Electronic prior authorization moves sensitive clinical and coverage information between organizations and applications. Security architecture needs to verify who is acting, which patient and purpose are in scope, and exactly what information may be disclosed.
Authorize the specific workflow
Use strong client and user identity, narrowly scoped permissions, token validation, and secure transport. Separate application access from the user's authority to act on a patient or organization.
Design for credential rotation, revocation, clock differences, replay prevention, and service-to-service authentication.
- Apply least-privilege scopes.
- Validate audience, issuer, signature, and expiration.
- Protect secrets outside application code.
- Rate-limit and monitor anomalous access.
Limit and trace disclosure
Send only information necessary for the request and applicable requirements. Attachments can contain unrelated sensitive data, so prefer criterion-specific evidence when possible.
Audit who accessed, changed, approved, and transmitted information. Logs should identify the case and action without unnecessarily duplicating protected content.
Prepare for incidents and vendors
Define retention, deletion, breach response, backup, and availability procedures. Evaluate intermediaries and AI services for data use, subcontractors, location, model training, and contractual safeguards.
Threat modeling and periodic access reviews should continue after launch as integrations and workflow scope expand.