DevOps can help make HIPAA compliance more achievable
Automating the provisioning of HIPAA-compliant server infrastructure enables compliant hosting service providers with the ability to provision and deploy infrastructure-as-code with minimal human intervention. Providing the automated process is thoroughly tested, revised and updated, it can offer a healthcare organization huge flexibility when enforcing a HIPAA-compliant server or serverless infrastructure within a private, hybrid or public cloud offering.
Organizations that practice centralized operations, also known as DevOps, have a unique team who have the desirable skills of software development, IT operations and quality assurance (QA). The DevOps objective is to create a performance-based IT solution within a greatly reduced provisioning lead time using technical server blueprints within a continuous delivery environment.
DevOps within a healthcare organization must be able to meet the stringent administrative, physical and technical safeguards required by HIPAA. In all cases, the required safeguards must be met, but with DevOps, it can be significantly easier to meet the addressable requirements of HIPAA.
Each healthcare organization can present differing business needs which they need a HIPAA-compliant service provider to resolve. It is not always possible to provide a cookie-cutter solution for every healthcare organization, often one design does not fit all; however, it is possible to create a baseline of operations using automation.
A great deal of planning must be completed with all relevant stakeholders to not only understand the technical solution but to gather critical information about unique aspects of the architecture and then plan ways to automate the delivery process.
It may not be possible to automate every workstream, but getting the DevOps team involved in the early planning stage will allow thorough and accurate playbooks to be created.
With advanced planning, significant gains can be made in defining the networking security layout for the healthcare clients virtual private cloud, work out what isolated cloud resources can be defined and make decisions about potentially leveraging network layer protection services such as DDOS protection or a software-defined web application firewall.
The next step to creating the infrastructure-as-code is to write the automation playbooks that will provide the infrastructure. There are several provisioning applications that can be used, such as Terraform, Chef, Puppet, Google Deployment manager or AWS Cloud Formation, and playbooks will need to be written (or converted to) a compatible language such a python, YAML or JSON.
The machine-readable code interacts with the service provider’s API front end; this may be an on-premises VMware vSphere cluster or a public cloud provider such as AWS, GCP or Azure. The API interprets the code and uses the descriptor commands to provision and deploy infrastructure in a cloud environment.
A DevOps engineer will select the cloud provider they using and then define all the environmental variables to use to create the infrastructure-as-code. Connection variables are usually configured first and will define the cloud provider locations, regions and availability zones, as well as the encrypted account passwords or IAM configuration to interact with the provider API.
Once the connection variables have been initiated with the provisioning software of your choice, they are used throughout the project life cycle. The next stage is to define the HIPAA infrastructure environment, including storage, network and compute resources. This will include provisioning resources and setting private and public networking.
At all stages of the design it important to define where ePHI data will be stored and processed. The process must include step-by-step documentation and a customer responsibility matrix. At this stage, it is imperative to incorporate technical safeguards such as server access control lists (groups), introduce activity logging and provide auditable controls.
Server hardening policies must be created for servers, active directory, workstations or providing least privilege authorization accounts at multiple levels, such as user profiles, that enable or restrict access to individuals or third-party systems. Preapproved software is typically installed at this step as well.
Next, the inclusion of boot volume encryption and encryption of disk objects and storage volumes must be defined, this is easily achievable on mass provisioning of servers, simply providing a volume ID and an encrypted $TRUE statement.
Throughout the playbook designing phase, testing is conducted to close loopholes, refine automated network configuration and create shared VPN tunnels with passwords that automatically cycle. The playbooks set the properties which make an organization HIPAA-compliant, and can also be used to create secured bastion servers if VPN is not an option.
Playbooks allow DevOps teams to create rotating security keys, SSL certs and log aggregation and filtering. This can also be configured to trigger automated messages that can be emailed in case of any errors or failures in the automation process.
When all the playbooks are streamlined and accurate, they can be used to define a healthcare clients service catalog, which enables the use of standardized templates to be used within the HIPAA environment. This may include server templates, container configuration, storage templates or any predefined software application.
Security tools can be used to track and inventory resource usage and any system changes, track all user activity and any API activity requests.
Monitoring tools can be used such as Cloud Watch, Nagios or Nimsoft to monitor server resources and application usage, these monitoring tools can also pick up errors or predictive errors and alert against predefined thresholds.
Many organizations choose to use serverless workloads such as Docker or Kubernetes. These massively scalable solutions also bring about a huge benefit that aids the DevOps continuous delivery approach of automated update rollouts—essentially, applications can be isolated over differing pods, allowing the underlying hardware to be updated or versioned with zero downtime.
DevOps is changing the automated delivery of HIPAA-compliant solutions. It is important to remember that DevOps does not have all the answers for HIPAA, especially many of the administrative regulation. However, it does empower managed service providers with the ability to provide tried and tested automated solutions that meet or exceed the technical and physical safeguards of HIPAA compliance.