SlideShare a Scribd company logo
1 of 106
Download to read offline
Health Information
Privacy & Security
Nawanan Theera-Ampornpunt, M.D., Ph.D.
Faculty of Medicine Ramathibodi Hospital
Mahidol University
For Ramathibodi M.S. & Ph.D. Programs in Data Science for Health Care
October 17, 2017
http://www.SlideShare.net/Nawanan
 Introduction to Information Privacy & Security
 Protecting Information Privacy & Security
 User Security
 Malware
 Security Standards
 Privacy & Security Laws
Outline
Introduction to
Information Privacy &
Security
Malware
Threats to Information Security
(Top) http://deadline.com/2014/12/sony-hack-timeline-any-pascal-the-interview-north-korea-1201325501/
(Bottom) http://www.bloomberg.com/news/articles/2014-12-07/sony-s-darkseoul-breach-stretched-from-thai-hotel-
to-hollywood
Security Threats & Thailand
http://www.aclu.org/ordering-pizza
Privacy Protections: Why?
Sources of the Threats
 Hackers
 Viruses & Malware
 Poorly-designed systems
 Insiders (Employees)
 People’s ignorance & lack of knowledge
 Disasters & other incidents affecting
information systems
 Information risks
 Unauthorized access & disclosure of confidential information
 Unauthorized addition, deletion, or modification of information
 Operational risks
 System not functional (Denial of Service - DoS)
 System wrongly operated
 Personal risks
 Identity thefts
 Financial losses
 Disclosure of information that may affect employment or other
personal aspects (e.g. health information)
 Physical/psychological harms
 Organizational risks
 Financial losses
 Damage to reputation & trust
 Etc.
Consequences of Security Attacks
Security & Privacy
http://en.wikipedia.org/wiki/A._S._Bradford_House
Privacy & Security
 Privacy: “The ability of an individual or group
to seclude themselves or information about
themselves and thereby reveal themselves
selectively.” (Wikipedia)
 Security: “The degree of protection to safeguard
... person against danger, damage, loss, and
crime.” (Wikipedia)
 Information Security: “Protecting information
and information systems from unauthorized
access, use, disclosure, disruption, modification,
perusal, inspection, recording or destruction”
(Wikipedia)
Privacy & Security
Information Security
 Confidentiality
 Integrity
 Availability
Examples of Confidentiality Risks
http://usatoday30.usatoday.com/life/people/2007-10-10-clooney_N.htm
Examples of Integrity Risks
http://www.wired.com/threatlevel/2010/03/source-code-hacks/
http://en.wikipedia.org/wiki/Operation_Aurora
“Operation Aurora”
Alleged Targets: Google, Adobe, Juniper Networks,
Yahoo!, Symantec, Northrop Grumman, Morgan Stanley,
Dow Chemical
Goal: To gain access to and potentially modify source
code repositories at high tech, security & defense
contractor companies
Examples of Integrity Risks
http://news.softpedia.com/news/700-000-InMotion-Websites-Hacked-by-TiGER-M-TE-223607.shtml
Web Defacements
Examples of Availability Risks
http://en.wikipedia.org/wiki/Blaster_worm
Viruses/worms that led to instability &
system restart (e.g. Blaster worm)
Examples of Availability Risks
http://en.wikipedia.org/wiki/Ariane_5_Flight_501
Ariane 5 Flight 501 Rocket Launch Failure
Cause: Software bug on rocket acceleration due to data conversion
from a 64-bit floating point number to a 16-bit signed integer without
proper checks, leading to arithmatic overflow
บทความใน JAMA เร็วๆ นี้
JAMA. 2015 Apr 14;313(14).
Protecting Information
Privacy & Security
 Attack
 An attempt to breach system security
 Threat
 A scenario that can harm a system
 Vulnerability
 The “hole” that is used in the attack
Common Security Terms
 Identify some possible means an
attacker could use to conduct a
security attack
Class Exercise
Alice
Simplified Attack Scenarios
Server Bob
Eve/Mallory
Alice
Simplified Attack Scenarios
Server Bob
- Physical access to client computer
- Electronic access (password)
- Tricking user into doing something
(malware, phishing & social
engineering)
Eve/Mallory
Alice
Simplified Attack Scenarios
Server Bob
- Intercepting (eavesdropping or
“sniffing”) data in transit
- Modifying data (“Man-in-the-
middle” attacks)
- “Replay” attacks
Eve/Mallory
Alice
Simplified Attack Scenarios
Server Bob
- Unauthorized access to servers through
- Physical means
- User accounts & privileges
- Attacks through software vulnerabilities
- Attacks using protocol weaknesses
- DoS / DDoS attacks Eve/Mallory
Alice
Simplified Attack Scenarios
Server Bob
Other & newer forms of
attacks possible
Eve/Mallory
Alice
Safeguarding Against Attacks
Server Bob
Administrative Security
- Security & privacy policy
- Governance of security risk management & response
- Uniform enforcement of policy & monitoring
- Disaster recovery planning (DRP) & Business continuity
planning/management (BCP/BCM)
- Legal obligations, requirements & disclaimers
Alice
Safeguarding Against Attacks
Server Bob
Physical Security
- Protecting physical access of clients & servers
- Locks & chains, locked rooms, security cameras
- Mobile device security
- Secure storage & secure disposition of storage devices
Alice
Safeguarding Against Attacks
Server Bob
User Security
- User account management
- Strong p/w policy (length, complexity, expiry, no meaning)
- Principle of Least Privilege
- “Clear desk, clear screen policy”
- Audit trails
- Education, awareness building & policy enforcement
- Alerts & education about phishing & social engineering
Alice
Safeguarding Against Attacks
Server Bob
System Security
- Antivirus, antispyware, personal firewall, intrusion
detection/prevention system (IDS/IPS), log files, monitoring
- Updates, patches, fixes of operating system vulnerabilities &
application vulnerabilities
- Redundancy (avoid “Single Point of Failure”)
- Honeypots
Alice
Safeguarding Against Attacks
Server Bob
Software Security
- Software (clients & servers) that is secure by design
- Software testing against failures, bugs, invalid inputs,
performance issues & attacks
- Updates to patch vulnerabilities
Alice
Safeguarding Against Attacks
Server Bob
Network Security
- Access control (physical & electronic) to network devices
- Use of secure network protocols if possible
- Data encryption during transit if possible
- Bandwidth monitoring & control
Alice
Safeguarding Against Attacks
Server Bob
Database Security
- Access control to databases & storage devices
- Encryption of data stored in databases if necessary
- Secure destruction of data after use
- Access control to queries/reports
- Security features of database management systems (DBMS)
Privacy Safeguards
Image: http://www.nurseweek.com/news/images/privacy.jpg
 Security safeguards
 Informed consent
 Privacy culture
 User awareness building & education
 Organizational policy & regulations
 Enforcement
 Ongoing privacy & security assessments, monitoring,
and protection
User Security
https://www.thaicert.or.th/downloads/files/BROCHURE_security_awareness.png
 Access control
 Selective restriction of access to the system
 Role-based access control
 Access control based on the person’s role
(rather than identity)
 Audit trails
 Logs/records that provide evidence of
sequence of activities
User Security
 Identification
 Identifying who you are
 Usually done by user IDs or some other unique codes
 Authentication
 Confirming that you truly are who you identify
 Usually done by keys, PIN, passwords or biometrics
 Authorization
 Specifying/verifying how much you have access
 Determined based on system owner’s policy & system
configurations
 “Principle of Least Privilege”
User Security
 Nonrepudiation
 Proving integrity, origin, & performer of an
activity without the person’s ability to refute
his actions
 Most common form: signatures
 Electronic signatures offer varying degrees of
nonrepudiation
 PIN/password vs. biometrics
 Digital certificates (in public key
infrastructure - PKI) often used to ascertain
nonrepudiation
User Security
 Multiple-Factor Authentication
 Two-Factor Authentication
 Use of multiple means (“factors”) for authentication
 Types of Authentication Factors
 Something you know
 Password, PIN, etc.
 Something you have
 Keys, cards, tokens, devices (e.g. mobile phones)
 Something you are
 Biometrics
User Security
Need for Strong Password Policy
So, two informaticians
walk into a bar...
The bouncer says,
"What's the password."
One says, "Password?"
The bouncer lets them
in.
Credits: @RossMartin & AMIA (2012)
Recommended Password Policy
 Length
 8 characters or more (to slow down brute-force attacks)
 Complexity (to slow down brute-force attacks)
 Consists of 3 of 4 categories of characters
 Uppercase letters
 Lowercase letters
 Numbers
 Symbols (except symbols that have special uses by the
system or that can be used to hack system, e.g. SQL Injection)
 No meaning (“Dictionary Attacks”)
 Not simple patterns (12345678, 11111111) (to slow down brute-
force attacks & prevent dictionary attacks)
 Not easy to guess (birthday, family names, etc.) (to prevent
unknown & known persons from guessing)
Personal opinion. No legal responsibility assumed.
Recommended Password Policy
 Expiration (to make brute-force attacks not possible)
 6-8 months
 Decreasing over time because of increasing computer’s
speed
 But be careful! Too short duration will force users to write
passwords down
 Secure password storage in database or system
(encrypted or store only password hashes)
 Secure password confirmation
 Secure “forget password” policy
 Different password for each account. Create variations
