Security Risk Assessment (SRA) Checklist Before Connecting a Stadium Medical Tent to Your EHR

Temporary care environments move fast, but your Electronic Health Record Integration must not. This Security Risk Assessment (SRA) checklist helps you connect a stadium medical tent to your EHR with confidence—minimizing exposure, preserving data integrity, and sustaining clinical operations under pressure.

Use this structured guide to identify risks, harden the network, protect patient information, enforce Access Management Controls, meet the HIPAA Security Rule, and operationalize monitoring and response. Adapt each control to your venue, timeframe, and clinical workflows.

Identify Key Components and Risks

Map the environment

• Inventory assets: laptops/tablets, label and wristband printers, vitals monitors, routers/switches, APs, cellular gateways, UPS, and any middleware or APIs used for EHR connectivity.
• Diagram data flows: registration and triage to EHR, orders/results, e-prescribing, device integrations, and any third-party telehealth or imaging endpoints.
• Define roles: registration staff, nurses/EMTs, physicians, pharmacists, IT, security, and vendors with access to systems or space.

Define PHI and workflows

• List the PHI elements handled (demographics, allergies, meds, vitals, notes) and where they are viewed, entered, or printed.
• Identify points where PHI could spill—shared kiosks, label printers, radios, whiteboards, or verbal handoffs.

Profile threats and vulnerabilities

• Physical: theft of devices, tailgating, unsecured racks, extreme weather, power loss, or tent relocation.
• Network: rogue APs, open SSIDs, weak Network Encryption Protocols, misconfigured VLANs/firewalls, default credentials, and unsafe USB media.
• Process: rushed onboarding, shared accounts, poor print controls, inadequate training, or missing offboarding after the event.

Prioritize and plan Risk Mitigation Strategies

• Rate likelihood × impact to form a risk register with owners, due dates, and acceptance criteria.
• Select treatments: avoid (disable service), mitigate (controls), transfer (insurance/vendor), or accept (documented rationale).

Assess Network Security and Connectivity

Design for secure, resilient connectivity

• Prefer isolated wired drops or private LTE/5G; if Wi‑Fi is required, stand up a temporary SSID for the tent—never use public or guest networks.
• Segment with dedicated VLANs and strict ACLs; allow only EHR endpoints, DNS, NTP, and update services needed for operations.

Harden transport with strong Network Encryption Protocols

• Use WPA3‑Enterprise with 802.1X for Wi‑Fi; disable WEP/TKIP and open networks.
• Tunnel site-to-site over IPsec or WireGuard; enforce TLS 1.2+ (prefer 1.3), modern ciphers, and certificate pinning for EHR APIs.

Control ingress/egress and exposure

• Block inbound from the internet; restrict outbound to approved FQDNs/addresses. Deny peer‑to‑peer traffic between endpoints (client isolation).
• Enable DNS security features (sinkhole known bad domains), DHCP snooping, and ARP inspection to thwart local attacks.

Plan for reliability and performance

• Provision redundant uplinks or cellular failover, UPS on network gear, and QoS for latency‑sensitive EHR traffic.
• Conduct a site survey for AP placement, interference, and capacity; document expected throughput, packet loss, and jitter targets.

Validate before go‑live

• Run end‑to‑end tests: identity, SSO, EHR launch, chart open/save, orders/results, and device integrations.
• Enable centralized logging (syslog/NDR) for network events; baseline normal traffic before the event starts.

Evaluate Data Protection Measures

Protect data in transit

• Enforce TLS 1.2+/1.3 with HSTS where applicable; use mutual TLS for device‑to‑middleware connections.
• Require SNMPv3, SFTP/FTPS, and secure management planes; disable plaintext and legacy protocols.

Protect data at rest

• Enable full‑disk encryption on all endpoints; store keys in enterprise MDM/EMM and require secure boot.
• Use remote‑wipe and geofencing policies for lost or decommissioned devices.

Harden endpoints

• Deploy EDR/anti‑malware, OS and browser patching, application allow‑listing, and USB control.
• Remove local admin rights; enforce auto‑lock and screen privacy filters in open areas.

Data Integrity Verification

• Enable audit trails for create/update/delete events; monitor for unusual bulk exports or print jobs.
• Use message signing/checksums for HL7/FHIR where supported; validate device data against expected ranges.

Backup and continuity

• Define RTO/RPO for tent workflows; ensure EHR downtime procedures, read‑only access, and safe paper fallback with secure storage/shredding.
• Protect backups with immutability and access separation; test restore ahead of the event.

Verify Access Control and User Authentication

Access Management Controls

• Implement least‑privilege, role‑based access tied to job functions (registration, triage, provider, pharmacy, logistics).
• Enforce time‑boxed access for temporary staff; auto‑expire roles after the event.

Strong authentication and device trust

• Require MFA for EHR and VPN/SSO (push/app or FIDO2 keys). Deny access from non‑compliant or unmanaged devices.
• Use SSO (SAML/OIDC) with conditional access by network, device posture, and geolocation.

Provisioning and lifecycle

• Use just‑in‑time provisioning with identity proofing; pre‑stage groups and templates to reduce errors.
• Maintain emergency “break‑glass” accounts with vaulting, monitoring, and immediate post‑use review.

Workstation and session controls

• Prefer single‑user sign‑ins; if using shared devices, enable kiosk modes and rapid user switching with tight inactivity timeouts.
• Disable local data storage and clipboard sharing where feasible; restrict printing to designated, secured printers.

