Securing Microsoft Technologies for HITECH Compliance

Securing Microsoft Technologies forHITECH ComplianceMarie-Michelle Strah, PhDSharePoint Saturday Philadelphia 2/4/2012

Introductions http://ideas.appliedis.comhttp://lifeincapslock.com

www.TriStateSharePoint.org

ObjectivesIntroduction: Why Microsoft Business Solutionsfor healthcare? •Context: ARRA/HITECH: INFOSEC and connected health information •Reference models: security, enterprise architecture and compliance for healthcare •Best Practices: privacy and security in Microsoft SharePoint Server 2010, Microsoft Dynamics CRM and Office365Panel: Q&A

What keeps a CMIO up at night?Excerpted from John D.Halamka, MD Life as aHealthcare CIO Blog…• Unstructured data• Compliance• Security• Workforce recruitmenthttp://geekdoctor.blogspot.com/2011/10/what-keeps-me-up-at-night-fy12-edition.html

Planning for Security and the “Black Swan”

2012 = Year of Privacy and ECM Privacy • Data (opt in/out) • PHI • PII “Black Swans” • Consumer Engagement • Business Associates

Enterprise Security Model �� = (�� ∗ �� )Information Security (Collaborative Model)EqualsPeople (all actors and agents)TimesArchitecture (technical, physical andadministrative)

2012: From HIPAA to HITECH and “Meaningful Use”• Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Pub L 104–191, 110 Stat 1936)• The Health Information Technology for Economic and Clinical Health Act (HITECH Act), enacted on February 17, 2009• American Recovery and Reinvestment Act of 2009 (ARRA) (Pub L 111-5, 123 Stat 115)

Complexity: RM, ECM and eDiscovery �� = (�� ∗ �� ) do the HITECH math… Application of HIPAA Security Standards to Business Associates“Business Associates”: 42 USC §17931• Legal• Accounting New Security Breach• Administrative Requirements• Claims Processing 42 USC §17932(j)• Data Analysis• QA Electronic Access Mandatory for• Billing Patients 42 USC 17935(e)45 CFR §160.103 Prohibited Sale of PHI withoutConsumer Engagement Patient Authorization 42 USC §17935(d)

You Don’t Believe Me?: In the NewsRecent Cryptzone Survey Healthcare IT NewsGothenburg, 19 January 2012 Sacramento, 23 November 2011Survey finds almost half of The theft of a computer during aSharePoint users disregard the break-in in October has spurred asecurity within SharePoint, and $1B class action lawsuit againstcopy sensitive or confidential Sutter Health, according to adocuments to insecure hard report published today by thedrives, USB keys or even email it to Sacramento Bee. The computera third party. contained data on more than 4 million patients.Read more: SharePoint UsersDevelop Insecure Habits - See also: Room for improvementFierceContentManagement on security, HIMSS survey shows

Complexity = Higher Risks and Costs

SOA: Service-Oriented Architecture“Hub” Model reduces complexity and variability while maintaining collaboration and interoperability

Challenge: connect, collaborate and compartmentalizeMicrosoft Connected Health Framework Businessand Technical Framework (Joint Architecture)http://hce.codeplex.com/

Microsoft Business Solutions as part of a Connected Health Framework• Patient Encounters• CPG• HIPAA Direct Identifiers Clinical Workflow• EEOI• ePHI EHR Integration Intake Forms Unstructured Data• SharePoint 2010• Dynamics CRM• Office365 R&D BPM

Microsoft Business Solutions as part of a Connected Health FrameworkCurrent example: multi-site resident treatment facility-Provider emails (nurse/contract doctors)-Word documents (patient notes) on file servers - unsecured-PDFs (scanned records/PHI) on file servers – unsecured -no encryption -no search -no IAM beyond Windows authentication-2011 EHR adoptionCurrent example 2:ePHI data with SSN being exported as whatever file type-No control over what file type-No way to force encryption-No way to force a file save location (sharephi_encrypted_folder)

Enterprise Security Planning• PRIVACY IMPACT ASSESSMENT • 18 direct identifiers (HIPAA) • “content shielding” • Data architecture• Encryption of data at rest/data in motion• 2 factor authentication• Perimeter topologies• Segmentation and compartmentalization of PHI/PII (logical and physical)• Wireless (RFID/Bluetooth)• Business Continuity• Backup and Recovery• Mobile Device Management/BYOD World

Security Architecture – SPS2010 Business ConnectivityAuthorization Services Hardware UPM Authentication Permissions Data Level Endpoint Federated ID Security Security Security Classic/Claims Groups LOB Mobile Integration Remote IIS/STS �� = (�� ∗ �� )

Behavioral Factors: Security Architecture • #hcsm • User population challenges • clinicians • business associates • domain knowledge •“Prurient interest” • Mobile technologies �� = (�� ∗ �� )

“Can’t Do it Alone:” Security Ecosystem• Native ISV • Network• 20% • Governance • Data at Rest • UPM/IAM • 100% • 60% SP2010 ISV On Premise Cloud 12/14/2011 • Office365 HIPAA/EU compliance • BAA

Sample: Security Planning Checklist• Content types (PHI/PII)• ECM/OCR• Digital Rights Management (DRM)• Business Connectivity Services and Visio Services (external data sources)• Excel, lists, SQL, custom data providers• Integrated Windows with constrained Kerberos• Metadata and tagging (PHI/PII)• Blogs and wikis (PHI)• Plan permission levels and groups (least privileges) – providers and business associates• Plan site permissions• Fine-grained permissions (item-level)• Security groups (custom)• Contribute permissions

Best Practices: Preventative Model• Involve HIPAA specialists early in the planning process. (This is NOT an IT problem)• Privacy Impact Assessment: PHI, ePHI, PII (Compartmentalization and segregation)• Trust, but verify• Look to experts to help with existing implementations. (Domain expertise in healthcare and clinical workflow as well as HIPAA/HITECH privacy and security)• Use connected health framework reference model• Governance, governance, governance

Governance: Adapting the Joint Commission Continuous Process Improvement Model Plan • Technical, Physical, Administrative Safeguards Document • Joint Commission, Policies, Procedures, IT Governance Train • Clinical, Administrative and Business Associates Track • Training, Compliance, Incidents, Access…. everything Review • Flexibility, Agility, Architect for Change

The Ideal Employees Contractors Partners Need to know Need to manage InfoSec IT Ops Legal

The Reality Employees IT Ops Contractors Partners Manage Know InfoSec Legal

The Challenge • There is no endpoint • There is no perimeter • Users own the data Employees Contractors Partners • No one owns the risk • Security doesn’t have control • IT Ops own the databases • IT Ops own the servers • IT Ops own the apps (SharePoint) InfoSec IT Ops Legal

• Unstructured Data – Scan – Quarantine PII – Tag• Compliance and Reporting – Enhance control of all ePHI and PII – In line with HIPPA and HITECH Act regulation © 2011 AvePoint, Inc. All rights reserved. No part of this may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written consent of AvePoint, Inc.

• Security – Easily set Rules and Permissions in bulk – Run scheduled reports on all SharePoint Activity – Safely archive inactive data for compliance• Workflow Management – Rearrange taxonomy to meet evolving business needs – Full fidelity backup and restoration of data – Improved performance, Environment monitoring © 2011 AvePoint, Inc. All rights reserved. No part of this may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written consent of AvePoint, Inc.

Thank You! For more information… http://ideas.appliedis.comhttp://lifeincapslock.com

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Securing Microsoft Technologies for HITECH Compliance

by Marie-Michelle Strah, PhD on Feb 06, 2012

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