to help remember. If not possible, have different sets of
accounts for differing security needs (e.g., bank
accounts vs. social media sites) Personal opinion. No legal responsibility assumed.
{
Dictionary Attack:
A story from a
computer security course
Techniques to Remember Passwords
 http://www.wikihow.com/Create-a-Password-You-Can-
Remember
 Note that some of the techniques are less secure!
 One easy & secure way: password mnemonic
 Think of a full sentence that you can remember
 Ideally the sentence should have 8 or more words, with
numbers and symbols
 Use first character of each word as password
 Sentence: I love reading all 7 Harry Potter books!
 Password: Ilra7HPb!
 Voila!
Personal opinion. No legal responsibility assumed.
Phishing E-mail
Phishing E-mail
Phishing E-mail
 Poor grammar
 Lots of typos
 Trying very hard to convince you to open
attachment, click on link, or reply without
enough detail
 May appear to be from known person (rely on
trust & innocence)
Signs of a Phishing Attack
 Don’t be too trusting of people
 Always be suspicious & alert
 An e-mail with your friend’s name & info doesn’t have
to come from him/her
 Look for signs of phishing attacks
 Don’t open attachments unless you expect them
 Scan for viruses before opening attachments
 Don’t click links in e-mail. Directly type in browser
using known & trusted URLs
 Especially cautioned if ask for passwords, bank
accounts, credit card numbers, social security numbers,
etc.
Ways to Protect against Phishing
Ransomware
The Day We All
WannaCry’ed
http://www.mirror.co.uk/news/uk-news/ransomware-nhs-cyber-attack-live-10409420
Infected with WannaCry
https://cdn.securelist.com/files/2017/05/wannacry_05.png
WannaCry: Infection Flow
http://blog.trendmicro.com/trendlabs-security-intelligence/files/2017/05/WannaCry-infection-flow02.jpg
WannaCry
WannaCry &
Medical Devices
Petya/Petwrap/NotPetya
https://www.bleepstatic.com/images/news/ransomware/p/notpetya/mbr-ransom-note.jpg
Software Security
 Consider a log-in form on a web page
Example of Weak Input Checking:
SQL Injection
 Source code would look
something like this:
statement = "SELECT * FROM users
WHERE name = '" + userName + "';"
 Attacker would enter as username:
' or '1'='1
 Which leads to this always-true query:
 statement = "SELECT * FROM users
WHERE name = '" + "' or '1'='1" + "';"
statement = "SELECT * FROM users WHERE name = '' or '1'='1';"
http://en.wikipedia.org/wiki/SQL_injection
 Defense in Depth
 Multiple layers of security defense are placed
throughout a system to provide redundancy
in the event a security control fails
 Secure the weakest link
 Promote privacy
 Trust no one
Some Security Principles
Saltzer & Schroeder (1975), Viega & McGraw (2000)
Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
http://en.wikipedia.org/wiki/Defense_in_depth_(computing)
 Modular design
 Check error conditions on return values
 Validate inputs (whitelist vs. blacklist)
 Avoid infinite loops, memory leaks
 Check for integer overflows
 Language/library choices
 Development processes
Secure Software Best Practices
Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
Malware
 Malicious software - Any code with intentional,
undesirable side effects
 Virus
 Worm
 Trojan
 Spyware
 Logic Bomb/Time Bomb
 Backdoor/Trapdoor
 Rootkit
 Botnet
Malware
 Virus
 Propagating malware that requires user action
to propagate
 Infects executable files, data files with
executable contents (e.g. Macro), boot sectors
 Worm
 Self-propagating malware
 Trojan
 A legitimate program with additional, hidden
functionality
Malware
 Spyware
 Trojan that spies for & steals personal
information
 Logic Bomb/Time Bomb
 Malware that triggers under certain conditions
 Backdoor/Trapdoor
 A hole left behind by malware for future access
Malware
 Rogue Antispyware (Ransomware)
 Software that tricks or forces users to pay before fixing
(real or hoax) spyware detected
 Rootkit
 A stealth program designed to hide existence of
certain processes or programs from detection
 Botnet
 A collection of Internet-connected computers that have
been compromised (bots) which controller of the
botnet can use to do something (e.g. do DDoS attacks)
Malware
 Installed & updated antivirus, antispyware, &
personal firewall
 Check for known signatures
 Check for improper file changes (integrity failures)
 Check for generic patterns of malware (for unknown
malware): “Heuristics scan”
 Firewall: Block certain network traffic in and out
 Sandboxing
 Network monitoring & containment
 User education
 Software patches, more secure protocols
Defense Against Malware
 Social media spams/scams/clickjacking
 Social media privacy issues
 User privacy settings
 Location services
 Mobile device malware & other privacy risks
 Stuxnet (advanced malware targeting certain
countries)
 Advanced persistent threats (APT) by
governments & corporations against specific
targets
Newer Threats
Security Standards
• ISO/IEC 27000 — Information security management systems — Overview and
vocabulary
• ISO/IEC 27001 — Information security management systems — Requirements
• ISO/IEC 27002 — Code of practice for information security management
• ISO/IEC 27003 — Information security management system implementation guidance
• ISO/IEC 27004 — Information security management — Measurement
• ISO/IEC 27005 — Information security risk management
• ISO/IEC 27031 — Guidelines for information and communications technology readiness
for business continuity
• ISO/IEC 27032 — Guideline for cybersecurity (essentially, 'being a good neighbor' on
the Internet)
• ISO/IEC 27033-1 — Network security overview and concepts
• ISO/IEC 27033-2 — Guidelines for the design and implementation of network security
• ISO/IEC 27033-3:2010 — Reference networking scenarios - Threats, design techniques
and control issues
• ISO/IEC 27034 — Guideline for application security
• ISO/IEC 27035 — Security incident management
• ISO 27799 — Information security management in health using ISO/IEC 27002
Some Information Security Standards
 US-CERT
 U.S. Computer Emergency Readiness Team
 http://www.us-cert.gov/
 Subscribe to alerts & news
 Microsoft Security Resources
 http://technet.microsoft.com/en-us/security
 http://technet.microsoft.com/en-
us/security/bulletin
 Common Vulnerabilities & Exposures
 http://cve.mitre.org/
More Information
Privacy & Security
Laws
 Respect for Persons (Autonomy)
 Beneficence
 Justice
 Non-maleficence
Ethical Principles in Bioethics
Hippocratic Oath
...
What I may see or hear in the course of
treatment or even outside of the
treatment in regard to the life of men,
which on no account one must spread
abroad, I will keep myself holding such
things shameful to be spoken about.
...
http://en.wikipedia.org/wiki/Hippocratic_Oath
Privacy Safeguards
Image: http://www.nurseweek.com/news/images/privacy.jpg
 Security safeguards
 Informed consent
 Privacy culture
 User awareness building & education
 Organizational policy & regulations
 Enforcement
 Ongoing privacy & security assessments, monitoring,
and protection
HIPAA
 Health Insurance Portability and Accountability Act of
1996 http://www.gpo.gov/fdsys/pkg/PLAW-
104publ191/pdf/PLAW-104publ191.pdf
 More stringent state privacy laws apply
 HIPAA Goals
 To protect health insurance coverage for workers &
families when they change or lose jobs (Title I)
 To require establishment of national standards for
electronic health care transactions and national
identifiers for providers, health insurance plans, and
employers (Title II: “Administrative Simplification”
provisions)
 Administrative Simplification provisions also address
security & privacy of health data
U.S. Health Information Privacy Law
http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act
 Title I: Health Care Access, Portability, and
Renewability
 Title II: Preventing Health Care Fraud and
Abuse; Administrative Simplification;
Medical Liability Reform
 Requires Department of Health & Human
Services (HHS) to draft rules aimed at increasing
efficiency of health care system by creating
standards for use and dissemination of health
care information
HIPAA (U.S.)
 Title III: Tax-Related Health Provisions
 Title IV: Application and Enforcement
of Group Health Plan Requirements
 Title V: Revenue Offsets
HIPAA (U.S.)
 HHS promulgated 5 Administrative
Simplification rules
 Privacy Rule
 Transactions and Code Sets Rule
 Security Rule
 Unique Identifiers Rule
 Enforcement Rule
HIPAA (U.S.)
 Covered Entities
 A health plan
 A health care clearinghouse
 A healthcare provider who transmits any health
information in electronic form in connection with a
transaction to enable health information to be exchanged
electronically
 Business Associates
Some HIPAA Definitions
 Protected Health Information (PHI)
 Individually identifiable health information transmitted or
maintained in electronic media or other form or medium
 Individually Identifiable Health Information
 Any information, including demographic information collected from
an individual, that—
 (A) is created or received by a CE; and
 (B) relates to the past, present, or future physical
 or mental health or condition of an individual, the provision of
health care to an individual, or the past, present, or future payment
for the provision of health care to an individual, and—
 (i) identifies the individual; or
 (ii) with respect to which there is a reasonable basis to believe that
the information can be used to identify the individual.
Some HIPAA Definitions