Physical access

• Badge control with color coding, locked cabinets for gear, and escort requirements for visitors and vendors.
• Maintain a device checkout log with chain‑of‑custody from setup to teardown.

Ensure Compliance with Healthcare Regulations

Map controls to the HIPAA Security Rule

• Administrative safeguards: formal SRA, risk management plan, workforce training, sanctions, and vendor oversight.
• Physical safeguards: facility access, workstation security, device/media controls, and contingency planning.
• Technical safeguards: access control, audit controls, integrity, authentication, and transmission security.

Business Associates and contracts

• Execute BAAs with connectivity providers, device vendors, and any service handling PHI; confirm breach notification obligations.
• Review data flow diagrams against BAAs to ensure scope matches actual integrations.

Additional requirements to consider

• State privacy/security laws, 42 CFR Part 2 for substance use records, and the 21st Century Cures Act information‑blocking exceptions.
• Document policies for minimum necessary use, retention, and secure disposal of temporary artifacts (labels, wristbands, paper forms).

Training and awareness

• Deliver a focused pre‑event briefing: PHI handling, device care, phishing, lost‑device steps, and escalation contacts.
• Post quick‑reference cards at work areas; confirm staff acknowledgment.

Breach response readiness

• Define incident classes and decision trees; align notification timelines with HIPAA/HITECH and state rules.
• Track evidence, preserve logs, and coordinate legal/privacy reviews before disclosures.

Document Procedural and Technical Checklist Items

Pre‑event (T‑7 to T‑1 days)

• Approve network design, segmentation, and firewall rules; register assets and tag them.
• Stage devices via MDM, apply patches, enforce encryption, and verify EDR health.
• Create user lists, roles, and access windows; test SSO/MFA and EHR workflows end‑to‑end.
• Prepare downtime kits: paper forms, secure clipboards, privacy screens, lockable bins, and shredders.
• Publish runbooks: escalation matrix, contact tree, Security Incident Response Plan, and comms templates.

Go‑live (event day)

• Validate connectivity, DNS/NTP, and certificate status; confirm VLAN/ACL enforcement and AP isolation.
• Conduct a privacy sweep: printer queues empty, screens shielded, whiteboards limited to non‑PHI shorthand.
• Open a command channel (bridge/chat) with IT, security, and clinical leads; begin log/metric dashboards.

Post‑event (T+0 to T+7 days)

• Revoke access, deprovision devices, wipe local data, and collect/verify all hardware against inventory.
• Review logs for anomalies, reconcile paper artifacts, and complete incident/breach assessments if needed.
• Hold a lessons‑learned session and update the risk register and playbooks.

Evidence to retain

• Signed SRA, risk treatment plan, BAA copies, network diagrams, access lists, training rosters, and monitoring reports.
• Test results for connectivity, failover, and recovery; incident drill records and after‑action items.

Implement Ongoing Monitoring and Incident Response

Establish comprehensive visibility

• Feed SIEM with firewall, VPN, AP/controller, endpoint, EDR, MDM, and EHR audit logs; set retention to meet policy and legal needs.
• Deploy NDR or netflow for east‑west visibility; alert on unusual data egress or authentication patterns.

Detection engineering and playbooks

• Create alerts for failed logins, disabled MFA, new unknown devices, rogue SSIDs, large print/export jobs, and privilege escalation.
• Maintain playbooks with clear owners, evidence checklists, and containment steps for common scenarios.

Security Incident Response Plan

• Use a prepare‑identify‑contain‑eradicate‑recover‑learn cycle; define severity levels and decision rights.
• Pre‑stage forensics kits, contact lists, legal templates, and isolation capabilities for tent devices and network segments.

Exercises, metrics, and improvement

• Run tabletop drills before the event; measure MTTD/MTTR, patch SLA adherence, and control coverage.
• Continuously update Risk Mitigation Strategies based on findings, and brief leadership on residual risk.

Conclusion

By rigorously assessing components, securing connectivity, protecting data, enforcing strong identity, aligning to the HIPAA Security Rule, and operationalizing monitoring and response, you reduce risk while keeping care moving. Treat this checklist as a living framework to guide safe, resilient EHR connectivity in any temporary clinical setting.

FAQs.

What are the primary security risks when connecting a medical tent to an EHR?

Key risks include device theft or loss, weak or shared credentials, insecure or public Wi‑Fi, misconfigured VLANs or firewalls, unpatched endpoints, uncontrolled printing, and rushed onboarding that bypasses least‑privilege. Each risk can expose PHI or disrupt care if not addressed by layered controls and clear procedures.

How can network connectivity be secured for temporary medical setups?

Use segmented networks with dedicated VLANs, WPA3‑Enterprise, and certificate‑based VPNs. Restrict outbound traffic to required EHR and update services, enforce modern TLS, and block peer‑to‑peer traffic. Add cellular or wired failover, UPS‑backed gear, centralized logging, and pre‑event end‑to‑end testing.

What compliance standards must be met for EHR integration?

At minimum, align with the HIPAA Security Rule across administrative, physical, and technical safeguards, backed by a documented SRA and risk management plan. Confirm BAAs with applicable vendors and account for state privacy/security laws, breach notification duties, and relevant 42 CFR Part 2 or Cures Act considerations.

How should data access be controlled for stadium medical personnel?

Implement role‑based access with least‑privilege, time‑boxed accounts for temporary staff, and MFA enforced by SSO. Require managed, encrypted devices; apply session timeouts and kiosk modes as needed; restrict printing and exports; and revoke all access immediately after the event with a verified deprovisioning checklist.