Zero Trust Architecture: The Future of Healthcare Data Security

Zero trust architecture(ZTA) is a network security model developed by a former research analyst of Forrester Research, John Kindervarg, with the motto “never trust, always verify”. Consequently, the Zero Trust model implements strict verification for every user and every device before granting them access to internal resources.

The current state of healthcare data security

Healthcare systems are highly susceptible to security breaches due to the large number of equipment and medical devices connected. One of the most devastating examples is that of a ransomware attack that affected around 230,000 computers worldwide in May 2017. Known as the Wannacry ransomware, it affected computers running on Microsoft Windows that failed to conduct regular security updates. This ransomware went on to affect thousands of NHS hospitals, costing them around 92 million pounds and affecting thousands of people in need of care. 

In the event of such a large data breach, hospitals stand to lose not just the financial details of patients but highly sensitive information such as diagnostic images, medical history and unique identification features of patients, personally identifying information (PII) such as Social Security numbers, and intellectual property related to medical research and innovation. This is what makes healthcare data a major target - it is a goldmine of information.

So scaling up your clinic/hospital's security infrastructure is a necessity, now more than ever, with the adoption of cloud-based solutions in healthcare. The answer is not to shy away from new technology and go back to retrograde ways but to leverage the existing technology to build stronger systems while retaining the benefits. The answer to this is zero trust architecture.

How is zero trust architecture different from the traditional security model?

Healthcare is now a bustling field of innovation, and what propels this is the digital transformation that is now prevalent in healthcare. In this era of collaborative patient care, the security of patient data has never been more critical—or more at risk. Sensitive patient records, diagnostic imaging, and medical research data are not just assets; they are lifelines that demand unparalleled protection.

Zero-trust continuously monitors everyone and everything trying to access resources, irrespective of whether they are inside or outside the network. Whereas the traditional approach trusts everyone who manages to enter the network, allowing broader access without constant verification. 

In the Zero Trust Architecture model, a device’s network location or IP address doesn’t qualify as a factor that implies trust. Instead, a number of factors, such as the identity of the user and the device, the location and time of access and several other attributes, have to be verified before granting access to resources. 

Granting access also doesn’t mean that users can now view everything inside a particular network. They only gain access to what they need to carry out their responsibilities. Moreover, users and devices are continuously monitored. This means that if the attributes of a user or a particular device change, the verification may be revoked and access removed.

Traditional security model - The Castle and moat approach

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The traditional network security model used in healthcare is called the castle and moat architecture. In this model, the network is like the castle, and the perimeter(the boundary between an organization's internal network and external network) is like the moat of a castle. Nobody outside the network can access the data inside, but once you are inside the network, you can access everything without any restrictions - just like how someone can freely roam inside the castle grounds once they cross the drawbridge.

In this approach, a lot of resources are used to secure the network perimeter. However, once someone launches an attack from inside, there are little to no measures to tackle that effectively. An attacker can easily breach the network by stealing user credentials, introducing a malware infection, or other methods. Though security measures like firewalls may stop some of these attacks, if a hacker manages to get through, the stakes are high. This is especially true in the case of healthcare data, which is a goldmine of information. With increased remote access to data and easy data availability, the risk of an information breach is very high.

However, in healthcare, remote access to data and information sharing is important to allow collaboration and provide high-quality care to patients. Zero Trust Architecture(ZTA) ensures the delivery of high-quality care without compromising healthcare data security. 

What are the Core principles of zero trust architecture?

• Least privileged access

In this model, users get access only to what they need to perform their core duties and responsibilities, and nothing more. Depending on the user roles, a person can have high privilege or low privilege access. The higher the access level that an individual has, the greater will be the impact on them if they become an insider threat.

• Microsegmentation

Microsegmentation refers to dividing a large network into smaller segments with its own separate security policy and needing to be accessed separately. This minimizes the impact of a breach on the segment that has been accessed and protects the rest of the access.

• Multi-Factor authentication(MFA)

This is a type of authentication where users are verified not just using passwords but with the help of multiple different authentication factors. The authentication process is usually centred around three aspects: something that the user has( physical token or device), is (Face ID, fingerprint) or knows (password, security questions, ID number)

• Continuous device monitoring

ZTA functions on the assumption that a breach is inevitable. ZTA involves continuous monitoring and tracking devices in the network for unusual and suspicious activity. Zero trust verifies device identity and security, and continuously re-verifies 

• End-to-end encryption

Encrypt all the sensitive information so that it becomes difficult to interpret data even if an outsider gets their hands on it.

ZTA outlines how these principles are applied across an enterprise's systems, networks, and workflows to ensure that no entity (user, device, or application) gains access without thorough validation.

What are the seven pillars of zero trust architecture?

