FHIR Server Security Auditing with AuditEvent and Provenance

FHIR Server Security FAQ
1. Why are FHIR servers considered "wide open" by default?
FHIR servers are designed to be flexible and interoperable, which means they generally accept any valid data sent to them and return any data requested through search queries. By default, they lack robust built-in security measures, requiring developers to implement specific access controls and safeguards.

2. How do AuditEvent and Provenance resources enhance FHIR server security?
These resources provide crucial audit trails for actions performed on FHIR data. AuditEvent records "who did what and when" for any access or modification event, while Provenance tracks the origins and modifications of data throughout its lifecycle. By meticulously populating these resources, you create a comprehensive log of data interactions, bolstering accountability and traceability.

3. What are some key questions to ask about your AuditEvent implementation?
Does the AuditEvent resource accurately identify the individual who accessed a resource? Ensure user identification is correctly logged for each event.
Are access controls implemented for AuditEvent resources themselves? Restrict access to these sensitive logs to prevent tampering or unauthorized viewing.
Are your AuditEvents stored within the same FHIR server as your primary data? This practice can introduce security vulnerabilities, consider separate, secure storage for audit logs.
4. How can you assess the effectiveness of Provenance in your FHIR server?
Are all updates to resources accompanied by a corresponding Provenance record? Each modification should trigger the creation of a Provenance entry to maintain a complete history.
Does the Provenance accurately identify all parties involved in data creation or modification? Ensure complete attribution for data changes.
Does Provenance link to specific historical versions of the modified resource? This allows tracking the evolution of data over time.
5. Why is it critical to prevent bypassing AuditEvent and Provenance creation?
If actions can be performed on the FHIR server without generating corresponding audit trails, the integrity and reliability of the entire auditing system are compromised. Developers should rigorously test and ensure no loopholes exist that allow bypassing these critical security mechanisms.

6. What is the significance of the question, "Can I bypass AuditEvent and Provenance creation using Postman?"
Postman is a popular tool for testing APIs. This question aims to uncover potential vulnerabilities that could allow unauthorized users to interact with the FHIR server outside the established auditing framework, highlighting the need for comprehensive security testing.

7. Is Smart-on-FHIR sufficient for securing a FHIR server?
Smart-on-FHIR is a valuable framework for authorization and authentication but is only one component of a comprehensive security strategy. It primarily focuses on controlling access to resources based on user roles and permissions, not on detailed auditing and provenance tracking.

8. How can I ensure the ongoing security of my FHIR server?
Implement a multi-layered security approach incorporating:

Strong authentication and authorization mechanisms.
Meticulous AuditEvent and Provenance tracking.
Regular security audits and penetration testing.
Adherence to industry best practices for FHIR server security.
Ongoing monitoring and vulnerability patching.