 Name
 Address
 Phone number
 Fax number
 E-mail address
 SSN
 Birthdate
 Medical Record No.
 Health Plan ID
 Treatment date
 Account No.
 Certificate/License No.
 Device ID No.
 Vehicle ID No.
 Drivers license No.
 URL
 IP Address
 Biometric identifier
including fingerprints
 Full face photo
Protected Health Information –
Personal Identifiers in PHI
 Establishes national standards to protect PHI; applies to CE &
business associates
 Requires appropriate safeguards to protect privacy of PHI
 Sets limits & conditions on uses & disclosures that may be made
without patient authorization
 Gives patients rights over their health information, including
rights to examine & obtain copy of health records & to request
corrections
HIPAA Privacy Rule
http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/index.html
 Timeline
 November 3, 1999 Proposed Privacy Rule
 December 28, 2000 Final Privacy Rule
 August 14, 2002 Modifications to Privacy Rule
 April 14, 2003 Compliance Date for most CE
 Full text (as amended)
http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/
adminsimpregtext.pdf
HIPAA Privacy Rule
http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/index.html
 Some permitted uses and disclosures
 Use of PHI
 Sharing, application, use, examination or
analysis within the entity that maintains the
PHI
 Disclosure of PHI
 Release or divulgence of information by an
entity to persons or organizations outside of
that entity.
HIPAA Privacy Rule
 A covered entity may not use or disclose
PHI, except
 with individual consent for treatment,
payment or healthcare operations (TPO)
 with individual authorization for other
purposes
 without consent or authorization for
governmental and other specified
purposes
HIPAA Privacy Rule
 Treatment, payment, health care operations
(TPO)
 Quality improvement
 Competency assurance
 Medical reviews & audits
 Insurance functions
 Business planning & administration
 General administrative activities
HIPAA Privacy Rule
 Uses & disclosures without the need for patient
authorization permitted in some circumstances
 Required by law
 For public health activities
 About victims of abuse, neglect, or domestic
violence
 For health oversight activities
 For judicial & administrative proceedings
 For law enforcement purposes
 About decedents
HIPAA Privacy Rule
 Uses & disclosures without the need for patient
authorization permitted in some circumstances
 For cadaveric organ, eye, or tissue donation purposes
 For research purposes
 To avert a serious threat to health or safety
 For workers’ compensation
 For specialized government functions
 Military & veterans activities
 National security & intelligence activities
 Protective services for President & others
 Medical suitability determinants
 Correctional institutions
 CE that are government programs providing public benefits
HIPAA Privacy Rule
 Control use and disclosure of PHI
 Notify patients of information practices (NPP, Notice of Privacy
Practices)
 Specifies how CE can use and share PHI
 Specifies patient’s rights regarding their PHI
 Provide means for patients to access their own record
 Obtain authorization for non-TPO uses and disclosures
 Log disclosures
 Restrict use or disclosures
 Minimum necessary
 Privacy policy and practices
 Business Associate agreements
 Other applicable statutes
 Provide management oversight and response to minimize threats and
breaches of privacy
Responsibilities of a CE
From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
 Individually identifiable health information
collected and used solely for research IS NOT PHI
 Researchers obtaining PHI from a CE must obtain
the subject’s authorization or must justify an
exception:
 Waiver of authorization (obtain from the IRB)
 Limited Data Set (with data use agreement)
 De-identified Data Set
 HIPAA Privacy supplements the Common Rule
and the FDA’s existing protection for human
subjects
HIPAA & Research
From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
 De-identified Data Set
 Remove all 18 personal identifiers of subjects,
relatives, employers, or household members
 OR biostatistician confirms that individual cannot be
identified with the available information
 Limited Data Set
 May include Zip, Birthdate, Date of death, date of
service, geographic subdivision
 Remove all other personal identifiers of subject, etc.
 Data Use Agreement signed by data recipient that
there will be no attempt to re-identify the subject
Research Data Sets
From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
 Assure the CE that all research-initiated HIPAA
requirements have been met
 Provide letter of approval to the researcher to
conduct research using PHI
 OR, Certify and document that waiver of
authorization criteria have been met
 Review and approve all authorizations and data
use agreements
 Retain records documenting HIPAA actions for 6
years
IRB’s New Responsibility
From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
 Establishes national standards to protect
individuals’ electronic PHI that is created,
received, used, or maintained by a CE.
 Requires appropriate safeguards to ensure
confidentiality, integrity & security of
electronic PHI
 Administrative safeguards
 Physical safeguards
 Technical safeguards
HIPAA Security Rule
http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/index.html
 Timeline
 August 12, 1998 Proposed Security Rule
 February 20, 2003 Final Security Rule
 April 21, 2005 Compliance Date for most CE
 Full Text
http://www.hhs.gov/ocr/privacy/hipaa/
administrative/securityrule/securityrulepdf.pdf
HIPAA Security Rule
http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/index.html
 The HIPAA Security Rule is:
 A set of information security “best practices”
 A minimum baseline for security
 An outline of what to do, and what procedures
should be in place
 The HIPAA Security Rule is not:
 A set of specific instructions
 A set of rules for universal, unconditional
implementation
 A document outlining specific implementations
(vendors, equipment, software, etc.)
HIPAA Security Rule: Meaning
From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
 Many rules are either Required or Addressable
 Required:
 Compliance is mandatory
 Addressable:
 If a specification in the Rule is reasonable and
appropriate for the CE, then the CE must implement
 Otherwise, documentation must be made of the
reasons the policy cannot/will not be implemented,
and when necessary, offer an alternative
HIPAA Security Rule: Meaning
From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
 Breach notification
 Extension of complete Privacy & Security
HIPAA provisions to business associates of
covered entities
 New rules for accounting of disclosures of a
patient’s health information
New in HITECH Act of 2009
 Conflicts between federal vs. state laws
 Variations among state laws of different
states
 HIPAA only covers “covered entities”
 No general privacy laws in place, only a few
sectoral privacy laws e.g. HIPAA
Health Information Privacy Law:
U.S. Challenges
 Canada - The Privacy Act (1983), Personal
Information Protection and Electronic Data
Act of 2000
 EU Countries - EU Data Protection Directive
 UK - Data Protection Act 1998
 Austria - Data Protection Act 2000
 Australia - Privacy Act of 1988
 Germany - Federal Data Protection Act of
2001
Health Information Privacy Law:
Other Western Countries
Thailand’s Health
Information Privacy
Law
 The Official Information Act, B.E.
2540
 Requires official information within
the government (with exceptions
such as some personal information)
to be disclosed to the public up front
or upon request
 “Disclose by default, protect by
exceptions”
Thai Privacy Laws
 No universal personal data privacy law
(Draft law has been proposed)
 National Health Act, B.E. 2550
 Provision 7 provides protection of
health information from disclosures
that could be damaging to an
individual without his/her consent or
as required by law.
Thai Privacy Laws
 Computer-Related Crimes Act, B.E. 2550 & 2560
 Focuses on prosecuting computer crimes &
computer-related crimes
 Responsibility of organizations as IT service
provider: Logging & provision of access data
to authorities
Thai ICT Laws
 Electronic Transactions Acts, B.E. 2544 & 2551
 Affirms legal status of electronic data
 Addresses how electronic transactions and
electronic signatures work in the legal context
 Security & privacy requirements for
 Determining legal validity & integrity of
electronic transactions and documents, print-
outs, & paper-to-electronic conversions
 Governmental & public organizations
 Critical infrastructures
 Financial sectors
 Electronic certificate authorities
Thai ICT Laws
Security Requirements for Critical Infrastructure in Thailand
Domain Basic Medium
(In addition to Basic)
High
(In addition to Medium)
Security policy 1 Item 1 Item -
Organization of information security 5 Items 3 Items 3 Items
Asset management 1 Item 4 Items -
Human resources security 6 Items 1 Item 2 Items
Physical and environmental security 5 Items 2 Items 6 Items
Communications & operations management 18 Items 5 Items 9 Items
Access control 9 Items 8 Items 8 Items
Information systems acquisition,
development and maintenance
2 Items 6 Items 8 Items
Information security incident management 1 Item - 3 Items
Business continuity management 1 Item 3 Items 1 Item
Regulatory compliance 3 Items 5 Items 2 Items
รวม 52 Items 38 Items (90 Items Total) 42 Items (132 Items Total)
Q & A

