials (in some cases the application servers themselves), and regulatory compliance rests on the user organization’s IT team – not the cloud vendor. In short, cloud infrastructure providers are responsible for protecting their service, while IT teams must ensure their organization’s private data and critical applications are protected.

Whether you are using cloud providers (such as AWS or Microsoft Azure) to host your sensitive applications and data, taking advantage of Microsoft Office 365, or leveraging the scalability of a cloud-based electronic health record (EHR) application, security is a shared responsibility between the IT security team and cloud provider. As more healthcare organizations turn to cloud services, it is becoming critical for IT and security teams to understand the delineation of responsibility.

Taking the right security measures in cloud infrastructures

Most of the same security risks that apply to data and applications residing within a traditional data center also apply to virtualized assets in cloud infrastructures like AWS, Azure, and others. Virtual servers can be infected with malware or ransomware, credentials can be stolen, and cyber criminals can extract data which makes cyber protection even more important.

Web applications are one of the most significant sources of enterprise data breaches, and public-facing web applications are often hosted on cloud platforms. Because cloud platforms are designed for easy sharing, data runs the risk of becoming unintentionally shared or exposed. Misconfigured cloud-based data stores have resulted in many vulnerabilities and threats.

To address these risks, IT security teams are adopting security tools such as virtualized firewalls, web application firewalls, intrusion detection systems, and vulnerability scanning tools developed for cloud infrastructures. These technologies are integrated using service provider application programming interfaces (APIs) that are designed to address the virtualized and dynamic nature of these environments.

Protecting SaaS applications in the cloud

Software as a service (SaaS) applications like EHR software, Office360, and Salesforce often store sensitive patient data and confidential business and operational information. A breach or inadvertent exposure of this data can result in compliance violations, revenue loss, significant recovery expense, and can damage irreparably the organization’s reputation.

MSSPs and cloud access security brokers (CASBs) can collect and analyze authentication, access control, and cloud application transaction logs to identify suspicious behavior. Such logs include downloads, logins, usage, and application specific behaviors that may be analyzed by an MSSP to determine indicators of compromise.

Importance of Maintaining HIPAA compliance

For healthcare organizations, the Health Insurance Portability and Accountability Act (HIPAA) is an omnipresent reality. HIPAA requires patient data to be properly protected, no matter where it is being stored. Those who fail to protect patient data face fines and other regulatory penalties.

To meet HIPAA requirements, IT security teams should apply the same level of vigor to safeguarding their cloud-based data and applications as they would to on-premise applications and data. This can include deploying virtualized firewalls, scanning virtual servers for vulnerabilities, and monitoring and retaining log events from the public cloud.

How MSSPs can help implement stringent security in the cloud

When cloud migration, many healthcare organizations consider implementing in-house security solutions. This means hiring security experts and around-the-clock staff to manage and respond to alerts. With the current cybersecurity skills shortage, finding and building the right team is not always easy.

How can a healthcare organization maximize the rewards of cloud-based data and applications while minimizing the security risks? One approach is to outsource the security monitoring, investigations, and incident response to an MSSP.

MSSPs have a service model that is well-suited for healthcare organizations with limited resources and strict compliance requirements. MSSPs can act as an extension of a healthcare organization’s IT security team at a fraction of the cost associated with hiring additional employees and operating a 24/7 security operations center (SOC).

When choosing an MSSP, it is important that healthcare organizations thoroughly evaluate providers and cross-reference their healthcare expertise to ensure a smooth transition to the cloud. Key questions organizations should ask an MSSP include:

• Are you experienced with helping healthcare organizations protect their data and applications in the cloud?
• Does your mix of security services include 24/7 monitoring, breach detection, and incident response?
• Can you monitor log events from my preferred cloud provider and cloud-based application vendor?
• How do you ensure we will receive accurate and relevant actionable alerts?
• Can you manage or co-manage vulnerability management tools, virtualized firewalls, and endpoint security in cloud environments?
• Do you have a single portal where we drill into security events and understand our security posture for both cloud-based and on-premise assets?
• Do you offer HIPAA reporting and services to prepare us in the event of an HHS audit?

By asking these questions, healthcare organizations should be able to determine if the MSSP is equipped to handle security needs. Especially for healthcare organizations with limited budgets and small IT teams, a qualified MSSP can serve as an extension of their team, help improve cybersecurity posture, and make the most of moving to the cloud.