Date post: | 18-Dec-2015 |
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Shouting from the Rooftops:
Improving Email Security
Dr. Maury Pinsk FRCPCUniversity of Alberta
Division of Pediatric Nephrology
Dr. V
Uses email to correspond with patients Answers questions Gives test results Changes medications
All emails are signed with disclaimer for confidentiality
Patient A asks how secure her medical information is
How secure is email?
Depends : Where it is being sent What you choose to use it for How it is being sent
Email - the basics
Your email program is a “mail user agent” Produces a text file Sends the file through the internet
using a set of instructions that allow commuters to communicate – a “Protocol”
E.g.: SMTP or simple message transfer protocol
Email - the basics
SMTP guides the email to final recipients server Can route through several servers if
necessary Once it reaches its final destination
server, it is stored to disk The recipient accesses the email using
a Post office protocol (POP)
So what are the security issues Sending an email is like sending a
postcard Any server through which it passes
is an opportunity for eyes to read For the keen individual, it
represents an opportunity to alter the contents of the email as well.
So what factors alter the security of the email?
Where is it being sent?
Data that stays on a server is less likely to fall into the wrong hands More so for dedicated service providers
(e.g.: intrauniversity, intrahospital) Less so for data that leaves a server
(e.g.: interhospital or interuniversity)
How is it being sent?
Data that is sent unprocessed is vulnerable to breach of confidentiality or integrity
What do I mean by processed? Encryption Digital signatures
Encryption
Key a large number used by encryption algorithm to
generate cipher code Public key owner can send you
encrypted email securely, but cannot decrypt it
Private key owner can decrypt the email.
The two keys are related, but through very complex algorithms that are difficult to crack
Encryption
Keys are stored, encrypted, on your computer, and used by your email software
Keys can be distributed by owner on disk, by email or via access to repository (key server)
PGP encryption: an extra layer of security for encryption
PGP – decryption – the same in reverse
Encryption, but for whom?
Encryption: keeps on-looking eyes away from sensitive data, but doesn’t verify the source
Authentication and integrity is verified by a digital signature
Digital Signature
Digital signatures
But how do you know the key is from the right person?
Key “forgery” is possible, hence the need for security certificates
Security certificate = digital signature + authentication from another user + public encryption key + user identification
What is being sent?
The best means of preserving data integrity and confidentiality is to decide if it is absolutely necessary to send it the data by email.
Return to Dr. V
Patients informed: Patient information continues to be
transferred over the internet, but patients sign a consent allowing this to happen
Information kept confidential: Public keys are issued to patients via key
server Patients encouraged to obtain own personal
key and distribute public key to Dr. V
Integrity of information confirmed: Security certificates issued with public
key All correspondence with digital
signature.
Further resources
Encryption and digital signature freeware Pretty Good Privacy (PGP)
http://www.pgpi.org
Guidelines for Patient Privacy HIPAA Privacy regulations
http://www.hhs.gov/ocr/hipaa