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Daniel Beaumont Information Assurance Lead eHealth Programme, Scottish Government NOT PROTECTIVELY MARKED

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Is there a mobile * explosion? *not really..

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...more like a 20 yr marathon First text message 1992 Internet early 1990s Pay-as-you-go (which created mass consumer market) mid-1990s Wireless LAN late 1990s GPRS/3G early 2000s (i-mode long before i-phone) Smart phone (PC, colour screen) early 2000s Board IT teams know all about this...and generally good at managing it (e.g. WLANs)

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....bumps in road Vendors have tried to get a wireless big bang (e.g. WAP phones, MMS and often fell flat): Lack of bandwidth Lack of battery power in devices Screen technology not advanced Mobile applications still in infancy Short-range wireless initially slow catch on consumer market High production costs for some components

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What is different now..? Key components for tipping point have come together

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eHealth leads face a lot of background noise........

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I am senior and I want one!

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Patient accessing service via wireless

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R.O.I from existing tools All of this demand just at time when we are supposed to be squeezing value out of existing IT investment (mainly fixed cable) Far less money for.. buying more kit, putting in ever more complex support models for wireless

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Getting to the nub of the problem Boards now need to deal with implications of this wireless application tipping point and derive benefits while managing risk Take into account consumer pressure/convenience (pester power) of staff but all decisions must be in interests of business even if it is not always popular Need to cut through all this background noise and work out what really are the information risks, and how to work out how to deal with them

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Forget much of what you have heard and start on a clean sheet........ There is no such thing as 100% security several pinches of salt for whatever vendors claim about devices/service (It meets xyz International standard) Do not consider ITSOs, IG Leads or Caldicott Guardians as people as people who say yes or no Do not think you must buy in security expertise every time Do not consider wireless as necessarily any more or less secure Do not think confidentiality requirement drives all decisions Do not think good security = encryption products

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Instead....

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Go for Information risk management approach NHS staff, clinical and managerial are already really good at risk management every day Identifying risk (this could happen to patient x given what I know about y) Explaining risk to others (you cannot move this patient because..) Treating, avoiding, retaining risk (we can treat x condition, but z condition can only be contained.

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Looking at information risks in the round How often have you heard about privacy risks? Hey, you cant do that, we have personal data to protect at all costs... not possible, because the product doesnt do encryption someone might eavesdrop on that data

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Remember: Information Assurance is C.I.A Confidentiality AND Integrity AND Availability NHS does have important confidentiality requirements (legal and moral) But often this can dominate all discussion to the point where availability and integrity risks hardly get a look in......

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Information risks in round: Availability But how seldom you hear: the need for availability of data to clinicians outweighs the very small risk of information loss I am worried that the chosen wireless solution could mean there are more service outages

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Information risks in round: Availability (2) All wireless technologies are by their very nature intermittent (radio, infrared, microwave etc) So a upper most in our minds must always be the availability risk (*hence title of this presentation)

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Broken cables rare event: have understanding single points of failure

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Wireless outages: still learning about impacts

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Information risks in the round: Integrity How seldom do you hear: I am worried that mobile devices will lead to duplication of data, or data out of synch We seem to be procuring a separate device for each application...the data will be different from desk-tops we have a pile of devices

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When should you do an information risk assessment? Organisational level: e.g. whole board, team, process Particular service to be launched (e.g. prior to delivery) especially if critical and/or if there is a high element of unknowns relating to security As result of a security incident (e.g. privacy breach)

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Who should do information risk assessment? Ideally, someone who is not in the project team and can provide an independent view BUT, before you think to pick up phone to a consultancy etc there are lots of NHSScotland options Your ISO ISO from another board Need to pool our skills much more internally

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Information risks: whole process Understanding business context (why is the service, which has wireless devices so important) Who might be the owners of that service What are the impacts (worst case scenarios) relating to something going wrong with that service/process

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Information risk assessment Devices How they are expected to be used How they might be used in unexpected ways Relevant regulatory requirements (e.g. Data Protection) Types of attacker/motivation Risks and vulnerabilities relating to any aspect of the whole process

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Information risk assessment

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Information risk assessment: reporting back to...?

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Who are the information risk owners? A Caldicott Guardian is a senior person responsible for protecting the confidentiality of patient and service-user information and enabling appropriate information-sharing. NOT the same as a SIRO (Senior Information Risk Owner) or information asset owner

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Who may need to be in the room? RoleWhy? Owner proposed serviceThere is no such thing as a an IT project; the technology is there to enable a process/service that must be owned/run by someone else Project ManagerTo explain exactly how requirements are met and broad risks Independent Risk AssessorExplain results of risk assessment; and options Caldicott Guardian/IGCompliance with DP etc and best practice eHealth leadIs the service suitable for current architecture, how will it be released into live environment?

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Creative tension between advisors/enforcers/owners

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Key questions to be posed? Which risks can and should be treated? What residual risk is still left even with treatment? Are the residual risks still too much to bear? Which risks can be avoided (e.g. not doing something)? Which risks can be retained?

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Example: risk retained smart phone, whole disk encryption not possible...but there is encryption on the application

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Residual risk.... User error could mean sensitive personal data ends up on the un-encrypted part of the device (e.g. My Documents, Camera) *Revised NHSScotland mobile data says this is permissible up to amber level. User training awareness only control to reduce this residual risk further......

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What about B.Y.O.D? Bring your own device

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B.Y.O.D: Fact or fiction? Commonly held assertionReality? Staff are clamouring for it now...? Staff would prefer not to use different device for each purpose (not necessarily own device) Vendors have cracked security ? OK for services up to amber and for email. But many other problems relating to personally owned devices.not covered by encryption Cheaper to support BYOD than official devices? Not always; sheer range of variables can add to support cost We could connect our own devices to NHS services via the web? We do not currently have the web-architecture to do this. Few online services. Our current remote access work on VPN/tokens/official devices etc

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Current situation NHSmail does allow use own mobile device (via Internet) Some staff use own devices for capturing information (e.g. notes from minutes). Do they ever save it in the right place?? Not much else...............?

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Emerging situation: move with caution..... What about choose your own device C.Y.O.R?? takes employee preferences into account but devices still owned and controlled by org Employees often complain about having multiple devices...... We could make a start by reducing the number of official devices in workplace. Supporting all the variables relating to peoples own phones can be more expensive than just issuing official ones.

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B.Y.O.D Need to sort out the identity & access management and authentication aspects for remote users in general Lots of products to secure applications; but having an agent installed on a personally-owned device does not = security Need to think far more about how we classify information

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So what is role of Scottish Government in all this?

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Balancing Act Removing barriers to information sharing and innovation while upholding ministerial priorities and right degree of compliance..

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Barriers are often around perceptions

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Priorities Information Assurance Strategy (working through it) Good practice guidance (based on risk assessments) Standards (where appropriate) Building communications ISO/IG communities Building capability (e.g. training, forums) Links with clinical and professional groups Leading and influencing within NHSScotland governance structures Significant incident lessons learned.

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Final thoughts. Tackling some of the emerging security risks around mobile technology space can be scary. BUT many of the current processes involving paper files and removable digital media are far scarier

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Almost daily headlines

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Mobile can help to improve security Secure email to any device (not the dreaded fax machine) Patient portal accessed by smart-phone (not paper mail) Remote access to the app (not the CD or memory stick) Addresses/combination codes to homes of the elderly on secure tablet (not held on a paper print out)

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Thanks for listening