Access control for smarter healthcare using policy spaces

Abstract

A fundamental requirement for the healthcare industry is that the delivery of care comes first and nothing should interfere with it. As a consequence, the access control mechanisms used in healthcare to regulate and restrict the disclosure of data are often bypassed in case of emergencies. This phenomenon, called "break the glass", is a common pattern in healthcare organizations and, though quite useful and mandatory in emergency situations, from a security perspective, it represents a serious system weakness. Malicious users, in fact, can abuse the system by exploiting the break the glass principle to gain unauthorized privileges and accesses. In this paper, we propose an access control solution aimed at better regulating break the glass exceptions that occur in healthcare systems. Our solution is based on the definition of different policy spaces, a language, and a composition algebra to regulate access to patient data and to balance the rigorous nature of traditional access control systems with the "delivery of care comes first" principle.

A Review of Delegation and Break-Glass Models for Flexible Access Control Management

“…These functions are implemented using the Clark-Wilson model (see [10]). A similar approach is presented by Ardagna et al [2]. They introduce a break-glass approach where an action can be performed by finding a corresponding emergency policy.…”

Generic support for RBAC break-glass policies in process-aware information systems

“…In [14], any access is legitimate and is thus granted. A similar approach is presented by Ardagna et al [2]. They introduce a break-glass approach where an action can be performed either by finding a corresponding emergency policy or by granting a break-glass override.…”

SHARE: Secure information sharing framework for emergency management

“…For instance, [6], [7], [8], [9], [10], [11], [12] use the concept of Break-the-Glass (BtG) policies to enforce a more flexible access control. According to this paradigm, when a subject requests an access, the system checks regular access control policies.…”