Apisecure, 14 & 15 March 2023 - Grahame Grieve, Principal at Health Intersections Pty Ltd.
summary
FHIR is a JSON/REST standard that leaves security choices to implementers, so real-world deployments use the SMART on FHIR profile (OAuth2/OpenID) for auth, add security labels on resources, and support break the glass emergency overrides; many orgs delegate logs via audit trail delegation to make admin tamper resistance. Recent audits find third‑party aggregators with trivial misconfigurations exposing patient data, attackers target institutions for ransom, and practical defenses include API gateways, zero‑trust, threat management and simple practices like issuing separate locked production laptops.
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chapters (24)
- 0:00Introduction
- 1:10What is FHIR and its role
- 4:38Healthcare data scope in FHIR
- 7:29FHIR for varied systems
- 9:56FHIR API basics
- 13:12Security challenges in APIs
- 18:29Security assumptions in FHIR
- 21:00Standardized APIs and security
- 25:11OAuth 2 and SMART on FHIR
- 27:44Break the glass concept
- 30:14Access control in clinical systems
- 31:40Audit trails importance
- 33:04Security labels role
- 36:33Digital signatures limits
- 38:43Binary attachments risks
- 42:17Consent management
- 45:06Current healthcare API security
- 47:13Why healthcare is targeted
- 49:19Security best practices for FHIR
- 50:24FHIR in open communities
- 53:16Third-party aggregators risks
- 57:11Political challenges in security
- 1:00:24Process improvements for APIs
- 1:03:10Future of FHIR security
