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HIE Security Checklist

HIE Security Checklist

Owned by Piotr Mankowski
Feb 20, 2025
4 min read

1. HIE Platform

1.1 Docker Environment

  • Run Containers as Non-Root: Drop privileges in the container where possible.

  • Use Official or Trusted Base Images: Keep images patched and regularly updated.

  • Minimize Attack Surface: Use multi-stage builds and minimal base images (e.g., Alpine, Distroless).

  • Segregate Services: Keep sensitive services (DBs, sensitive APIs) on internal networks not exposed externally.

  • Container Security Monitoring: Solutions like Falco or Aqua Security to watch containers for suspicious runtime activity.

1.1 Reverse Proxy

  • Enable HTTPS/TLS: Use strong ciphers, TLS 1.2+ (preferably 1.3). Obtain certificates from a reputable CA.

  • Hide Internal Services: Only expose necessary routes/ports; keep other service ports internal.

  • HTTP to HTTPS Redirection: Force all traffic over secure channels to eliminate plain HTTP usage.

  • Leverage Docker Swarm Secrets: Store database credentials, API keys, etc. in Docker Secrets rather than environment variables.

  • Enable Resource Limits: Limit CPU, memory, and disk I/O per container to prevent resource hogging.

  • Micro-Segmentation: Use firewall rules or network policies at the container level to restrict service-to-service traffic.

  • ModSecurity / Nginx WAF: If self-managed, integrate ModSecurity with Nginx or Apache.

    • Rule Customization: Tailor WAF rules for HIE traffic, filtering known exploit signatures. (Optional additional item)

1.3 Docker Swarm & Cluster Hardening

  • Control Swarm Membership: Use mutual TLS authentication; only add trusted nodes.

  • Rotate Secrets & Certificates: Regularly rotate Docker Swarm certificates to reduce exposure.

  • Enable Swarm Overlay Network Encryption: If possible, enable IPSEC encryption for container-to-container traffic.

    • Overlay Network Encryption: Configure IPSEC encryption if using Docker Swarm overlay networks.

1.4 Host & OS Hardening

  • Logging & Auditing: Maintain logs at both host (syslog) and container level. Consider a centralized log aggregator (Elastic Stack, Splunk, Graylog, etc.).

  • Log Correlation: Combine logs (reverse proxy, Docker, application, OS) for a unified intrusion detection approach.

  • Intrusion Detection: Tools like Snort, Suricata, or OSSEC to monitor for known attack signatures.

1.5 Application Security

  • Authentication & Authorization: Use strong auth (OAuth, JWT, mutual TLS) to protect HIE APIs.

  • Encrypt PHI at Rest: Use strong encryption (e.g., AES-256) for databases storing PHI.

  • Data Access Logging: Track who accesses PHI for audit and compliance.

  • Implement Secure Session Management: Enforce session expiration and secure cookies.

2. Hosting Environment

2.1 Docker

  • Lock Docker Swarm: (docker swarm ca --rotate + passphrase) Encrypts/locks the Swarm’s root CA key.

  • Use a Private Network for Swarm Traffic: Ensure manager/worker communications occur over a secure VLAN/VPC or VPN.

2.2 Host and OS Hardening

  • Patch & Update: Keep Linux distributions updated with the latest security patches.

  • Limit SSH Access: Enforce key-based authentication; disable root login; consider an SSH bastion or VPN.

  • Use a Host Firewall (iptables/nftables): Whitelist only necessary inbound/outbound connections.

  • Implement SELinux / AppArmor: Strengthen process-level isolation. (Optional additional item)

2.3 Cloud-Specific Controls

  • External WAF: If on AWS, consider AWS WAF or a third-party service like Cloudflare, F5, etc.

  • AWS Security Groups: Restrict inbound/outbound traffic to only what’s necessary.

  • Load Balancer: Use AWS ALB/NLB to distribute traffic and integrate with AWS WAF.

  • EBS / RDS Encryption: Use KMS-managed keys for storing data volumes and databases.

  • IAM Roles: Grant least privilege to EC2 containers and services.

  • CloudWatch / GuardDuty: Enable real-time threat detection and log analysis.

  • S3 Bucket Policies: Restrict access to logs/backups. (Optional additional item)

3. Governance

3.1 Role-Based Access Control

  • Fine-Grained Permissions: Assign minimal privileges to each service/user role (e.g., read-only for certain APIs).

  • Review and Revoke: Regularly review roles/permissions and remove unnecessary access. (Optional additional item)

3.2 Auditing & Compliance

  • Audit Trails: Log every access to patient data in the HIE.

  • Data Retention Policies: Have a clear policy on how long to retain logs and PHI data.

  • GDPR/Local Regulations: Ensure compliance with local data protection laws. (Optional additional item)

4. Advanced Security Capabilities (Future Directions)

4.1 Zero Trust Architecture

  • Enforce Authentication/Authorization for every connection, including internal microservices.

  • Short-Lived Certificates or Tokens: Rotate credentials frequently to reduce risk.

  • Secure Service Discovery: Ensure internal services only discover/connect with authorized peers.

4.2 Service Mesh

  • Mutual TLS: Use a service mesh (Istio, Linkerd, etc.) to provide mTLS for inter-service communication.

  • Policy Enforcement (RBAC): Enforce fine-grained RBAC policies at the mesh/network layer.

  • Advanced Observability: Use mesh telemetry for improved monitoring and troubleshooting.

4.3 Secrets & Key Management

  • Dedicated Secrets Manager: Store secrets in Vault, AWS Secrets Manager, or an HSM.

  • Regular Key Rotation: Rotate encryption keys, TLS certificates, and credentials on a set schedule (e.g., every 90 days).

  • Access Controls on Secrets: Strictly limit which services/roles can fetch specific secrets. (Optional additional item)

4.4 Continuous Security Testing

  • Penetration Testing: Regularly test the environment/applications to uncover vulnerabilities.

  • Chaos Engineering (Security-Focused): Simulate node failures, container breakouts, or other attacks to test detection and recovery.

  • Continuous Integration Checks: Automate scanning of images, code, and dependencies in CI/CD pipelines. (Optional additional item)

 

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