Hospitals are some of the finest examples of practical risk management. Every day choices are weighed and actions are taken in clinical care and administrative support to achieve the best possible outcomes. Part of the reason for the amazing impact modern hospitals have on our daily lives is due to the application of sound decision making processes that are well documented, measured, and evaluated. This process is what constitutes management, and it does not detract from the talents of so many dedicated individuals that make up the staff of the hospital, but rather enhances the combined effectiveness of the entire team.
One of the cornerstones of good management is risk management. Most hospitals have a risk management committee. But for those who do not participate on the committee, it may seem far removed from the daily goings-on of the hospital, so I would like to explain what risk management is, within the narrow application of information security.
If you read my previous blog on information security, you already have an understanding of the importance of this field on hospitals, insurers, and managed care organizations. Information security risks can be documented and measured based on several methodologies, but here is a quick reference to help everyone understand how those methodologies work, and the language used to describe them.
To start, information faces certain threats and vulnerabilities (to clarify, threats are from outside your organization, and vulnerabilities are inside your organization). Sometimes, threats and vulnerabilities work together, and the end result of one or both achieving their purpose is called an impact. When talking about information security, impacts are usually described in terms of confidentiality, integrity, and availability (more about these below). Along with impacts, the probability that an impact will occur is also factored in. To determine the risk posed by the threats and vulnerabilities, the probability and impact are used to arrive at a risk score. If it is too high a risk, controls are put in place to reduce the risk to an acceptable level.
Why does any of this matter if you are not on a risk committee? Because we all manage risk every day, even if you don’t call it by this name. For example, when you are preparing to go to work, you hear the weather report and it says there is a 50% chance of rain by noon, becoming freezing rain by the evening. So there is a threat of rain. Combined with your vulnerability to cold wet conditions (hypothermia, etc.) leading to sickness, you decide the risk (the impact combined with the probability) are too high for you to accept. You decide to bring a rain coat and umbrella, as well as a change of shoes, and now the risk is greatly reduced that you will be sick due to the weather.
When it comes to information security, rather than hypothermia, the concerns are disclosure of patient information (confidentiality), the usefulness and clarity of the information (integrity), and the ability to pull up patient information when and where it is needed (availability). Without this information, every patient contact would require re-examination, there would be no records to reference, and patient privacy could not exist.
So the rules and policies imposed by the IT department, while seemingly a cumbersome pile of techno-speak, are really responses to the risks faced by medical facilities with regard to patient information and treatment, whose end goal is to reduce the risks to acceptable levels while allowing everyone to continue to do their part for successful patient care and ongoing hospital administration.