More Related Content

What's hot

Medical Records Privacy Confidentiality And Security
Medical Records Privacy Confidentiality And SecurityMedical Records Privacy Confidentiality And Security
Medical Records Privacy Confidentiality And Security
Abbas Shojaee MD, CHDA
 
Health information systems (his)
Health information systems (his)Health information systems (his)
Health information systems (his)
Nkosinathi Lungu
 
Healthcare confidentiality training.2013bev
Healthcare confidentiality training.2013bevHealthcare confidentiality training.2013bev
Healthcare confidentiality training.2013bev
blk70130
 
Powerpoint on electronic health record lab 1
Powerpoint on electronic health record lab 1Powerpoint on electronic health record lab 1
Powerpoint on electronic health record lab 1
nephrology193
 
Patient confidentiality
Patient confidentialityPatient confidentiality
Patient confidentiality
ptamayo1958
 

What's hot (20)

Cybersecurity Challenges in Healthcare
Cybersecurity Challenges in HealthcareCybersecurity Challenges in Healthcare
Cybersecurity Challenges in Healthcare
 
eBook - Data Analytics in Healthcare
eBook - Data Analytics in HealthcareeBook - Data Analytics in Healthcare
eBook - Data Analytics in Healthcare
 
Clinical Information Systems
Clinical Information SystemsClinical Information Systems
Clinical Information Systems
 
Mobile Health(mHealth): A Technology in Healthcare
Mobile Health(mHealth): A Technology in HealthcareMobile Health(mHealth): A Technology in Healthcare
Mobile Health(mHealth): A Technology in Healthcare
 
Medical Records Privacy Confidentiality And Security
Medical Records Privacy Confidentiality And SecurityMedical Records Privacy Confidentiality And Security
Medical Records Privacy Confidentiality And Security
 
Data Security in Healthcare
Data Security in HealthcareData Security in Healthcare
Data Security in Healthcare
 
Clinical Information Systems, Hospital Information Systems & Electronic Healt...
Clinical Information Systems, Hospital Information Systems & Electronic Healt...Clinical Information Systems, Hospital Information Systems & Electronic Healt...
Clinical Information Systems, Hospital Information Systems & Electronic Healt...
 
e-health
e-healthe-health
e-health
 
Health information systems (his)
Health information systems (his)Health information systems (his)
Health information systems (his)
 
Healthcare confidentiality training.2013bev
Healthcare confidentiality training.2013bevHealthcare confidentiality training.2013bev
Healthcare confidentiality training.2013bev
 
Health Information Privacy and Security
Health Information Privacy and SecurityHealth Information Privacy and Security
Health Information Privacy and Security
 
Clinical Decision Support Systems
Clinical Decision Support SystemsClinical Decision Support Systems
Clinical Decision Support Systems
 
Overview of Health Informatics
Overview of Health InformaticsOverview of Health Informatics
Overview of Health Informatics
 
Introduction to Health Informatics and Health Information Technology (Part 1)...
Introduction to Health Informatics and Health Information Technology (Part 1)...Introduction to Health Informatics and Health Information Technology (Part 1)...
Introduction to Health Informatics and Health Information Technology (Part 1)...
 
EMR vs EHR
EMR vs EHREMR vs EHR
EMR vs EHR
 
Patient Privacy and Safety in Healthcare
Patient Privacy and Safety in HealthcarePatient Privacy and Safety in Healthcare
Patient Privacy and Safety in Healthcare
 
Health Data ppt
Health Data pptHealth Data ppt
Health Data ppt
 
Powerpoint on electronic health record lab 1
Powerpoint on electronic health record lab 1Powerpoint on electronic health record lab 1
Powerpoint on electronic health record lab 1
 
Introduction to Health Informatics
Introduction to Health InformaticsIntroduction to Health Informatics
Introduction to Health Informatics
 
Patient confidentiality
Patient confidentialityPatient confidentiality
Patient confidentiality
 

Similar to Health Information Privacy and Security

Security ConceptsDr. Y. ChuCIS3360 Security in Computing.docx
Security ConceptsDr. Y. ChuCIS3360 Security in Computing.docxSecurity ConceptsDr. Y. ChuCIS3360 Security in Computing.docx
Security ConceptsDr. Y. ChuCIS3360 Security in Computing.docx
bagotjesusa
 
SegurançA Da InformaçãO Faat V1 4
SegurançA Da InformaçãO Faat V1 4SegurançA Da InformaçãO Faat V1 4
SegurançA Da InformaçãO Faat V1 4
Rodrigo Piovesana
 
302 Content Server Security Challenges And Best Practices
302   Content Server Security   Challenges And Best Practices302   Content Server Security   Challenges And Best Practices
302 Content Server Security Challenges And Best Practices
phanleson
 
1.Security Overview And Patching
1.Security Overview And Patching1.Security Overview And Patching
1.Security Overview And Patching
phanleson
 
CYBER SECURITY PRIMERCYBER SECURITY PRIMERA brief in
CYBER SECURITY PRIMERCYBER SECURITY PRIMERA brief inCYBER SECURITY PRIMERCYBER SECURITY PRIMERA brief in
CYBER SECURITY PRIMERCYBER SECURITY PRIMERA brief in
OllieShoresna
 
Mobile Security Training, Mobile Device Security Training
Mobile Security Training, Mobile Device Security TrainingMobile Security Training, Mobile Device Security Training
Mobile Security Training, Mobile Device Security Training
Tonex
 
Protecting Windows Networks From Malware 31 Jan09
Protecting Windows Networks From Malware 31 Jan09Protecting Windows Networks From Malware 31 Jan09
Protecting Windows Networks From Malware 31 Jan09
technext1
 

Similar to Health Information Privacy and Security (20)

Health Information Security and Privacy (June 19, 2017)
Health Information Security and Privacy (June 19, 2017)Health Information Security and Privacy (June 19, 2017)
Health Information Security and Privacy (June 19, 2017)
 
Overview of Information Security & Privacy
Overview of Information Security & PrivacyOverview of Information Security & Privacy
Overview of Information Security & Privacy
 
Information Security & Privacy in Healthcare (February 9, 2021)
Information Security & Privacy in Healthcare (February 9, 2021)Information Security & Privacy in Healthcare (February 9, 2021)
Information Security & Privacy in Healthcare (February 9, 2021)
 
Health Information Privacy and Security (October 30, 2019)
Health Information Privacy and Security (October 30, 2019)Health Information Privacy and Security (October 30, 2019)
Health Information Privacy and Security (October 30, 2019)
 
Health Information Privacy and Security
Health Information Privacy and SecurityHealth Information Privacy and Security
Health Information Privacy and Security
 
Cybersecurity (November 12, 2021)
Cybersecurity (November 12, 2021)Cybersecurity (November 12, 2021)
Cybersecurity (November 12, 2021)
 
Health Information Privacy and Security (October 21, 2020)
Health Information Privacy and Security (October 21, 2020)Health Information Privacy and Security (October 21, 2020)
Health Information Privacy and Security (October 21, 2020)
 
Security ConceptsDr. Y. ChuCIS3360 Security in Computing.docx
Security ConceptsDr. Y. ChuCIS3360 Security in Computing.docxSecurity ConceptsDr. Y. ChuCIS3360 Security in Computing.docx
Security ConceptsDr. Y. ChuCIS3360 Security in Computing.docx
 
Legal and Ethical Considerations in Nursing Informatics
Legal and Ethical Considerations in Nursing InformaticsLegal and Ethical Considerations in Nursing Informatics
Legal and Ethical Considerations in Nursing Informatics
 
Cognitive Computing in Security with AI
Cognitive Computing in Security with AI Cognitive Computing in Security with AI
Cognitive Computing in Security with AI
 
CISSP Cheatsheet.pdf
CISSP Cheatsheet.pdfCISSP Cheatsheet.pdf
CISSP Cheatsheet.pdf
 
SegurançA Da InformaçãO Faat V1 4
SegurançA Da InformaçãO Faat V1 4SegurançA Da InformaçãO Faat V1 4
SegurançA Da InformaçãO Faat V1 4
 
Overview
OverviewOverview
Overview
 
information security and backup system
information security and backup systeminformation security and backup system
information security and backup system
 
302 Content Server Security Challenges And Best Practices
302   Content Server Security   Challenges And Best Practices302   Content Server Security   Challenges And Best Practices
302 Content Server Security Challenges And Best Practices
 
1.Security Overview And Patching
1.Security Overview And Patching1.Security Overview And Patching
1.Security Overview And Patching
 
CYBER SECURITY PRIMERCYBER SECURITY PRIMERA brief in
CYBER SECURITY PRIMERCYBER SECURITY PRIMERA brief inCYBER SECURITY PRIMERCYBER SECURITY PRIMERA brief in
CYBER SECURITY PRIMERCYBER SECURITY PRIMERA brief in
 
Oracle UCM Security: Challenges and Best Practices
Oracle UCM Security: Challenges and Best PracticesOracle UCM Security: Challenges and Best Practices
Oracle UCM Security: Challenges and Best Practices
 
Mobile Security Training, Mobile Device Security Training
Mobile Security Training, Mobile Device Security TrainingMobile Security Training, Mobile Device Security Training
Mobile Security Training, Mobile Device Security Training
 
Protecting Windows Networks From Malware 31 Jan09
Protecting Windows Networks From Malware 31 Jan09Protecting Windows Networks From Malware 31 Jan09
Protecting Windows Networks From Malware 31 Jan09
 

