How to Keep Sensitive Patient Data Safe on Your PACS Server?

Maintaining PACS server open-source compliance and protecting sensitive patient data is crucial for any healthcare organization.

With the widespread adoption of open-source PACS servers to store medical images and records, proper privacy controls are essential.

In this article, we provide 10 vital tips to configure your open-source PACS server for optimal patient data protection.

Follow these best practices to avoid data breaches and ensure adherence to healthcare regulations like HIPAA and GDPR.

PACS server open-source

1. Enable Transport Layer Security (TLS)

Transport Layer Security (TLS) secures connections to prevent unauthorized access to data in transit. Mandating TLS across all connections to your PACS server is vital for encryption and security.

Here's a simple guide to enabling TLS:

  1. Obtain a TLS certificate from a trusted Certificate Authority
  2. Install the certificate on your PACS server
  3. Enable TLS on incoming network ports like 80 and 443
  4. Configure PACS workstations and imaging modalities to use TLS

2. Restrict Network Access

Limiting network availability for your PACS server reduces external entry points that could expose patient data. We suggest these access controls:

●      Allow only specific IP ranges to connect

●      Configure internal firewall rules to block unused ports

●      Disable ICMP pings to make discovery harder

●      Use VPN for external connections instead of open ports

3. Implement Strong Authentication

Secure sign-on processes prevent unauthorized usage that could lead to breaches:

●      Enforce complex passwords changed every 90 days

●      Configure two-factor or multi-factor authentication

●      Maintain a user access control list

●      Promptly deactivate ex-employee credentials

4. Log Significant System Events

Comprehensive activity logging provides an audit trail showing how your PACS system processes and protects health data.

●      Record login attempts

●      Track file accesses and permission changes

●      Monitor user actions within applications

●      Archive logs externally in read-only format

5. Encrypt Data Storage Volumes

Since PACS servers store protected health information (PHI), encrypting your data volumes adds another layer of security.

We recommend using an enterprise-grade encryption solution supporting AES-256 or above. This converts data to coded form, only allowing access using encryption keys. 

Solution

Details

VeraCrypt

Free \ open source tool for creating encrypted volumes

BitLocker

Windows built-in volume encryption

LUKS

Standard for Linux distributions

6. Harden the Operating System

Optimizing OS-level configurations enhances security:

●      Blacklist unnecessary software

●      Remove deprecated communication protocols

●      Limit user shell access to prevent exploits

●      Automate security patches and updates

7. Phase out Legacy Software

Migrating from outdated PACS applications reduces vulnerabilities:

●      Legacy apps sometimes lack encryption or TLS

●      Difficult to update old platforms

●      New software adheres to modern protocols

●      Avoid end-of-life systems with expiring support

PACS server open-source

8. Compartmentalize System Functions

Separating PACS functions across distinct systems limits damage from compromises:

●      Isolate database servers

●      Maintain different web frontends

●      Split image archives by facility or year

●      Restrict connectivity through ACLs

9. Develop Incident Response Plans

Despite best efforts, breaches can still occur. Preparation shortens recovery time:

●      Document processes for various scenarios

●      Train staff to swiftly identify and isolate threats

●      Maintain emergency contacts for reporting violations

●      Know required timeframes for notifications

10. Perform Third-Party Risk Assessments

External vendors like cloud storage or analytics providers may access your PACS. Confirming their security helps protect patient data in their systems.

●      Review their architectural diagrams and dataflow

●      Verify encryption, access controls, and logging

●      Update terms in contracts or agreements

●      Conduct periodic audits of partners

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