Kristen Luong Dec 07, 2023

Ensuring Data Security in FHIR: A Vital Step Towards Healthcare Interoperability

The healthcare industry has been witnessing the exponential popularity of FHIR (Fast Healthcare Interoperability Resources) owing to the growing thirst for interoperability. However, to many healthcare providers, data security is of major concern when it comes to any technology, including FHIR, because medical data is extremely sensitive. In this article, we will help you understand some common threats to data security in FHIR and recommend effective security measures to protect your patient data.


Is it true that FHIR guarantees data security? 


According to HL7 FHIR, FHIR is not a security protocol, which means that your data is not automatically ensured when FHIR is integrated into your healthcare system. Hence, you will need to install a separate security system to guarantee data security in FHIR. The great news is that the exchange protocols and content models within FHIR can easily align with any security protocols you want. 


Common threats to data security in FHIR


  • Unauthorized Access: One of the primary threats to FHIR data security is unauthorized access to patient health records and other sensitive information. This can occur through various means, such as weak authentication mechanisms, compromised user credentials, or inadequate access control policies. If unauthorized users can access sensitive medical data of patients, they can leak this valuable information outside. This will dramatically impact your patient’s trust and damage your reputation. 


  • Data Interception during transit: FHIR relies on data exchange mechanisms such as APIs and web services for interoperability. However, if proper encryption measures are not in place, attackers can intercept and eavesdrop on data transmitted between systems. This poses a high risk of sensitive patient information being exposed.


  • Data Integrity issues: Data integrity can be affected by multiple factors such as inaccurate data entry, data transformation errors between formats in FHIR, or incomplete data sets. To prevent these problems, comprehensive data security is a must but it will be extremely challenging for healthcare organizations to access all these risks themselves. That’s why we highly recommend you work with a reliable vendor that has experience in FHIR installation, like Ominext, to achieve strong data security in FHIR. 



  • Third-party risks: Integrating FHIR systems with external applications or relying on third-party vendors for hosting or maintaining infrastructure introduces additional risks. Inadequate security practices by third parties can lead to data breaches or unauthorized access to FHIR data.


  • Lack of Audit Logging and Monitoring: Without robust audit logging and real-time monitoring, it becomes troublesome to detect and respond to security incidents effectively. Failure to capture and analyze logs can hinder the identification of suspicious activities, compromises, or unauthorized access attempts.


Best practices for ensuring data security in FHIR


  • Access Control and Role-Based Permissions: It is crucial that you implement strong authentication mechanisms, such as two-factor authentication, to ensure that only authorized individuals can access FHIR systems. For higher data security in FHIR, you should use role-based access control (RBAC) to assign appropriate permissions to users based on their roles and responsibilities.


  • Data Encryption: You should use secure communication channels, such as HTTPS, to encrypt data during transit between FHIR systems to guarantee data integrity. Besides protecting data in transit, we recommend you encrypt data at rest to safeguard patient information stored in databases to further improve data security in FHIR. 


  • Audit Trail: Maintaining detailed audit trails will help you monitor access to FHIR resources, including user activities and system events. As a result, data checking will become more easy and convenient as you can see who has logged in or adjusted the patient data. Don’t forget to regularly review audit logs to detect and investigate any intrusion attempts or unauthorized activities as soon as possible to prevent or minimize the risks for your organization.


  • Data Masking and Anonymization: Data anonymization removes sensitive or personal information from datasets, whereas data masking hides confidential data by changing the values in the database. Anonymizing or masking data whenever possible is a data security measure we highly recommend to our clients to minimize the risk of sensitive information exposure in FHIR.



  • Compliance with Regulations: It is significant that you understand and comply with relevant data protection regulations, such as HIPAA, GDPR, or regional security standards. Make sure you stay informed about updates to regulations and promptly adjust security measures to maintain compliance.


  • Data Backup and Incident Response Plan: To prevent data loss due to unexpected system failures, breaches, or other emergencies, all healthcare providers need to implement regular data backup procedures and develop an incident response plan to effectively respond to security incidents. These measures will help you ensure the availability and integrity of FHIR data even in the worst scenarios. 



Unauthorized access, data interception, data integrity, third-party risks, and lack of audits are the problems that many healthcare providers usually have to deal with if they don’t incorporate comprehensive data security in FHIR at first. By implementing these measures and continually evaluating and improving security practices, you will be able to maintain the accuracy and strengthen the reliability of FHIR data, ultimately improving patient care and outcomes.