More from Nawanan Theera-Ampornpunt

More from Nawanan Theera-Ampornpunt (20)

Health Informatics for Health Service Systems (March 11, 2024)
Health Informatics for Health Service Systems (March 11, 2024)Health Informatics for Health Service Systems (March 11, 2024)
Health Informatics for Health Service Systems (March 11, 2024)
 
Personal Data Protection Act and the Four Subordinate Laws (February 29, 2024)
Personal Data Protection Act and the Four Subordinate Laws (February 29, 2024)Personal Data Protection Act and the Four Subordinate Laws (February 29, 2024)
Personal Data Protection Act and the Four Subordinate Laws (February 29, 2024)
 
Privacy & PDPA Awareness Training for Ramathibodi Residents (October 5, 2023)
Privacy & PDPA Awareness Training for Ramathibodi Residents (October 5, 2023)Privacy & PDPA Awareness Training for Ramathibodi Residents (October 5, 2023)
Privacy & PDPA Awareness Training for Ramathibodi Residents (October 5, 2023)
 
Case Study PDPA Workshop (September 15, 2023)
Case Study PDPA Workshop (September 15, 2023)Case Study PDPA Workshop (September 15, 2023)
Case Study PDPA Workshop (September 15, 2023)
 
Case Studies on Overview of PDPA and its Subordinate Laws (September 15, 2023)
Case Studies on Overview of PDPA and its Subordinate Laws (September 15, 2023)Case Studies on Overview of PDPA and its Subordinate Laws (September 15, 2023)
Case Studies on Overview of PDPA and its Subordinate Laws (September 15, 2023)
 
Ramathibodi Security & Privacy Awareness Training (Fiscal Year 2023)
Ramathibodi Security & Privacy Awareness Training (Fiscal Year 2023)Ramathibodi Security & Privacy Awareness Training (Fiscal Year 2023)
Ramathibodi Security & Privacy Awareness Training (Fiscal Year 2023)
 
Relationship Between Thailand's Official Information Act and Personal Data Pr...
Relationship Between Thailand's Official Information Act and Personal Data Pr...Relationship Between Thailand's Official Information Act and Personal Data Pr...
Relationship Between Thailand's Official Information Act and Personal Data Pr...
 
Social Media - PDPA: Is There A Way Out? (October 19, 2022)
Social Media - PDPA: Is There A Way Out? (October 19, 2022)Social Media - PDPA: Is There A Way Out? (October 19, 2022)
Social Media - PDPA: Is There A Way Out? (October 19, 2022)
 
Do's and Don'ts on PDPA for Doctors (May 31, 2022)
Do's and Don'ts on PDPA for Doctors (May 31, 2022)Do's and Don'ts on PDPA for Doctors (May 31, 2022)
Do's and Don'ts on PDPA for Doctors (May 31, 2022)
 
Telemedicine: A Health Informatician's Point of View
Telemedicine: A Health Informatician's Point of ViewTelemedicine: A Health Informatician's Point of View
Telemedicine: A Health Informatician's Point of View
 
Meeting Management (March 2, 2022)
Meeting Management (March 2, 2022)Meeting Management (March 2, 2022)
Meeting Management (March 2, 2022)
 
การบริหารความเสี่ยงคณะฯ (February 9, 2022)
การบริหารความเสี่ยงคณะฯ (February 9, 2022)การบริหารความเสี่ยงคณะฯ (February 9, 2022)
การบริหารความเสี่ยงคณะฯ (February 9, 2022)
 
จริยธรรมและกฎหมายที่เกี่ยวข้องกับเทคโนโลยีสารสนเทศทางสุขภาพ (February 8, 2022)
จริยธรรมและกฎหมายที่เกี่ยวข้องกับเทคโนโลยีสารสนเทศทางสุขภาพ (February 8, 2022)จริยธรรมและกฎหมายที่เกี่ยวข้องกับเทคโนโลยีสารสนเทศทางสุขภาพ (February 8, 2022)
จริยธรรมและกฎหมายที่เกี่ยวข้องกับเทคโนโลยีสารสนเทศทางสุขภาพ (February 8, 2022)
 
พระราชบัญญัติคุ้มครองข้อมูลส่วนบุคคล พ.ศ. 2562 (PDPA) (January 21, 2022)
พระราชบัญญัติคุ้มครองข้อมูลส่วนบุคคล พ.ศ. 2562 (PDPA) (January 21, 2022)พระราชบัญญัติคุ้มครองข้อมูลส่วนบุคคล พ.ศ. 2562 (PDPA) (January 21, 2022)
พระราชบัญญัติคุ้มครองข้อมูลส่วนบุคคล พ.ศ. 2562 (PDPA) (January 21, 2022)
 
Digital Health Transformation for Health Executives (January 18, 2022)
Digital Health Transformation for Health Executives (January 18, 2022)Digital Health Transformation for Health Executives (January 18, 2022)
Digital Health Transformation for Health Executives (January 18, 2022)
 
Updates on Privacy & Security Laws (November 26, 2021)
Updates on Privacy & Security Laws (November 26, 2021)Updates on Privacy & Security Laws (November 26, 2021)
Updates on Privacy & Security Laws (November 26, 2021)
 
Hospital Informatics (November 26, 2021)
Hospital Informatics (November 26, 2021)Hospital Informatics (November 26, 2021)
Hospital Informatics (November 26, 2021)
 
Health Informatics for Clinical Research (November 25, 2021)
Health Informatics for Clinical Research (November 25, 2021)Health Informatics for Clinical Research (November 25, 2021)
Health Informatics for Clinical Research (November 25, 2021)
 
Research Ethics and Ethics for Health Informaticians (November 15, 2021)
Research Ethics and Ethics for Health Informaticians (November 15, 2021)Research Ethics and Ethics for Health Informaticians (November 15, 2021)
Research Ethics and Ethics for Health Informaticians (November 15, 2021)
 
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...
 

Recently uploaded

Modular Monolith - a Practical Alternative to Microservices @ Devoxx UK 2024
Modular Monolith - a Practical Alternative to Microservices @ Devoxx UK 2024Modular Monolith - a Practical Alternative to Microservices @ Devoxx UK 2024
Modular Monolith - a Practical Alternative to Microservices @ Devoxx UK 2024
Victor Rentea
 

Recently uploaded (20)

Connector Corner: Accelerate revenue generation using UiPath API-centric busi...
Connector Corner: Accelerate revenue generation using UiPath API-centric busi...Connector Corner: Accelerate revenue generation using UiPath API-centric busi...
Connector Corner: Accelerate revenue generation using UiPath API-centric busi...
 
Apidays New York 2024 - The value of a flexible API Management solution for O...
Apidays New York 2024 - The value of a flexible API Management solution for O...Apidays New York 2024 - The value of a flexible API Management solution for O...
Apidays New York 2024 - The value of a flexible API Management solution for O...
 
Modular Monolith - a Practical Alternative to Microservices @ Devoxx UK 2024
Modular Monolith - a Practical Alternative to Microservices @ Devoxx UK 2024Modular Monolith - a Practical Alternative to Microservices @ Devoxx UK 2024
Modular Monolith - a Practical Alternative to Microservices @ Devoxx UK 2024
 
Emergent Methods: Multi-lingual narrative tracking in the news - real-time ex...
Emergent Methods: Multi-lingual narrative tracking in the news - real-time ex...Emergent Methods: Multi-lingual narrative tracking in the news - real-time ex...
Emergent Methods: Multi-lingual narrative tracking in the news - real-time ex...
 
Apidays New York 2024 - The Good, the Bad and the Governed by David O'Neill, ...
Apidays New York 2024 - The Good, the Bad and the Governed by David O'Neill, ...Apidays New York 2024 - The Good, the Bad and the Governed by David O'Neill, ...
Apidays New York 2024 - The Good, the Bad and the Governed by David O'Neill, ...
 
Exploring Multimodal Embeddings with Milvus
Exploring Multimodal Embeddings with MilvusExploring Multimodal Embeddings with Milvus
Exploring Multimodal Embeddings with Milvus
 
ICT role in 21st century education and its challenges
ICT role in 21st century education and its challengesICT role in 21st century education and its challenges
ICT role in 21st century education and its challenges
 
Understanding the FAA Part 107 License ..
Understanding the FAA Part 107 License ..Understanding the FAA Part 107 License ..
Understanding the FAA Part 107 License ..
 
EMPOWERMENT TECHNOLOGY GRADE 11 QUARTER 2 REVIEWER
EMPOWERMENT TECHNOLOGY GRADE 11 QUARTER 2 REVIEWEREMPOWERMENT TECHNOLOGY GRADE 11 QUARTER 2 REVIEWER
EMPOWERMENT TECHNOLOGY GRADE 11 QUARTER 2 REVIEWER
 
Apidays New York 2024 - APIs in 2030: The Risk of Technological Sleepwalk by ...
Apidays New York 2024 - APIs in 2030: The Risk of Technological Sleepwalk by ...Apidays New York 2024 - APIs in 2030: The Risk of Technological Sleepwalk by ...
Apidays New York 2024 - APIs in 2030: The Risk of Technological Sleepwalk by ...
 
