Anatomy Of An Electronic Health Record Zero-Day

How a dangerous security flaw discovered in one of the most pervasive electronic medical record platforms in the U.S. was found and fixed before it could do damage

Graduate student Doug Mackey was starting to wonder whether his research on the security of one of the nation's most ubiquitous electronic health records (EHR) software platforms was so interesting after all. A month of poking around for vulnerabilities in the simulated EHR system he had fashioned in a makeshift lab in his apartment hadn't turned up anything out of the ordinary in the code.

But then one day this spring, he spotted something in a second interface he was testing that shocked him: "It was very quickly obvious that it had no real security at all," says Mackey, a student in Georgia Tech's information security program. "I was quite surprised."

Mackey had discovered a major logic flaw in a key component of the code in the so-called VistaA (Veterans Health Information Systems and Technology Architecture) software, a platform originally built by the U.S. Veterans Administration for internal use at its hospitals and clinics, and later handed over to the open-source community to further its development and adoption across the entire health-care industry. It's one of the most widely adopted platforms for EHR in the country by VA and commercial hospitals and clinics, and it has also gained some traction overseas.