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Search Search CSRC MENU Search Search Projects Publications Expand or Collapse Drafts for Public Comment All Public Drafts Final Pubs FIPS (standards) Special Publications (SP s ) IR (interagency/internal reports) CSWP (cybersecurity white papers) ITL Bulletins Project Descriptions Journal Articles Conference Papers Books Topics Expand or Collapse Security & Privacy Applications Technologies Sectors Laws & Regulations Activities & Products News & Updates Events Glossary About CSRC Expand or Collapse Computer Security Division Cryptographic Technology Software Security Group Hardware Security Group Security Engineering and Risk Management Applied Cybersecurity Division Cybersecurity and Privacy Applications National Cybersecurity Center of Excellence (NCCoE) National Initiative for Cybersecurity Education (NICE) Contact Us Information Technology Laboratory Computer Security Resource Center Publications NIST SP 1800-24 Securing Picture Archiving and Communication System (PACS): Cybersecurity for the Healthcare Sector Share to Facebook Share to X Share to LinkedIn Share ia Email Documentation Topics Date Published: December 2020 Author(s) Jennifer Cawthra (NIST) , Bronwyn Hodges (MITRE) , Jason Kuruvilla (MITRE) , Kevin Littlefield (MITRE) , Robert Niemeyer (MITRE) , Chris Peloquin (MITRE) , Sue Wang (MITRE) , Ryan Williams (MITRE) , Kangmin Zheng (MITRE) Abstract Medical imaging plays an important role in diagnosing and treating patients. The system that manages medical images is known as the picture archiving communication system (PACS) and is nearly ubiquitous in healthcare environments. PACS is defined by the Food and Drug Administration (FDA) as a Class II device that “provides one or more capabilities relating to the acceptance, transfer, display, storage, and digital processing of medical images.” PACS centralizes functions surrounding medical imaging workflows and serves as an authoritative repository of medical image information. PACS fits within a highly complex healthcare delivery organization (HDO) environment that involves interfacing with a range of interconnected systems. PACS may connect with clinical information systems and medical devices and engage with HDO-internal and affiliated health professionals. Complexity may introduce or expose opportunities that allow malicious actors to compromise the confidentiality, integrity, and availability of a PACS ecosystem. The NCCoE at NIST analyzed risk factors regarding a PACS ecosystem by using a risk assessment based on the NIST Risk Management Framework. The NCCoE also leveraged the NIST Cybersecurity Framework and other relevant standards to identify measures to safeguard the ecosystem. The NCCoE developed an example implementation that demonstrates how HDOs can use standards-based, commercially available cybersecurity technologies to better protect a PACS ecosystem. This practice guide helps HDOs implement current cybersecurity standards and best practices to reduce their cybersecurity risk and protect patient privacy while maintaining the performance and usability of PACS. Medical imaging plays an important role in diagnosing and treating patients. The system that manages medical images is known as the picture archiving communication system (PACS) and is nearly ubiquitous in healthcare environments. PACS is defined by the Food and Drug Administration (FDA) as a Class... See full abstract Medical imaging plays an important role in diagnosing and treating patients. The system that manages medical images is known as the picture archiving communication system (PACS) and is nearly ubiquitous in healthcare environments. PACS is defined by the Food and Drug Administration (FDA) as a Class II device that “provides one or more capabilities relating to the acceptance, transfer, display, storage, and digital processing of medical images.” PACS centralizes functions surrounding medical imaging workflows and serves as an authoritative repository of medical image information. PACS fits within a highly complex healthcare delivery organization (HDO) environment that involves interfacing with a range of interconnected systems. PACS may connect with clinical information systems and medical devices and engage with HDO-internal and affiliated health professionals. Complexity may introduce or expose opportunities that allow malicious actors to compromise the confidentiality, integrity, and availability of a PACS ecosystem. The NCCoE at NIST analyzed risk factors regarding a PACS ecosystem by using a risk assessment based on the NIST Risk Management Framework. The NCCoE also leveraged the NIST Cybersecurity Framework and other relevant standards to identify measures to safeguard the ecosystem. The NCCoE developed an example implementation that demonstrates how HDOs can use standards-based, commercially available cybersecurity technologies to better protect a PACS ecosystem. This practice guide helps HDOs implement current cybersecurity standards and best practices to reduce their cybersecurity risk and protect patient privacy while maintaining the performance and usability of PACS. Hide full abstract Keywords access control ; auditing ; authentication ; authorization ; behavioral analytics ; cloud storage ; DICOM ; EHR ; electronic health records ; encryption ; microsegmentation ; multifactor authentication ; PACS ; PAM ; picture archiving and communication system ; privileged account management ; vendor neutral archive ; VNA Control Families Access Control ; Configuration Management ; Contingency Planning ; Identification and Authentication ; Risk Assessment ; System and Communications Protection ; System and Information Integrity Documentation Publication: https://doi.org/10.6028/NIST.SP.1800-24 Download URL Supplemental Material: SP 1800-24 files Project homepage Related NIST Publications: Project Description Document History: 09/16/19: SP 1800-24 (Draft) 12/21/20: SP 1800-24 (Final) Topics Security and Privacy access control , authentication , personally identifiable information , risk assessment , security programs & operations , vulnerability management Technologies cloud & virtualization , firewalls , hardware , storage Applications cybersecurity framework , Internet of Things Laws and Regulations Health Insurance Portability and Accountability Act Sectors healthcare HEADQUARTERS 100 Bureau Drive Gaithersburg, MD 20899 X (link is external) facebook (link is external) linkedin (link is external) instagram (link is external) youtube (link is external) rss govdelivery (link is external) Want updates about CSRC and our publications? 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