Elevate Developer Efficiency & build GenAI Application with Amazon Q​
Elevate Developer Efficiency & build GenAI Application with Amazon Q​Elevate Developer Efficiency & build GenAI Application with Amazon Q​
Elevate Developer Efficiency & build GenAI Application with Amazon Q​
 
Polkadot JAM Slides - Token2049 - By Dr. Gavin Wood
Polkadot JAM Slides - Token2049 - By Dr. Gavin WoodPolkadot JAM Slides - Token2049 - By Dr. Gavin Wood
Polkadot JAM Slides - Token2049 - By Dr. Gavin Wood
 
TrustArc Webinar - Unlock the Power of AI-Driven Data Discovery
TrustArc Webinar - Unlock the Power of AI-Driven Data DiscoveryTrustArc Webinar - Unlock the Power of AI-Driven Data Discovery
TrustArc Webinar - Unlock the Power of AI-Driven Data Discovery
 
Strategize a Smooth Tenant-to-tenant Migration and Copilot Takeoff
Strategize a Smooth Tenant-to-tenant Migration and Copilot TakeoffStrategize a Smooth Tenant-to-tenant Migration and Copilot Takeoff
Strategize a Smooth Tenant-to-tenant Migration and Copilot Takeoff
 
Six Myths about Ontologies: The Basics of Formal Ontology
Six Myths about Ontologies: The Basics of Formal OntologySix Myths about Ontologies: The Basics of Formal Ontology
Six Myths about Ontologies: The Basics of Formal Ontology
 
How to Troubleshoot Apps for the Modern Connected Worker
How to Troubleshoot Apps for the Modern Connected WorkerHow to Troubleshoot Apps for the Modern Connected Worker
How to Troubleshoot Apps for the Modern Connected Worker
 
ProductAnonymous-April2024-WinProductDiscovery-MelissaKlemke
ProductAnonymous-April2024-WinProductDiscovery-MelissaKlemkeProductAnonymous-April2024-WinProductDiscovery-MelissaKlemke
ProductAnonymous-April2024-WinProductDiscovery-MelissaKlemke
 
Introduction to Multilingual Retrieval Augmented Generation (RAG)
Introduction to Multilingual Retrieval Augmented Generation (RAG)Introduction to Multilingual Retrieval Augmented Generation (RAG)
Introduction to Multilingual Retrieval Augmented Generation (RAG)
 
Web Form Automation for Bonterra Impact Management (fka Social Solutions Apri...
Web Form Automation for Bonterra Impact Management (fka Social Solutions Apri...Web Form Automation for Bonterra Impact Management (fka Social Solutions Apri...
Web Form Automation for Bonterra Impact Management (fka Social Solutions Apri...
 
Strategies for Landing an Oracle DBA Job as a Fresher
Strategies for Landing an Oracle DBA Job as a FresherStrategies for Landing an Oracle DBA Job as a Fresher
Strategies for Landing an Oracle DBA Job as a Fresher
 

