HL7 Data Interfaces in Medical Environments: Understanding the Fundamental Flaw in Healthcare

Ask healthcare IT professionals where the sensitive data resides and most will inevitably direct attention to a hardened server or database with large amounts of protected health information (PHI). The respondent might even know details about data storage, backup plans, etc. Asked the same question, a penetration tester or security expert may provide a similar answer before discussing database or operating system vulnerabilities. Fortunately, there is likely nothing wrong with the data at that point in its lifetime. It potentially sits on a fully encrypted disk protected by usernames, passwords, and it might have audit-level tracking enabled. The server may also have some level of segmentation from non-critical servers or access restrictions based on source IP addresses. But how did those bits and bytes of healthcare data get to that hardened server? Typically, in a way no one would ever expect... 100% unencrypted and unverified. HL7 is the fundamentally flawed, insecure standard used throughout healthcare for nearly all system-to-system communications. This research examines the HL7 standard, potential attacks on the standard, and why medical records require better protection than current efforts provide.