The Identity Management Crisis In Healthcare: Identity Sprawl & Access Abuse
In healthcare environments, identity is everything.
It’s the key to accessing patient records, prescribing medications, viewing lab results, and coordinating care. But with that access comes risk — and right now, many healthcare organisations are facing a growing identity management crisis.
The Challenge: Identity Sprawl in a High-Pressure Environment
Healthcare is a unique and demanding sector. Clinical workflows are fast-paced, the workforce is fluid, and access to critical systems is time-sensitive. This creates the perfect conditions for identity sprawl — the unchecked growth of user accounts and credentials across the organisation.
Some of the most common contributors include:
- Rotating clinical staff: Nurses, residents, and specialists frequently move between departments, hospitals, or even regions.
- Temporary and contract workers: Locum physicians, traveling nurses, and short-term contractors are onboarded (and offboarded) constantly.
- Shared credentials: In high-pressure situations, staff often share login credentials to save time or bypass complex logins.
- Siloed systems: Multiple EHRs/EMRs, imaging platforms, and clinical apps that don’t talk to each other can create duplicate or unmanaged identities.
The result? Poor visibility into who is accessing what, and when, which has become a serious security and compliance risk.
The Risk: Access Abuse & Audit Failures
When identity sprawl goes unmanaged, it opens the door to:
- Excessive or lingering privileges– Users retain access to sensitive systems long after they’ve changed roles or left the organisation.
- Shared accounts – These break audit trails and make it nearly impossible to attribute activity to a specific individual.
- Unauthorised access – Insider threats or credential misuse can go undetected, especially without real-time monitoring.
- Compliance violations – HIPAA and other regulations require strict access controls and logging — and failure to comply can result in hefty fines.
The Solution: Secure Identity, Seamless Access
Tackling these challenges in healthcare requires more than just account provisioning — it calls for a strategic, integrated approach to identity and access management (IAM) and Privileged Access Management (PAM).
Addressing the following will make a significant impact:
Integration with Clinical Systems
Enabling seamless identity and access management integration with core clinical platforms like EHR/EMRs, imaging systems, and patient portals. This ensures identities are mapped across systems, reducing redundancy and enabling centralised control.
Role-Based Access Control + Contextual ZTNA
Enforce least privilege access by aligning permissions with clinical roles — and dynamically adjusting access based on contextual signals (location, device, time of day, etc.) using Zero Trust Network Access (ZTNA) principles.
MFA, SSO, and Real-Time Visibility
Implement Multi-Factor Authentication (MFA) and Single Sign-On (SSO) to streamline secure access — reducing credential sharing and improving user experience. Combined with real-time access logging, security teams gain visibility into who accessed what, when, and from where.
Final Thoughts: Identity Is the New Front Line
In a sector where every second counts, access must be both secure and seamless. But without a solid identity management foundation, healthcare organisations risk compromising both security and care quality.
Solving the identity crisis isn’t just about technology — it’s about enabling trust in every interaction, ensuring the right people have the right access at the right time.