WASHINGTON, DC -- Even as the use of mobile health, or mHealth, technology grew over the last few years, health care executives have paid too little attention to the need for mobile device security, and existing policies are often not followed by physicians, according to presenters at the mHealth Summit 2012.
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Andrew Litt, M.D., chief medical officer for Dell Healthcare, said the health care industry is currently experiencing an explosion of data resulting in part from the growing use of mobile devices and adoption of electronic health records. The more data that organizations accumulate, the greater the need is for putting in place provisions to protect that information.
However, Litt pointed out that even though hospitals are a favorite target of hackers due to the high value of stolen patient records, hospital administrators have been slow to grasp the need for tight security.
Andrew Littchief medical officer, Dell Healthcare
"This has not been a priority for a lot of CIOs," he said.
Security may be a low priority for some providers because they are not familiar with regulations and requirements. Rohit Nayak, vice president of Care360, said he has found physicians tend to be least familiar with the security requirements of meaningful use. This is particularly true of ambulatory care doctors; many of whom do not know what a security risk assessment is. Nayak said understanding both HIPAA and meaningful use security requirements should be the first step in protecting patient data.
Mobile device security requires many different tasks
There are a number of reasons why security may not receive sufficient attention from hospital executives. One of the primary reasons is securing patient information in all its forms involves many different tasks, particularly for providers that utilize mobile devices and services. Information may exist on mobile phones, hospital information systems, cloud servers and medical devices, said Omar Hussain, president and CEO of information security company Imprivata.
He said protecting sensitive information is much easier in other industries, such as banking. There, systems must simply keep out those who do not have a right to access information. But security isn't so clear-cut when it comes to health care. There are many different entities, from payers, to patients, to nurses, who all have some right to access records. Developing systems that grant the right amount of access to the right people can be difficult.
To make matters worse, the health care industry is relatively new to these kinds of security considerations, Hussain said. While most other industries implemented computerized record keeping systems years ago, health care is still in the process of adopting EHRs. Providers are trying to figure out exactly how to secure new tools for accessing information.
The emerging trends surrounding bring your own device policies further complicate security matters. Providers can't guarantee the security of patient data when they don't know exactly how employees are accessing it. Various consumer electronics like smartphones and tablets all have different security protocols, which makes allowing physicians and nurses to use their personal devices to access patient information is a risk for hospitals that do not have a solid BYOD policy in place, said Brian Balow, a member of the law firm Dickinson Wright.
He recommended health care organizations develop a clearly defined BYOD policy that lets employees know exactly what's expected of them when it comes to accessing data, and then enforce that policy. Rules should instill professionalism and protect employees and the organization from liability. Since the use of personal smartphones and devices has become so common in health care settings today, it is hard for organizations to get around the issue otherwise.
"Today on the question of whether to allow BYOD, the cow has left the barn," Balow said.
Beyond BYOD: Ensure security protocols are followed
Jay Savaiano, director of health care business development for information management company CommVault, said organizations must also work to ensure employees aren't working around established security provisions. Hospitals may have policies that instruct workers not to send patient information through insecure methods like text messaging or third-party cloud services, but these policies are useless if clinicians continue to use insecure services.
One way to discourage the use of insecure communication tools is to give physicians more secure ones, Savaiano said. For example, he said IT workers should have seen the need for cloud storage services such as Dropbox coming and developed their own secure versions. Similarly, they should recognize that many physicians communicate with each through text messaging or insecure email, even though these services are unencrypted and represent a security risk.
But developing a policy and training employees on following it cannot be a one-time event. Dell Healthcare's Litt said policies should constantly be updated to reflect any changes in the security or regulatory environment. Hackers are also constantly looking to find new ways to obtain potentially valuable patient records, which means that IT workers must continually strive to stay ahead of them. This process typically involves regular risk analyses and updates to security infrastructure and policy whenever vulnerabilities are discovered.
"This isn't a one-time issue," Litt said. "The people out there who are working against us have long-term interests too and they get better every year, so we have to get better."