Easy access: physicians and employees of Wichita healthcare organization gain the benefits of remote access - Internet Security

Health Management Technology, April, 2003

Michael Knocke was a man on a mission. As applications manager at Via Christi Regional Medical Center, a multicampus acute care facility in Wichita, KS, Knocke needed to provide 1,000 physicians with access to digitized radiological, filmless images. Via Christi decided to go digital after incurring up to $70,000 monthly in film and courier costs.

Knocke wanted to extend physician access beyond the walls of the center's secure internal network. "Strong security and easy access were primary requirements," he explains. "It was important to preserve the cost savings from going filmless and critical to safeguard our network while positioning it for HIPAA.

"We decided to go with a virtual private network (VPN), but it didn't take long before we realized that wasn't feasible," says Knocke. "The support issues became increasingly difficult. The physicians' own networks and firewalls were wreaking havoc on our VPN clients, and we weren't staffed to support it." Also, Knocke estimates the VPN deployment would have cost about $60,000 annually.

Remote Access Opportunity

Via Christi also was investigating how to provide its 4,000 Kansas-based employees secure remote access from any standard Internet browser to the corporate intranet, including e-mail, human resources and other business-critical applications. "When we began looking at ways to deliver our intranet outside the walls of the institution," Knocke says, "we came across Whale Communications and realized we might be able to transmit the digital images through its remote access product."

Knocke brought Whale's e-Gap Remote Access Appliance product in-house to test, and, after a month, Via Christi began implementing the solution. "We could eliminate the (VPN) client altogether and provide technology that leveraged any regular Internet browser," he says. "While the product allowed access to our intranet, in order to get a clear return on our investment, we had to show that it would work just as well with digital images."

With the appliance in place, the physicians gained access to a portal specifically tailored to their needs, which included digital images, lab results and clinical documentation. Employees also can gain remote entry to the intranet. Both types of access are granted while adhering to the healthcare's stringent security requirements.

"Usability for the physicians was important, but what we really liked about the solution were the security features," says Knocke. "The appliance limits the scope of what someone can access. The physicians can be anywhere they have Internet access and get the information they need."

Server-Based Solution

The appliance solution is server-rather than client-based. It resides on the network's perimeter and requires no changes to the healthcare system's infrastructure. The solution also leveraged Via Christi's existing strong authentication procedures.

"Because the appliance allows us to be physically disconnected from the outside world, we were able to close some of the holes we had poked through our firewalls," says Knocke. "The product is constantly filtering all communications to ensure that only legitimate URLs are processed."

The appliance, which physically disconnects the Internet from the LAN via an air-gap switch, allows applications to be accessed without connecting them to the Internet. This is accomplished by shuttling application-level data over the air gap in real time via dedicated hardware. This architecture, in addition to positive-logic rule sets that allow only expected URLs to pass, mitigates application- and network-level attacks to the corporate network.

Knocke estimates that after a one-time cost of $67,000 for the appliance, he is saving $40,000 monthly in film and courier costs. "Having a server-based solution makes it simple for us to add and manage users, and the physicians now have 24/7 access to the information they need to serve their patients better."

This article was edited from "Red Flags, "prepared for and published in HMT's sister publication, Communications News, by Nelson Publishing Inc.