Health systems face heightened risk when privileged accounts and critical systems become targets for disruption. As remote and hybrid work have become embedded across healthcare organisations, safeguarding access to high-value systems such as electronic health records (EHRs) is central to operational resilience. Privileged access management (PAM) provides an additional security layer by requiring stronger authentication and authorisation before elevated privileges are granted. Deployed well, PAM offers visibility across onsite and offsite activity, adapts to changing risk signals and reduces the likelihood that compromised credentials lead to service interruption. For healthcare leaders balancing security with clinical efficiency, PAM’s ability to apply the right level of friction at the right time is pivotal to protecting sensitive data and maintaining continuity of care.
Zero-Trust PAM for Distributed Teams
PAM is designed to protect what are often described as the keys to the most critical systems by tightening controls around privileged accounts. In healthcare settings this means additional diligence when administrators or super users seek elevated access to systems that underpin day-to-day operations. Rather than relying on a traditional network perimeter, PAM extends security to the identity level, aligning with zero-trust principles that treat identity as the new boundary. This is especially relevant for organisations with remote or hybrid staff and a complex ecosystem of third parties, including contractors, technology vendors and service providers.
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Remote workers operating on organisation-managed devices may benefit from the full security stack, from anti-malware to endpoint detection and data loss prevention. The risk profile changes, however, when external partners connect using equipment that the health system does not own or manage. Zero-trust-aligned PAM addresses this by asserting that any remote system accessing sensitive data should be treated as part of the organisation’s protected environment, not as an unmanaged personal device. In practice, this involves strong identity verification, such as face recognition, passkeys or ID checking, and continuous monitoring of authentication and authorisation events across locations.
By centralising visibility over who is requesting access, from where and to what, PAM equips security teams to enforce policy consistently whether users are onsite or remote. It also supports just-in-time access models that grant privileges only when needed and only for as long as required, reducing the window in which elevated credentials could be misused. Credential rotation further limits risk by ensuring that once access expires, the same credential cannot be reused to reach sensitive systems.
Risk-Based Controls and Workflow Safeguards
A core strength of PAM lies in risk-based authentication that goes beyond verifying a username and password. Behavioural context is assessed to determine whether a request aligns with a user’s typical patterns. Signals such as the usual working hours, location, device type, frequency of access to specific applications and the sensitivity of requested data inform whether to grant or step up authentication. For example, a user who seldom accesses an EHR but suddenly attempts multiple logins in a short period may be prompted for additional verification, even if the initial credentials are correct.
These adaptive controls aim to introduce graduated friction in proportion to the risk. When conditions are stable, PAM can streamline access by avoiding unnecessary steps for recognised users operating in expected contexts. When risk signals deviate, the system can automatically require stronger proof of identity before privileges are elevated. This approach reduces the burden on clinicians and administrators during routine tasks while preserving the ability to respond decisively when anomalies emerge.
Maintaining clinical workflow is a practical constraint in healthcare environments where delays carry patient safety implications. PAM therefore emphasises least-privilege access, granting users the minimal rights needed to perform a defined task, such as updating patient records from home without exposing the broader network. Built-in automation helps ensure that security interventions remain targeted. If an IT administrator accesses familiar systems from a usual location at a normal time, an intelligent PAM policy can determine that multi-layer authentication is unnecessary, thereby avoiding disruption. Conversely, when context changes, the same policies can enforce additional checks without requiring manual intervention.
Emergency access presents another operational consideration. PAM solutions must strike a balance between protecting privileged systems and ensuring clinicians can obtain time-critical access when patient care demands it. By using contextual risk evaluation and temporary elevation mechanisms, health systems can maintain safeguards while enabling urgent workflows. The goal is to create well-judged speed bumps rather than hard blocks, reserving full stoppages for clearly malicious activity.
Compliance and Auditability for Remote Access
Regulatory compliance is integral to healthcare security decisions, especially when third parties require remote access to privileged systems. PAM helps reduce compliance risk by enforcing strong controls around EHR access and other critical applications, including for non-employees. Centralised policy enforcement, identity verification and least-privilege models contribute to a more resilient posture when vendors, contractors or service providers connect from outside the organisation.
Auditability is a further requirement. Effective PAM implementations record the sequence of events associated with privileged access so that actions can be traced after the fact. The ability to review what occurred during an access session supports incident analysis, control testing and regulatory inquiries. Comprehensive logs and replay capability also inform process improvements, enabling teams to refine access policies based on observed behaviour.
For remote and hybrid scenarios, audit trails provide accountability across diverse environments and devices. When combined with credential rotation and just-in-time access, auditing helps close gaps that attackers might exploit, such as persistent privileged sessions or unmonitored connections. This visibility extends to identity proofing methods, step-up authentication events and changes in risk posture that triggered additional controls. As healthcare organisations widen their digital ecosystems and deepen reliance on external partners, these records become essential to demonstrating that privileged access is governed and proportionate.
PAM offers healthcare organisations a structured way to protect privileged accounts, critical systems and sensitive data while accommodating the realities of remote and hybrid work. By aligning with zero-trust principles, incorporating risk-based authentication and enforcing least-privilege access with credential rotation, PAM reduces exposure without impeding routine clinical and administrative tasks. Adaptive controls introduce friction only when warranted, preserving workflow continuity and supporting emergency access when needed. With robust auditability to trace privileged activity, PAM also strengthens compliance in environments where third-party access is common. These capabilities provide a practical pathway to resilient operations and sustained trust in digital services.
Source: HealthTech
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