United States: Best Cybersecurity Practices For Healthcare Organizations – Loss Or Theft Of Devices

This article is part of a series of blog posts exploring the recommendations and guidance Health & Human Services (HHS) provides to healthcare organizations in its Cybersecurity Best Practices report. For previous articles in the series, click here.

The report on cybersecurity best practices (Report) weighs in on one of the issues many entities find hardest to control – the loss or theft of devices and records. As work travel and remote working continue to increase, so too do the instances when company devices leave campus and become vulnerable to loss and theft. The Report states that from Jan. 1, 2018, to Aug. 31, 2018, covered entities reported 192 incidents of theft, affecting 2,041,668 individuals. Adding further gravity to the impact of theft, stolen laptops are not an insignificant source of Office of Civil Rights (OCR) fines:

  • In 2016, OCR levied a $1.55 million fine against a provider because of the theft of a password-protected laptop containing personal health information (PHI) of 9,497 patients.
  • In 2017, OCR fined a provider of remote heart monitoring $2.5 million after a laptop containing 1,400 patients' information was stolen.
  • In 2018, a provider was fined $4.3 million for three separate incidents involving theft of a laptop and the loss of two USB drives containing unencrypted data of more than 33,500 patients.

And these are only a sample. The most frustrating feature of these incidents is that theft will continue to happen. Entities must therefore focus on how to mitigate the impact of the theft. Encrypting devices may not be "quick" or "easy" for entities with large information technology (IT) inventory, but it is a surefire way to ensure that the theft will not result in the disclosure of PHI, and thus the impact of the theft will be limited to the cost of replacing the device.

Aside from encryption, the Report provides additional practical steps for entities to mitigate these types of incidents.

For Small, Midsize and Large Entities

Promptly report loss/theft to designated company individuals in order to terminate access to the device and/or network. This recommendation is contingent on the entity implementing proper access management controls. Entities "need to clearly identify all users and maintain audit trails that monitor each user's access to data, applications, systems, and endpoints" as part of their access management plan. The security controls that support this recommendation include:

  • Establishing a unique account for each user.
  • Limiting the use of shared or generic accounts.
  • Tailoring access to the needs of each user.
  • Providing role-based access.
  • Configuring systems and endpoints with automatic lock and logoff.
  • Implementing single sign-on.
  • Implementing multifactor authentication for the cloud.

Maintain a complete, accurate and current asset inventory to mitigate threats, especially the loss and theft of mobile devices such as laptops and USB/thumb drives. An accurate inventory of IT assets will pay dividends both with and apart from a theft. For instance, an entity that is rolling out encryption on all laptops can know whether the deployment is complete only if they've checked their list of devices on which encryption was installed against the current inventory list. IT may identify that there are one or two devices that are inventoried but have not received the encryption update. With a thoroughly populated inventory, IT will know to whom the device was issued and can contact that person or department directly to go about finding the device. This may uncover a device that is not working properly and needs patching/decommissioning, or it may reveal a theft or loss, which IT can then begin to mitigate by remotely wiping the device, reviewing access logs and/or employing other containment strategies. Without the inventory, the entity would be unable to determine what happened to the device and what patient information may have been on it (by virtue of user roles and access), and thus may determine that its only option is to notify all patients. To prevent such a drastic outcome, the Report recommends that the following information be captured in the inventory for each device (workstations, laptops, servers, portable drives, mobile devices, tablets and smartphones):

  • Asset ID (primary key)
  • Host name
  • Purchase order
  • Operating system
  • Media access control (MAC) address
  • IP address
  • Person deployed to (user)
  • User's last logon
  • Purchase date
  • Cost
  • Physical location

Define a process with clear accountabilities to clean sensitive data from every device before it is retired, refurbished or resold. The technical volumes provide different technical controls for small and midsize/large entities in support of this recommendation. For small entities, the technical volume recognizes that these entities often use third-party providers that specialize in secure destruction. The technical volume recommends that a small entity's procedure ensures that the decommissioning of each device is recorded, along with the certification of destruction (where applicable) provided by the service provider.

For midsize/large entities, the technical volume recommends the following procedures:

  • Central collection: Entities should collect and store IT assets in a central, locked area until the assets are decommissioned. Workforce members must be trained to turn in any asset no longer in use so that assets can be secured in this central location.
  • Central destruction/wipe: Once collected for decommissioning, assets must undergo a secure process to be destroyed or electronically wiped to ensure the device is properly sanitized before leaving the entity's control. Whether this is done by internal resources or a third-party provider, evidence of destruction and/or wiping should be kept on file for audit purposes.
  • Record keeping: Once the asset is wiped or destroyed, the inventory entry for the asset should reflect its status. The asset should not be deleted from the inventory, as it may become relevant at a later stage.

For Midsize and Large Entities

Implement proven and tested data backups, with proven and tested restoration of data. In the context of a lost or stolen device, having a recent, restorable backup of the lost/stolen device can be the difference between notifying an entire subset of an entity's patient population and providing targeted notification. Without backups, an entity generally does not know what documents were saved on or accessible via a particular device. Relying on a user to recount what has been saved and downloaded to the device since it was issued, and which of that data has been deleted, is dubious. Without backups to identify exactly what was contained on the device, entities are left to take a broad, conservative approach. For instance, if a 3-year-old laptop belonging to a urologist were stolen and the urologist stated that he regularly downloaded MRI images to review offline, the population to notify would be any patient seen by the urologist in the past three years for whom the doctor ordered an MRI.

Implement a safeguards policy for mobile devices, supplemented with ongoing user awareness training on securing these devices. While entities should have policies in place requiring strong passwords for all devices, mobile devices can be harder to control – making idle-time lockouts for mobile devices and training of workforce members on compliance with these directives just as important. Organizations may choose to require workforce members with access to PHI on their mobile devices to download remote-wipe software so that if the device is lost or stolen, mitigation can occur swiftly.

Acquire and use data loss prevention tools. One of the most challenging aspects of data loss prevention (DLP) tools is determining the methodology to be used to identify sensitive information. The methodologies are described in the technical volume on page 48. Whichever method is chosen by the entity, the next step is to determine what data channels should be monitored for potential PHI. For midsize entities, the Report recommends monitoring email, endpoints and the network. For large entities, it recommends that DLP monitoring also include cloud storage, on-site file storage and web-based scanning.

Encrypt data at rest on mobile devices to make it inaccessible to anyone who finds the device. Full disk encryption should be enabled on all devices, not just mobile devices. When cloud-based services are used, the Report recommends enabling native encryption to prevent exposure if the cloud provider is compromised.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

In association with
Related Topics
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Mondaq Free Registration
Gain access to Mondaq global archive of over 375,000 articles covering 200 countries with a personalised News Alert and automatic login on this device.
Mondaq News Alert (some suggested topics and region)
Select Topics
Registration (please scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions