ILLUSTRATION © VLADISLAV KOCHELAEVS / PICSFIVE 3


unauthorized server access, a healthcare institution should encrypt its entire network, both wired and wireless. 3. Database Encryption is by far


the most overlooked encryption strategy in health IT. The major database vendors sell a transparent data encryption (TDE) product, and most have offered it since 2005: Oracle with Oracle 10g, InterSystems with Caché, Microsoft with SQL Server 2005, and SQL Server 2008. If you have purchased an electronic health record (EHR) system that uses one of these databases, verify that TDE is in fact enabled within the application. Although the database may be capable of TDE, it doesn’t necessarily mean the vendor automatically uses it. Remember that for TDE in databases, the best practice is to make sure that the encryption keys are kept on a different server from the one where the database resides.


Include Backup Tapes


in Your Strategy In 2008, the University of Utah


reported that a container of backup tapes with the billing records of some 1.7 million patients was stolen from the vehicle of a courier from the university’s off-site storage vendor. These tapes contained the names, demographic information, and Social Security numbers of patients of the University of Utah Health Care hospitals and clinics. Healthcare CIOs must be aware of


the risks associated with unencrypted backup media. If tapes are encrypted, anyone who steals them will have useless media. This ensures that there will be no breach of medical information—which means there will also be no fines, penalties, or restitution requirements. However, if tapes are not encrypted, the Health Information Technology for Economic and Clinical Health (HITECH) Act’s


data breach compliance requirements kick in. An organization could pay millions in federal fines on top of the millions that must be spent on breach notification, consumer credit monitoring, and other fees. For backup media encryption, here


are a few tips to keep in mind: • Hardware-encrypted tapes are the


best media to use as they don’t use CPU cycles to encrypt while they are backing up data, and can encrypt at hardware speed. Many of the newest hardware-encrypted backup storage offerings on the market also are the fastest to provide backup services.


• Make sure you don’t lose the encryption keys—you won’t be able


to retrieve the data without them. • Storing the keys with the tapes is


like printing the combination of the office safe on the safe’s front door, so be sure to store them separately.


• Use the highest level of tape encryption available. The investment


is well worth it. Network Encryption


as a Key Approach Many healthcare CIOs forget


about wired and wireless network encryption. This is an important encryption strategy that should not be overlooked as there are many ways to attack a network and pull data as it goes by. In February 2010, the Federal


Trade Commission (FTC) notified more 90 organizations that personal information had been taken from their computer networks. The primary method used in the data breach was peer-to-peer (P2P) file-sharing. “[We] found health-related information, financial records, and driver’s license and Social Security numbers—the kind of information that could lead to identity theft,” FTC Chairman Jon Leibowitz said in a statement. “Companies should take a hard look at their systems to ensure


that there are no unauthorized P2P file-sharing programs, and that authorized programs are properly configured and secure.” The following network encryption


basics will help you protect data: • Be sure the routing works before


you try to encrypt. A remote peer may not have a route for the interface, which means you will not be able to have an encryption session with that peer.


• Encrypt your network at the endpoints. Encrypting routers


redundantly (decrypting and re-encrypting all traffic) wastes CPU cycles.


• Pay attention to network


bottlenecks. Low-end routers should not be used in main network cores. You will get a “CPU hog”-type message, because the volume of traffic uses all of the router’s CPU cycles to encrypt the traffic.


• If you need to encrypt anything


other than IP traffic, use a tunnel. • Network encryption encrypts


only the data in transmission. The data does not stay encrypted when it lands at the destination, so the data can be stolen if the destination server is breached, that data gets stolen, and all the work to encrypt the transmission is for naught.


• Guard against P2P network applications. If they are allowed


to run on your healthcare network, EHR data will be compromised. Overall, infrastructure encryption is


worth the investment. Though it can never be considered the “silver bullet” for medical record security, it is a best practice for securing EHR data if it’s used appropriately and at multiple hardware levels.


ABOUT THE AUTHOR Al Gallant is the director of technical services at Dartmouth-Hitchcock Medical Center in Lebanon, NH.


CONNECTION


VOLUME 1 • ISSUE 3


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36