Leveraging Immutable Infrastructure to Help Protect an Organization’s Healthcare Data

June 06, 2022 - Immutable infrastructure allows healthcare organizations to maintain reliable data backups and safeguard patient information while preserving data integrity and mitigating cyber risk.  Understanding what immutability is and the many ways to leverage it can help healthcare organizations strengthen their IT infrastructures and protect critical workloads.

What is immutability?

The word “immutable” implies that something cannot be changed over time. Following the same principles, immutable IT infrastructures and data stores contain unchangeable components.

“Just imagine if someone removed the delete button from your keyboard,” suggested Hector Rodriguez, executive security advisor, Worldwide Public Sector healthcare and life sciences at AWS.

“Many organizations are afraid of threat actors deleting their backups. But what if there was no delete option? Now, you’ve eliminated that possibility.”

In a typical IT infrastructure, servers can be changed and updated in place after creation. This traditional, mutable approach presents the risk of configuration drift, which occurs when software changes are made without following a systematic approach. Configuration drift can lead to system failures if not addressed, which can affect patient care.

Immutability reduces the likelihood of configuration drift because updates and configuration changes cannot occur directly on production systems. Instead, the old version and its components are replaced by an entirely new iteration, enabling consistency and simplicity in deployments.

The case for immutable infrastructure in healthcare

“Using immutable infrastructure ensures that when you do have to restart or recover, you can go back to that immutable copy as your reset point,” Rodriguez noted.

“It really is about making copies to enable you to meet your recovery objectives and align with your business continuity and disaster recovery plans.” For healthcare organizations, this is critical, as any loss of data or downtime can potentially impact patient outcomes.

Cyber resilience is critical to navigating today’s threat landscape. In healthcare and other industries, ransomware attacks are at an all-time high. With this in mind, organizations should be prepared to put their incident response plans into effect.

Threat actors frequently go after sensitive data that fetches a high price on the black market, making healthcare records a prime target. As the threat landscape evolves, threat actors are increasingly leveraging ransomware-as-a-service (RaaS) models, double extortion, and software vulnerability exploits to target their victims.

Regardless of the tactic, cyberattacks can lead to data encryption, EHR downtime, and data exfiltration, all of which can threaten data integrity—the maintenance, preservation, and consistency of data over its lifecycle.

“Changing data in healthcare could be life-threatening,” Rodriguez pointed out. “And, on the financial side, it could affect the way that organizations are reimbursed if the billing data is impacted.”

The ability to reliably maintain data integrity presents a strong case for immutability. Immutability can enable a resilient infrastructure and protect the integrity of highly sensitive patient data. In the face of a cyberattack, organizations with immutable infrastructure know that they have reliable backups. In addition, immutable data stores can serve as a virtual air gap, isolating data backups from malicious actors.

Additionally, immutability reduces the potential attack surface and scope for threat actors. With a mutable system, a threat actor may be able to gain credentials and modify server configurations freely. But immutability prevents servers from being changed, which in turn reduces the number of attack vectors available to threat actors.

Preserving data integrity and enabling quicker incident response and recovery are just two benefits of immutability. Immutable infrastructure’s reproducibility, scalability, and consistency enable enterprise-wide cyber resilience, allowing healthcare organizations to focus on what matters most—protecting and caring for patients.

How healthcare organizations can leverage immutability

“I would not look at this as a big, costly project,” Rodriguez emphasized. “Start with some critical workloads, prove that it works for your organization, and then apply immutability where it is most effective and supports your organization’s goals.”

Immutable servers are a prime example of how immutability can strengthen infrastructure and processes. Immutable servers can be an asset to any organization because they ensure repeatability and scalability across the infrastructure.

“Golden images” are critical to building an immutable server. Golden images are essentially templates that experts can update accordingly as new patches and vulnerabilities come to light. Organizations should consider automating the creation of golden images using services such as the Amazon Elastic Compute Cloud (Amazon EC2) Image Builder.

There is no need for an organization to build an entirely new IT infrastructure from scratch just to reap the benefits of immutable infrastructure. As cloud adoption continues to grow across the healthcare sector, immutability can be weaved into an organization’s existing architecture.

“You can leverage the cloud as your immutable data store and infrastructure, and architect that way, even if you still are primarily on-prem,” Rodriguez advised. “That way, you will get the best of both worlds and minimize your recovery and response time and for both data and systems availability.”

Leveraging immutable infrastructure has the potential to not only enhance a healthcare organization’s security posture, but also simplifying IT processes and safeguarding health data.

______________________________

AWS is the trusted technology and innovation partner to the global healthcare industry. As the most mature and reliable cloud platform with the broadest and deepest portfolio of healthcare solutions, AWS provides the security and privacy required to enable the highly regulated healthcare industry to increase the pace of innovation, unlock the potential of data, and personalize the healthcare journey.