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Security concerns with writing to an external URL from Cloverleaf

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  • October 25, 2019 at 2:55 pm #113362
    Susan Jones
    Participant

      We are currently on Cloverleaf 6.1 on AIX 7.1. We have been asked to write ADT and orders messages to a vendor’s URL (https), which is not something we have done before. The only external connections we have done from Cloverleaf have been through VPN.

      We have been able to make the connection and successfully send a test message, but we have concerns about potentially exposing our server to the outside world. We process several million messages monthly, most of which contain at least some level of PHI.

      Are there steps we can take to minimize the risk? Are we worried unnecessarily? Any thoughts or suggestions are welcome.

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      • October 25, 2019 at 3:50 pm #113363
        Anonymous

          Does the vendor have documentation of HIPPA compliance?

        • October 25, 2019 at 4:55 pm #113367
          Susan Jones
          Participant

            I will check, but even if they do, does that prevent unscrupulous persons from finding a way into our server? Of course, that could potentially happen anyway if our internal network gets compromised, but we don’t want to inadvertently provide a back door, if you will, to our server or network.

          • October 25, 2019 at 5:18 pm #113368
            Anonymous

              I don’t know. I would consult with your Network group. Sounds like this is the first implementation that connects your Cloverleaf server to the internet that isn’t through a VPM or private network.

            • October 28, 2019 at 3:56 am #113397
              Arie Klop
              Participant

                We used to have a policy saying you need a VPN for sending data outside the hospital, but nowadays we have a policy of VPN or TLS >= 1.2. Data is just as encrypted between the two.

                We also use SOAP to transfer data to another party, via a url. This is  no different. FHIR works the same.

                There are two mayor issues: 1 are  you sure you are (still) posting to the right party and 2 are your data being sent secure, or is it possible to eavesdrop.

                These concerns can be addressed by making sure you use TLS (https) and enforcing a valid certificate with an expiration date not to far in the future (2 years?). By doing so you also solve the problem of losing sight of a data target and having it being sent elsewhere.

                I would advise to not send every patient, but only those really needed. And only the info they really need. ADT is a protocol from a time when all receivers needed all patient info from all patients. That is seldomly the case nowadays. Privacy by design is really important IMO.

              • October 29, 2019 at 12:49 pm #113425
                Susan Jones
                Participant

                  Thanks for the responses – very much appreciated. 🙂

                  Arie, may I ask how we enforce the valid certificate? My apologies, but this is new type of setup for us on Cloverleaf.

                  • This reply was modified 5 years, 1 month ago by Susan Jones.
                • October 30, 2019 at 9:24 am #113430
                  manoune sadakhom
                  Participant

                    Typically using Https is very secured if you are utilizing the private key store and trust store to do the data exchange. Some of the vendor even goes further by signing with the certificate and encrypting it.

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