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Modern health care systems incorporate databases for effective and efficient management of patient health care

Modern health care systems incorporate databases for effective and efficient management of patient health care. Databases are vulnerable to cyberattacks and must be designed and built with security controls from the beginning of the life cycle.


Although hardening the database early in the life cycle is better, security is often incorporated after deployment, forcing hospital and health care IT professionals to play catch-up. Database security requirements should be defined at the requirements stage of acquisition and procurement.


System security engineers and other acquisition personnel can effectively assist vendors in building better health care database systems by specifying security requirements up front within the request for proposal (RFP). In this project, you will be developing an RFP for a new medical health care database management system.


Step 1

As the contracting officer’s technical representative (COTR), you are the liaison between your hospital and potential vendors. It is your duty to provide vendors with an overview of your organization. To do so, identify information about your hospital. Conduct independent research on hospital database management. Think about the hospital’s different organizational needs. What departments or individuals will use the Security Concerns Common to All RDBMSs, and for what purposes?

Provide an overview with the types of data that may be stored in the system and the importance of keeping these data secure. Include this information in the RFP.

(A relational database management system (RDBMS) is used to organize and manage data tables by using keys in a way that all the data can be accessed without reorganization. The keys represent attributes and uniquely identify rows in a table.


According to Trivedi, Zavarsky, and Butakov, although “many prominent relational database management systems provides inbuilt security controls and mechanisms, the information resided in the data-store are at great risk” (2016). Several features, including authentication, roles and access management, ownership and user schema management, authorization and permission on objects and encryption, are implemented to mitigate security concerns and reduce the chances of unauthorized access.


Trivedi, D., Zavarsky, P., & Butakov, S. (2016). Enhancing relational database security by metadata segregation. ScienceDirect, 94. )


Step 2

Now that you have provided vendors with an overview of your hospital’s needs, you will provide the vendors with a context for the work needed.

Since you are familiar with the application and implementation, give guidance to the vendors by explaining the attributes of the database and by describing the environment in which it will operate. Details are important in order for the vendors to provide optimal services.

It is important to understand the vulnerability of a relational database management system (RDBMS).

Describe the security concepts and concerns for databases.

Identify at least three security assurance and security functional requirements for the database that contain information for medical personnel and emergency responders.

Include this information in the RFP.


Step 3

In the previous step, you added context for the needed work. Now, provide a set of internationally recognized standards that competing vendors will incorporate into the database. These standards will also serve as a checklist to measure security performance and security processes.

Address the concepts and issues with respect to disasters and disaster recovery, mission continuity, threats, and cyberattacks.

Include these security standards in the RFP.


Step 4

Now that you have established security standards for the RFP, you will define the use of defense models. This information is important since the networking environment will have numerous users with different levels of access.


Provide requirements in the RFP for the vendor to state its overall strategy for defensive principles. Explain the importance of understanding these principles. To further your understanding, click the link and read about defensive principles.

Explain how enclave computing relates to defensive principles. The network domains should be at different security levels, have different levels of access, and different read and write permissions.

Define enclave computing boundary defense.

Include enclave firewalls to separate databases and networks.

Define the different environments you expect the databases to be working in and the security policies applicable.


Step 5

Labs separate assignment.


Step 6

In the previous step, you identified defense requirements for the vendor. In this step of the RFP, you will focus on the structure of the system.

Provide requirement statements for a web interface to:

Allow patients and other health care providers to view, modify, and update the database.

Allow integrated access across multiple systems.

Prevent data exfiltration through external media.

State these requirements in the context of the medical database. Include this information in the RFP.


Step 7

In the previous step, you composed requirement statements regarding the system setup. In this step, you will provide the operating system security components that will support the database and the security protection mechanisms.

Read these resources on operating system security. Then:

Provide requirements for segmentation by operating system rings to ensure processes do not affect each other.

Provide one example of a process that could violate the segmentation mechanism. Ensure your requirement statements prevent such a violation from occurring.

Specify requirement statements that include a trusted platform module (TPM), in which a cryptographic key is supplied at the chip level. In those specifications:


Describe the expected security gain from incorporating TPM.

Provide requirement statements that adhere to the trusted computing base (TCB) standard.

Provide examples of components to consider in the TCB.

Provide requirements of how to ensure protection of these components, such as authentication procedures and malware protection.


Step 8

The previous step required you to identify operating system security components to support the database. For this step, you will focus on identification, authentication, and access. Access to the data is accomplished using security concepts and security models that ensure confidentiality and integrity of the data. Refer to access control and authentication to refresh your knowledge.

The healthcare database should be able to incorporate multiple independent levels of security (MILS) because the organization plans to expand the number of users.

Write requirement statements for MILS for your database in the RFP.

Include the definitions and stipulations for cybersecurity models, including the Biba Integrity Model, Bell-LaPadula Model, and the Chinese Wall Model.

Indicate any limitations for the application of these models.

Read the following resources and note which cybersecurity models are most beneficial to your database:

Include requirement statements for addressing insecure handling of data.


Step 9

In the previous step, you wrote requirements for multiple levels of security, including the topics of identification, authentication, and access. In this step, you will focus on access control. The vendor will need to demonstrate capabilities to enforce identification, authentication, access, and authorization to the database management systems.

Include requirement statements in the RFP that the vendor must identify, the types of access control capabilities, and how they execute access control.

Provide requirement statements for the vendor regarding access control concepts, authentication, and direct object access.




Step 10

Incorporate a short paragraph requiring the vendor to propose a test plan after reviewing these guidelines for a test and remediation results (TPRR) report.

Provide requirements for the vendor to supply an approximate timeline for the delivery of technology.

Modern health care systems incorporate databases for effective and efficient management of patient health care



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