Rapid and reliable information sharing of patient healthcare information has become critical for achieving better care with lower costs. However, such healthcare information sharing requires to be done securely with privacy guarantees, as required by law. Among its other requirements, the Health Insurance Portability and Accountability Act (HIPAA) requires the use of appropriate access control mechanisms to protect healthcare information. Despite these legal requirements, currently implemented access control models in the healthcare domain are typically inadequate as demonstrated by the large and increasing numbers of successful attacks on healthcare systems. In particular, current access control models do not provide sufficient protection for healthcare systems from attacks by insiders, i.e., authorized healthcare personnel. This paper examines how healthcare information can be protected from unauthorized or improper use, disclosure, alteration, and destruction by health- care providers. Using a holistic approach toward modeling access control, the authors construct a threat model for access control in healthcare systems. The constructed model is then used to assess the effectiveness of current access control mechanisms such as Role-Based Access Control (RBAC) and Attribute-Based Access Control (ABAC), as well as the BiLayer Access Control (BLAC) model, which was proposed as a flexible, higher-performance replacement for both RBAC and ABAC.
Department, Program, or Center
Computer Science (GCCIS)
Alshehri, Suhair; Mishra, Sumita; and Raj, Rajendra, "Insider threat mitigation and access control in healthcare systems" (2013). Accessed from
RIT – Main Campus