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World desk4 min

How to Secure Remote Access to Hospital Systems Without Disrupting Care

Hospitals can reduce remote-access risk without cutting off necessary clinical work by mapping approved connections, using risk-based authentication, maintaining access trails, and testing emergency and downtime procedures.
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Hospitals should keep the remote access clinicians and support teams need, while making each approved connection identifiable, appropriately authenticated, limited to its purpose, and reviewable. That means managing remote access as both a cybersecurity risk and a clinical-continuity requirement—not trying to eliminate it wholesale.

Start with the care that remote access must support

Clinicians may need access to patient information or care platforms away from the hospital, while administrators, IT staff, and vendors may need connections to maintain systems. HHS’s Health Sector Cybersecurity Coordination Center (HC3) identifies VPNs, remote desktop software, telehealth platforms, and secure messaging among common healthcare remote-access tools. HC3 also warns that attackers can misuse legitimate remote-access software. The practical goal is therefore to preserve authorized work while controlling the paths into hospital systems.

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Before changing access controls, identify which clinical and operational functions depend on each connection and what happens if it is unavailable. That allows security and clinical teams to distinguish necessary access from connections that can be restricted, changed, or retired without interrupting care.

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Map the remote-access paths

Build and maintain an inventory of approved ways users and services connect from outside the hospital environment. Include, at minimum, the categories HC3 describes and any other remote connections in the local environment:

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  • VPN connections to hospital networks or applications.
  • Remote desktop tools used by staff or support teams.
  • Vendor and administrator connections used to support systems.
  • Telehealth platforms and secure messaging tools.
  • Remote access to connected devices or other systems, where applicable.

For each path, record who uses it, which systems or information it can reach, who approves it, and who is responsible for reviewing its use. Do not assume that a familiar tool is safe merely because it is legitimate software: HC3’s October 4, 2023 alert, Securing Remote Access and Management Software, notes that mitigating risk is not as simple as applying a patch or reconfiguring an application.

Make identity and authentication fit the risk

Use distinct identities and appropriate permissions

Make access attributable to an individual or other clearly identified account rather than allowing users to blend into a shared identity. Grant permissions suited to the user’s role and task, and consider the sensitivity and importance of the systems reached through the connection. HHS 405(d)’s 2023 Health Industry Cybersecurity Practices (HICP) emphasizes clearly identifying users and maintaining audit trails of their access to data, applications, systems, and endpoints.

Require MFA for remote and privileged access

Use multi-factor authentication (MFA) for remote network access and privileged or administrative access. HHS’s Healthcare Cybersecurity Performance Goals include MFA for remote access; the goals are voluntary prioritized practices, not a standalone statement of legal requirements. HHS Office for Civil Rights (OCR), relaying CISA guidance in its June 2023 Cybersecurity Newsletter, recommends validating that remote network access and privileged or administrative access require MFA. CISA’s recommendation, as relayed by OCR, is to enforce phishing-resistant MFA to the greatest extent possible.

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Choose authentication controls through risk analysis and account for the clinical workflow: a control that blocks a legitimate, time-sensitive task can affect care. MFA is an important layer, not a complete remote-access security program; identity, permissions, monitoring, and emergency procedures matter too.

A 2026 HHS Office of Inspector General audit illustrates why authentication deserves attention. In one large southeastern hospital, an account-management application lacked strong identification and authentication controls such as MFA, and OIG used credentials obtained through phishing campaigns to access it. This is an example from one hospital audit, not a measure of how common the weakness is across hospitals.

Make access reviewable and assign monitoring ownership

Maintain audit trails that can show which user accessed which relevant data, applications, systems, or endpoints. Decide which team reviews those records, how potential misuse is escalated, and who is responsible for responding. HICP’s emphasis on user identification and access audit trails supports both investigation and routine oversight; logs that cannot be tied to a distinct identity are less useful for either purpose.

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Design emergency access and downtime procedures with clinicians

Document how authorized staff can obtain the information or systems necessary for care when normal access controls or systems are unavailable. The workflow should specify who may initiate emergency access, what it enables, how its use is recorded, and how normal access is restored afterward. Define the clinical and operational processes that must continue in emergency mode, rather than relying on an improvised exception during an outage.

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HHS OCR’s Audit Protocol, updated July 2018, identifies emergency procedures for obtaining necessary electronic protected health information (ePHI), limits on who can initiate those procedures, restoration of normal access, emergency-mode operations, and periodic contingency-plan testing and revision as review areas. Test the procedures with the clinicians and support staff expected to use them, then revise them when a test, incident, or workflow change exposes a gap.

Review the program as systems and workflows change

For U.S. HIPAA covered entities and business associates, HHS OCR describes risk management as essential to Security Rule compliance and cybersecurity preparedness. Use risk analysis to determine which controls and exceptions fit the organization’s actual systems, clinical workflows, and connected environment. HHS guidance sets out control principles, not a universal network design, and no single configuration guarantees compliance.

Revisit the inventory and decisions when systems, vendors, workflows, or threats change. Treat remote access as an ongoing part of security and continuity governance—not as a one-time software purchase or a reason to disable access that care depends on.

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