Health Information Privacy and Security

  • 1. Health Information Privacy & Security Nawanan Theera-Ampornpunt, M.D., Ph.D. Faculty of Medicine Ramathibodi Hospital Mahidol University For Ramathibodi M.S. & Ph.D. Programs in Data Science for Health Care October 17, 2017 http://www.SlideShare.net/Nawanan
  • 2.  Introduction to Information Privacy & Security  Protecting Information Privacy & Security  User Security  Malware  Security Standards  Privacy & Security Laws Outline
  • 7. Sources of the Threats  Hackers  Viruses & Malware  Poorly-designed systems  Insiders (Employees)  People’s ignorance & lack of knowledge  Disasters & other incidents affecting information systems
  • 8.  Information risks  Unauthorized access & disclosure of confidential information  Unauthorized addition, deletion, or modification of information  Operational risks  System not functional (Denial of Service - DoS)  System wrongly operated  Personal risks  Identity thefts  Financial losses  Disclosure of information that may affect employment or other personal aspects (e.g. health information)  Physical/psychological harms  Organizational risks  Financial losses  Damage to reputation & trust  Etc. Consequences of Security Attacks
  • 10.  Privacy: “The ability of an individual or group to seclude themselves or information about themselves and thereby reveal themselves selectively.” (Wikipedia)  Security: “The degree of protection to safeguard ... person against danger, damage, loss, and crime.” (Wikipedia)  Information Security: “Protecting information and information systems from unauthorized access, use, disclosure, disruption, modification, perusal, inspection, recording or destruction” (Wikipedia) Privacy & Security
  • 11. Information Security  Confidentiality  Integrity  Availability
  • 12. Examples of Confidentiality Risks http://usatoday30.usatoday.com/life/people/2007-10-10-clooney_N.htm
  • 13. Examples of Integrity Risks http://www.wired.com/threatlevel/2010/03/source-code-hacks/ http://en.wikipedia.org/wiki/Operation_Aurora “Operation Aurora” Alleged Targets: Google, Adobe, Juniper Networks, Yahoo!, Symantec, Northrop Grumman, Morgan Stanley, Dow Chemical Goal: To gain access to and potentially modify source code repositories at high tech, security & defense contractor companies
  • 14. Examples of Integrity Risks http://news.softpedia.com/news/700-000-InMotion-Websites-Hacked-by-TiGER-M-TE-223607.shtml Web Defacements
  • 15. Examples of Availability Risks http://en.wikipedia.org/wiki/Blaster_worm Viruses/worms that led to instability & system restart (e.g. Blaster worm)
  • 16. Examples of Availability Risks http://en.wikipedia.org/wiki/Ariane_5_Flight_501 Ariane 5 Flight 501 Rocket Launch Failure Cause: Software bug on rocket acceleration due to data conversion from a 64-bit floating point number to a 16-bit signed integer without proper checks, leading to arithmatic overflow
  • 17. บทความใน JAMA เร็วๆ นี้ JAMA. 2015 Apr 14;313(14).
  • 19.  Attack  An attempt to breach system security  Threat  A scenario that can harm a system  Vulnerability  The “hole” that is used in the attack Common Security Terms
  • 20.  Identify some possible means an attacker could use to conduct a security attack Class Exercise
  • 22. Alice Simplified Attack Scenarios Server Bob - Physical access to client computer - Electronic access (password) - Tricking user into doing something (malware, phishing & social engineering) Eve/Mallory
  • 23. Alice Simplified Attack Scenarios Server Bob - Intercepting (eavesdropping or “sniffing”) data in transit - Modifying data (“Man-in-the- middle” attacks) - “Replay” attacks Eve/Mallory
  • 24. Alice Simplified Attack Scenarios Server Bob - Unauthorized access to servers through - Physical means - User accounts & privileges - Attacks through software vulnerabilities - Attacks using protocol weaknesses - DoS / DDoS attacks Eve/Mallory
  • 25. Alice Simplified Attack Scenarios Server Bob Other & newer forms of attacks possible Eve/Mallory
  • 26. Alice Safeguarding Against Attacks Server Bob Administrative Security - Security & privacy policy - Governance of security risk management & response - Uniform enforcement of policy & monitoring - Disaster recovery planning (DRP) & Business continuity planning/management (BCP/BCM) - Legal obligations, requirements & disclaimers
  • 27. Alice Safeguarding Against Attacks Server Bob Physical Security - Protecting physical access of clients & servers - Locks & chains, locked rooms, security cameras - Mobile device security - Secure storage & secure disposition of storage devices
  • 28. Alice Safeguarding Against Attacks Server Bob User Security - User account management - Strong p/w policy (length, complexity, expiry, no meaning) - Principle of Least Privilege - “Clear desk, clear screen policy” - Audit trails - Education, awareness building & policy enforcement - Alerts & education about phishing & social engineering
  • 29. Alice Safeguarding Against Attacks Server Bob System Security - Antivirus, antispyware, personal firewall, intrusion detection/prevention system (IDS/IPS), log files, monitoring - Updates, patches, fixes of operating system vulnerabilities & application vulnerabilities - Redundancy (avoid “Single Point of Failure”) - Honeypots
  • 30. Alice Safeguarding Against Attacks Server Bob Software Security - Software (clients & servers) that is secure by design - Software testing against failures, bugs, invalid inputs, performance issues & attacks - Updates to patch vulnerabilities
  • 31. Alice Safeguarding Against Attacks Server Bob Network Security - Access control (physical & electronic) to network devices - Use of secure network protocols if possible - Data encryption during transit if possible - Bandwidth monitoring & control
  • 32. Alice Safeguarding Against Attacks Server Bob Database Security - Access control to databases & storage devices - Encryption of data stored in databases if necessary - Secure destruction of data after use - Access control to queries/reports - Security features of database management systems (DBMS)
  • 33. Privacy Safeguards Image: http://www.nurseweek.com/news/images/privacy.jpg  Security safeguards  Informed consent  Privacy culture  User awareness building & education  Organizational policy & regulations  Enforcement  Ongoing privacy & security assessments, monitoring, and protection
  • 36.  Access control  Selective restriction of access to the system  Role-based access control  Access control based on the person’s role (rather than identity)  Audit trails  Logs/records that provide evidence of sequence of activities User Security
  • 37.  Identification  Identifying who you are  Usually done by user IDs or some other unique codes  Authentication  Confirming that you truly are who you identify  Usually done by keys, PIN, passwords or biometrics  Authorization  Specifying/verifying how much you have access  Determined based on system owner’s policy & system configurations  “Principle of Least Privilege” User Security
  • 38.  Nonrepudiation  Proving integrity, origin, & performer of an activity without the person’s ability to refute his actions  Most common form: signatures  Electronic signatures offer varying degrees of nonrepudiation  PIN/password vs. biometrics  Digital certificates (in public key infrastructure - PKI) often used to ascertain nonrepudiation User Security
  • 39.  Multiple-Factor Authentication  Two-Factor Authentication  Use of multiple means (“factors”) for authentication  Types of Authentication Factors  Something you know  Password, PIN, etc.  Something you have  Keys, cards, tokens, devices (e.g. mobile phones)  Something you are  Biometrics User Security
  • 40. Need for Strong Password Policy So, two informaticians walk into a bar... The bouncer says, "What's the password." One says, "Password?" The bouncer lets them in. Credits: @RossMartin & AMIA (2012)
  • 41. Recommended Password Policy  Length  8 characters or more (to slow down brute-force attacks)  Complexity (to slow down brute-force attacks)  Consists of 3 of 4 categories of characters  Uppercase letters  Lowercase letters  Numbers  Symbols (except symbols that have special uses by the system or that can be used to hack system, e.g. SQL Injection)  No meaning (“Dictionary Attacks”)  Not simple patterns (12345678, 11111111) (to slow down brute- force attacks & prevent dictionary attacks)  Not easy to guess (birthday, family names, etc.) (to prevent unknown & known persons from guessing) Personal opinion. No legal responsibility assumed.
  • 42. Recommended Password Policy  Expiration (to make brute-force attacks not possible)  6-8 months  Decreasing over time because of increasing computer’s speed  But be careful! Too short duration will force users to write passwords down  Secure password storage in database or system (encrypted or store only password hashes)  Secure password confirmation  Secure “forget password” policy  Different password for each account. Create variations to help remember. If not possible, have different sets of accounts for differing security needs (e.g., bank accounts vs. social media sites) Personal opinion. No legal responsibility assumed.
  • 43. { Dictionary Attack: A story from a computer security course
  • 44. Techniques to Remember Passwords  http://www.wikihow.com/Create-a-Password-You-Can- Remember  Note that some of the techniques are less secure!  One easy & secure way: password mnemonic  Think of a full sentence that you can remember  Ideally the sentence should have 8 or more words, with numbers and symbols  Use first character of each word as password  Sentence: I love reading all 7 Harry Potter books!  Password: Ilra7HPb!  Voila! Personal opinion. No legal responsibility assumed.
  • 48.  Poor grammar  Lots of typos  Trying very hard to convince you to open attachment, click on link, or reply without enough detail  May appear to be from known person (rely on trust & innocence) Signs of a Phishing Attack
  • 49.  Don’t be too trusting of people  Always be suspicious & alert  An e-mail with your friend’s name & info doesn’t have to come from him/her  Look for signs of phishing attacks  Don’t open attachments unless you expect them  Scan for viruses before opening attachments  Don’t click links in e-mail. Directly type in browser using known & trusted URLs  Especially cautioned if ask for passwords, bank accounts, credit card numbers, social security numbers, etc. Ways to Protect against Phishing
  • 51. The Day We All WannaCry’ed http://www.mirror.co.uk/news/uk-news/ransomware-nhs-cyber-attack-live-10409420
  • 57.  Consider a log-in form on a web page Example of Weak Input Checking: SQL Injection  Source code would look something like this: statement = "SELECT * FROM users WHERE name = '" + userName + "';"  Attacker would enter as username: ' or '1'='1  Which leads to this always-true query:  statement = "SELECT * FROM users WHERE name = '" + "' or '1'='1" + "';" statement = "SELECT * FROM users WHERE name = '' or '1'='1';" http://en.wikipedia.org/wiki/SQL_injection
  • 58.  Defense in Depth  Multiple layers of security defense are placed throughout a system to provide redundancy in the event a security control fails  Secure the weakest link  Promote privacy  Trust no one Some Security Principles Saltzer & Schroeder (1975), Viega & McGraw (2000) Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271 http://en.wikipedia.org/wiki/Defense_in_depth_(computing)
  • 59.  Modular design  Check error conditions on return values  Validate inputs (whitelist vs. blacklist)  Avoid infinite loops, memory leaks  Check for integer overflows  Language/library choices  Development processes Secure Software Best Practices Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  • 61.  Malicious software - Any code with intentional, undesirable side effects  Virus  Worm  Trojan  Spyware  Logic Bomb/Time Bomb  Backdoor/Trapdoor  Rootkit  Botnet Malware
  • 62.  Virus  Propagating malware that requires user action to propagate  Infects executable files, data files with executable contents (e.g. Macro), boot sectors  Worm  Self-propagating malware  Trojan  A legitimate program with additional, hidden functionality Malware
  • 63.  Spyware  Trojan that spies for & steals personal information  Logic Bomb/Time Bomb  Malware that triggers under certain conditions  Backdoor/Trapdoor  A hole left behind by malware for future access Malware
  • 64.  Rogue Antispyware (Ransomware)  Software that tricks or forces users to pay before fixing (real or hoax) spyware detected  Rootkit  A stealth program designed to hide existence of certain processes or programs from detection  Botnet  A collection of Internet-connected computers that have been compromised (bots) which controller of the botnet can use to do something (e.g. do DDoS attacks) Malware
  • 65.  Installed & updated antivirus, antispyware, & personal firewall  Check for known signatures  Check for improper file changes (integrity failures)  Check for generic patterns of malware (for unknown malware): “Heuristics scan”  Firewall: Block certain network traffic in and out  Sandboxing  Network monitoring & containment  User education  Software patches, more secure protocols Defense Against Malware
  • 66.  Social media spams/scams/clickjacking  Social media privacy issues  User privacy settings  Location services  Mobile device malware & other privacy risks  Stuxnet (advanced malware targeting certain countries)  Advanced persistent threats (APT) by governments & corporations against specific targets Newer Threats
  • 68. • ISO/IEC 27000 — Information security management systems — Overview and vocabulary • ISO/IEC 27001 — Information security management systems — Requirements • ISO/IEC 27002 — Code of practice for information security management • ISO/IEC 27003 — Information security management system implementation guidance • ISO/IEC 27004 — Information security management — Measurement • ISO/IEC 27005 — Information security risk management • ISO/IEC 27031 — Guidelines for information and communications technology readiness for business continuity • ISO/IEC 27032 — Guideline for cybersecurity (essentially, 'being a good neighbor' on the Internet) • ISO/IEC 27033-1 — Network security overview and concepts • ISO/IEC 27033-2 — Guidelines for the design and implementation of network security • ISO/IEC 27033-3:2010 — Reference networking scenarios - Threats, design techniques and control issues • ISO/IEC 27034 — Guideline for application security • ISO/IEC 27035 — Security incident management • ISO 27799 — Information security management in health using ISO/IEC 27002 Some Information Security Standards
  • 69.  US-CERT  U.S. Computer Emergency Readiness Team  http://www.us-cert.gov/  Subscribe to alerts & news  Microsoft Security Resources  http://technet.microsoft.com/en-us/security  http://technet.microsoft.com/en- us/security/bulletin  Common Vulnerabilities & Exposures  http://cve.mitre.org/ More Information
  • 71.  Respect for Persons (Autonomy)  Beneficence  Justice  Non-maleficence Ethical Principles in Bioethics
  • 72. Hippocratic Oath ... What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about. ... http://en.wikipedia.org/wiki/Hippocratic_Oath
  • 73. Privacy Safeguards Image: http://www.nurseweek.com/news/images/privacy.jpg  Security safeguards  Informed consent  Privacy culture  User awareness building & education  Organizational policy & regulations  Enforcement  Ongoing privacy & security assessments, monitoring, and protection
  • 74. HIPAA
  • 75.  Health Insurance Portability and Accountability Act of 1996 http://www.gpo.gov/fdsys/pkg/PLAW- 104publ191/pdf/PLAW-104publ191.pdf  More stringent state privacy laws apply  HIPAA Goals  To protect health insurance coverage for workers & families when they change or lose jobs (Title I)  To require establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers (Title II: “Administrative Simplification” provisions)  Administrative Simplification provisions also address security & privacy of health data U.S. Health Information Privacy Law http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act
  • 76.  Title I: Health Care Access, Portability, and Renewability  Title II: Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform  Requires Department of Health & Human Services (HHS) to draft rules aimed at increasing efficiency of health care system by creating standards for use and dissemination of health care information HIPAA (U.S.)
  • 77.  Title III: Tax-Related Health Provisions  Title IV: Application and Enforcement of Group Health Plan Requirements  Title V: Revenue Offsets HIPAA (U.S.)
  • 78.  HHS promulgated 5 Administrative Simplification rules  Privacy Rule  Transactions and Code Sets Rule  Security Rule  Unique Identifiers Rule  Enforcement Rule HIPAA (U.S.)
  • 79.  Covered Entities  A health plan  A health care clearinghouse  A healthcare provider who transmits any health information in electronic form in connection with a transaction to enable health information to be exchanged electronically  Business Associates Some HIPAA Definitions
  • 80.  Protected Health Information (PHI)  Individually identifiable health information transmitted or maintained in electronic media or other form or medium  Individually Identifiable Health Information  Any information, including demographic information collected from an individual, that—  (A) is created or received by a CE; and  (B) relates to the past, present, or future physical  or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual, and—  (i) identifies the individual; or  (ii) with respect to which there is a reasonable basis to believe that the information can be used to identify the individual. Some HIPAA Definitions
  • 81.  Name  Address  Phone number  Fax number  E-mail address  SSN  Birthdate  Medical Record No.  Health Plan ID  Treatment date  Account No.  Certificate/License No.  Device ID No.  Vehicle ID No.  Drivers license No.  URL  IP Address  Biometric identifier including fingerprints  Full face photo Protected Health Information – Personal Identifiers in PHI
  • 82.  Establishes national standards to protect PHI; applies to CE & business associates  Requires appropriate safeguards to protect privacy of PHI  Sets limits & conditions on uses & disclosures that may be made without patient authorization  Gives patients rights over their health information, including rights to examine & obtain copy of health records & to request corrections HIPAA Privacy Rule http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/index.html
  • 83.  Timeline  November 3, 1999 Proposed Privacy Rule  December 28, 2000 Final Privacy Rule  August 14, 2002 Modifications to Privacy Rule  April 14, 2003 Compliance Date for most CE  Full text (as amended) http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/ adminsimpregtext.pdf HIPAA Privacy Rule http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/index.html
  • 84.  Some permitted uses and disclosures  Use of PHI  Sharing, application, use, examination or analysis within the entity that maintains the PHI  Disclosure of PHI  Release or divulgence of information by an entity to persons or organizations outside of that entity. HIPAA Privacy Rule
  • 85.  A covered entity may not use or disclose PHI, except  with individual consent for treatment, payment or healthcare operations (TPO)  with individual authorization for other purposes  without consent or authorization for governmental and other specified purposes HIPAA Privacy Rule
  • 86.  Treatment, payment, health care operations (TPO)  Quality improvement  Competency assurance  Medical reviews & audits  Insurance functions  Business planning & administration  General administrative activities HIPAA Privacy Rule
  • 87.  Uses & disclosures without the need for patient authorization permitted in some circumstances  Required by law  For public health activities  About victims of abuse, neglect, or domestic violence  For health oversight activities  For judicial & administrative proceedings  For law enforcement purposes  About decedents HIPAA Privacy Rule
  • 88.  Uses & disclosures without the need for patient authorization permitted in some circumstances  For cadaveric organ, eye, or tissue donation purposes  For research purposes  To avert a serious threat to health or safety  For workers’ compensation  For specialized government functions  Military & veterans activities  National security & intelligence activities  Protective services for President & others  Medical suitability determinants  Correctional institutions  CE that are government programs providing public benefits HIPAA Privacy Rule
  • 89.  Control use and disclosure of PHI  Notify patients of information practices (NPP, Notice of Privacy Practices)  Specifies how CE can use and share PHI  Specifies patient’s rights regarding their PHI  Provide means for patients to access their own record  Obtain authorization for non-TPO uses and disclosures  Log disclosures  Restrict use or disclosures  Minimum necessary  Privacy policy and practices  Business Associate agreements  Other applicable statutes  Provide management oversight and response to minimize threats and breaches of privacy Responsibilities of a CE From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
  • 90.  Individually identifiable health information collected and used solely for research IS NOT PHI  Researchers obtaining PHI from a CE must obtain the subject’s authorization or must justify an exception:  Waiver of authorization (obtain from the IRB)  Limited Data Set (with data use agreement)  De-identified Data Set  HIPAA Privacy supplements the Common Rule and the FDA’s existing protection for human subjects HIPAA & Research From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
  • 91.  De-identified Data Set  Remove all 18 personal identifiers of subjects, relatives, employers, or household members  OR biostatistician confirms that individual cannot be identified with the available information  Limited Data Set  May include Zip, Birthdate, Date of death, date of service, geographic subdivision  Remove all other personal identifiers of subject, etc.  Data Use Agreement signed by data recipient that there will be no attempt to re-identify the subject Research Data Sets From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
  • 92.  Assure the CE that all research-initiated HIPAA requirements have been met  Provide letter of approval to the researcher to conduct research using PHI  OR, Certify and document that waiver of authorization criteria have been met  Review and approve all authorizations and data use agreements  Retain records documenting HIPAA actions for 6 years IRB’s New Responsibility From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
  • 93.  Establishes national standards to protect individuals’ electronic PHI that is created, received, used, or maintained by a CE.  Requires appropriate safeguards to ensure confidentiality, integrity & security of electronic PHI  Administrative safeguards  Physical safeguards  Technical safeguards HIPAA Security Rule http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/index.html
  • 94.  Timeline  August 12, 1998 Proposed Security Rule  February 20, 2003 Final Security Rule  April 21, 2005 Compliance Date for most CE  Full Text http://www.hhs.gov/ocr/privacy/hipaa/ administrative/securityrule/securityrulepdf.pdf HIPAA Security Rule http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/index.html
  • 95.  The HIPAA Security Rule is:  A set of information security “best practices”  A minimum baseline for security  An outline of what to do, and what procedures should be in place  The HIPAA Security Rule is not:  A set of specific instructions  A set of rules for universal, unconditional implementation  A document outlining specific implementations (vendors, equipment, software, etc.) HIPAA Security Rule: Meaning From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
  • 96.  Many rules are either Required or Addressable  Required:  Compliance is mandatory  Addressable:  If a specification in the Rule is reasonable and appropriate for the CE, then the CE must implement  Otherwise, documentation must be made of the reasons the policy cannot/will not be implemented, and when necessary, offer an alternative HIPAA Security Rule: Meaning From a teaching slide in UMN’s Spring 2006 Health Informatics II class by Dr. David Pieczkiewicz
  • 97.  Breach notification  Extension of complete Privacy & Security HIPAA provisions to business associates of covered entities  New rules for accounting of disclosures of a patient’s health information New in HITECH Act of 2009
  • 98.  Conflicts between federal vs. state laws  Variations among state laws of different states  HIPAA only covers “covered entities”  No general privacy laws in place, only a few sectoral privacy laws e.g. HIPAA Health Information Privacy Law: U.S. Challenges
  • 99.  Canada - The Privacy Act (1983), Personal Information Protection and Electronic Data Act of 2000  EU Countries - EU Data Protection Directive  UK - Data Protection Act 1998  Austria - Data Protection Act 2000  Australia - Privacy Act of 1988  Germany - Federal Data Protection Act of 2001 Health Information Privacy Law: Other Western Countries
  • 101.  The Official Information Act, B.E. 2540  Requires official information within the government (with exceptions such as some personal information) to be disclosed to the public up front or upon request  “Disclose by default, protect by exceptions” Thai Privacy Laws
  • 102.  No universal personal data privacy law (Draft law has been proposed)  National Health Act, B.E. 2550  Provision 7 provides protection of health information from disclosures that could be damaging to an individual without his/her consent or as required by law. Thai Privacy Laws
  • 103.  Computer-Related Crimes Act, B.E. 2550 & 2560  Focuses on prosecuting computer crimes & computer-related crimes  Responsibility of organizations as IT service provider: Logging & provision of access data to authorities Thai ICT Laws
  • 104.  Electronic Transactions Acts, B.E. 2544 & 2551  Affirms legal status of electronic data  Addresses how electronic transactions and electronic signatures work in the legal context  Security & privacy requirements for  Determining legal validity & integrity of electronic transactions and documents, print- outs, & paper-to-electronic conversions  Governmental & public organizations  Critical infrastructures  Financial sectors  Electronic certificate authorities Thai ICT Laws
  • 105. Security Requirements for Critical Infrastructure in Thailand Domain Basic Medium (In addition to Basic) High (In addition to Medium) Security policy 1 Item 1 Item - Organization of information security 5 Items 3 Items 3 Items Asset management 1 Item 4 Items - Human resources security 6 Items 1 Item 2 Items Physical and environmental security 5 Items 2 Items 6 Items Communications & operations management 18 Items 5 Items 9 Items Access control 9 Items 8 Items 8 Items Information systems acquisition, development and maintenance 2 Items 6 Items 8 Items Information security incident management 1 Item - 3 Items Business continuity management 1 Item 3 Items 1 Item Regulatory compliance 3 Items 5 Items 2 Items รวม 52 Items 38 Items (90 Items Total) 42 Items (132 Items Total)
  • 106. Q & A