The US Cybersecurity and Infrastructure Security Agency (CISA) developed the seven pillars of Zero Trust to help organizations comply with the federal government’s executive order on zero trust.

• Identity

This refers to all the attributes or collection of data that defines a human and non-human entity online. In the zero trust model, the identity of all users is thoroughly checked before granting access. 

• Device

Device defines all the devices that can connect to the organization’s network. This includes desktops, printers, medical devices and mobile devices. The organization must have a complete list of all these assets, as well as their compliance and configuration, to ensure that they function properly without compromising the core principles of ZTA.

• Network

This refers to the network environment and includes an organization's internal network or any other hardware or wireless network connecting to the Internet.

• Applications and workloads

This refers to all the software programs and services that are running on mobile devices, cloud environments and on-premise architectures.

• Data

Data includes an entire set of information available in an organization in both structured and unstructured formats stored in the organization’s IT infrastructure. This includes applications, devices, systems, databases, networks and backups.

• Visibility and Analytics

Part of this pillar is the analysis of network and system activity to detect threats. This refers to having a comprehensive monitoring system that actively tracks all types of user activities, devices, network traffic, and any other forms of data that indicate anomalies and suspicious behaviours. 

• Automation and Orchestration

Implementing a ZTA also involves having automated systems that respond to potential threats based on security protocols in place. This approach enhances the efficiency and precision of the response to potential security incidents.

What makes Zero-Trust Architecture a safer option for healthcare?

According to Verizon’s 2018 Protected Health Information Data Breach Report (PHIDBR), 70% of incidents involving malicious code were ransomware infections. Healthcare is the only industry where internal resources act as the biggest threat - 58% of breach incidents involve insiders. This means that it is not just from hackers that the information needs to be protected. Most healthcare organizations still rely on the traditional castle and moat approach to secure their data. To ensure all-round protection of patient data from both inside and outside threats, hospitals need to implement a zero-trust model.

• Just like the name suggests, this security model trusts no one. It is based on the assumption that security risk is present not just outside the network but inside as well. In this model, instead of just guarding the main door of the castle(the network perimeter), every single door inside(the internal network) is guarded and can be entered only after thorough verification.
• In this model, the network only serves as an entry point to reach specific work-related applications. However, to access the data within, users have to be authorized and authenticated. User authentication acts as a barrier that determines the users who are allowed and those who are not, irrespective of whether they are located within or outside the network perimeter. This reduces the risk of data breaches.
• Strict access controls, the principle of least privilege, continuous monitoring and real-time analytics, which form the basis of ZTA, also serve as strong deterrents that protect healthcare data from insider threats through the timely detection of suspicious behaviour patterns. 
• The increased use of connected medical devices has also increased the attack on healthcare. However, in the ZTA model, any IoT medical device that is connected to the network is continuously monitored to ensure that if any device is compromised, it can be identified and isolated quickly.

Wrapping up

The shift to Zero Trust Architecture is no longer a forward-thinking strategy—it’s a necessity for healthcare survival. As cyberattacks grow more sophisticated and patient data becomes a lucrative target, clinging to the outdated "castle and moat" model cannot guarantee overall protection. ZTA offers a smarter approach: verifying every user, device, and request, segmenting networks to contain breaches, and encrypting data to render it useless to attackers.

By adopting ZTA, healthcare organizations not only protect sensitive patient information but also future-proof their operations against evolving threats, from ransomware to insider risks. By implementing Zero Trust principles—least privilege access, micro-segmentation, and continuous monitoring—clinics and hospitals can secure their digital ecosystems without sacrificing the collaboration and innovation that modern healthcare demands. The question isn’t whether your organization can afford to implement ZTA but whether it can afford not to.Frequently Asked Questions

Frequently Asked Questions

1. What are the challenges in implementing Zero Trust Architecture?

Configuration issues with legacy systems, as well as cost and effort involved, are some of the challenges involved in implementing Zeto Trust Architecture.

2.How does Zero Trust address insider threats, like accidental employee errors?

A: By enforcing the least privilege access, ZTA ensures employees only access data essential to their roles. Continuous monitoring helps in detecting unusual activity (e.g., an employee downloading 1,000 files at midnight), allowing quick response to accidental or malicious actions.

3.How can zero trust architecture be implemented in healthcares?

Segment your healthcare organization’s network, implement zero trust policies, MAF, and continuous monitoring and behavioral analysis. Also, a software-defined perimeter should be implemented to hide all internet-connected devices from the internet, and network access control should be used to access devices before allowing them to be on the network.

4.Can Zero Trust Architecture be applied to cloud environments? 

Yes. It is possible to apply zero trust in the cloud. Zero trust includes allowing for granular access controls and continuous verification of user identities across different cloud services, making it a highly suitable security model for cloud-based solutions.