How PIAM Simplifies Physical Access Reviews in Healthcare Organizations

Introduction: In a World of Dynamic Roles, Access Reviews Are No Longer Optional

Hospitals are constantly in motion. Staff shift between roles, departments reassign duties, new hires onboard daily, and contractors rotate weekly. In this whirlwind of movement, access permissions—if not carefully managed—quickly drift out of alignment with actual job functions.

This misalignment creates a growing risk: employees and contractors retaining access to zones they no longer need or should never have had. Left unchecked, this results in privilege creep, compliance violations, and security vulnerabilities that can expose healthcare organizations to HIPAA breaches, regulatory penalties, and even patient safety issues.

That’s why regular physical access reviews—also called access recertifications—are a critical part of identity governance in healthcare. These reviews verify that each person has the right level of access, based on their current role, credentials, and assignment.

But here’s the challenge: most healthcare systems still conduct access reviews manually—using spreadsheets, paper logs, and ad hoc emails. These processes are time-consuming, error-prone, and often fail to produce audit-ready outcomes.

Enter Physical Identity and Access Management (PIAM). Platforms like Soloinsight’s CloudGate PIAM automate the entire access review process—from scheduling and policy enforcement to approval workflows and reporting. The result? Access reviews that are accurate, efficient, and always ready for inspection.

In this blog, we explore how PIAM simplifies physical access reviews in healthcare organizations, turning a burdensome process into a strategic advantage.

The Compliance Imperative for Access Reviews

1. HIPAA and Joint Commission Requirements

• Access must be granted based on the minimum necessary standard.

• Organizations must prove that access is reviewed regularly and that outdated permissions are revoked.

2. DEA and OSHA Oversight

• Controlled substance zones, data centers, and high-risk areas require clear access governance.

• Failure to conduct timely access reviews can result in citations or audit failures.

3. Insider Threat Mitigation

• Regular access reviews reduce the likelihood of ex-employees, contractors, or vendors retaining access to sensitive spaces.

The Hidden Costs of Manual Access Reviews

• Security and HR teams spend weeks compiling lists of users and comparing them against job roles.

• Department heads receive long spreadsheets with little context and often respond inconsistently.

• Revocation requests may not be processed, resulting in stale or overprivileged credentials.

• Review documentation is disorganized, making audits difficult and stressful.

How PIAM Simplifies Physical Access Reviews

Soloinsight’s CloudGate PIAM replaces outdated manual processes with automated, policy-driven, and auditable access reviews tailored to the pace and complexity of healthcare operations.

1. Centralized Access Visibility Across All Facilities

With CloudGate PIAM:

• Every person’s access rights are mapped in real time to their role, location, and credential status.

• Admins and compliance teams can see who has access to what zones, and why.

• Reports can be filtered by department, facility, time window, or role type.

This visibility makes it easy to spot:

• Individuals with excessive or outdated access

• Staff assigned to departments they no longer serve

• Orphaned credentials still tied to former contractors or vendors

2. Automated Review Scheduling and Reminders

CloudGate PIAM enables:

• Policy-based scheduling of reviews (e.g., monthly for high-risk zones, quarterly for admin areas)

• Automated workflows that notify department heads or compliance officers

• Built-in reminders to ensure reviews are completed on time

Review cadences can vary based on zone sensitivity:

• Pharmacy, data center, ICU: every 30 days

• Office or admin areas: every 90 days

• Visitor access logs: reviewed post-engagement

3. Role-Aware Review Workflows for Accuracy and Efficiency

Access reviews are routed to the right reviewers based on:

• Departmental responsibility

• Zone ownership

• Role of the person being reviewed

Each reviewer can:

• Approve continued access

• Request revocation or escalation

• Add notes for exception handling

The entire process happens within the PIAM dashboard—no spreadsheets, no emails, no manual routing.

4. One-Click Revocation and Access Adjustment

If access needs to be changed, PIAM supports:

• Instant revocation of credentials across all facilities and devices

• Automated downgrade of permissions tied to new role assignments

• Temporary suspension of access pending re-verification (e.g., expired licensure or training)

This ensures that review decisions are acted on immediately, not lost in administrative backlog.

5. Tamper-Proof Documentation and Audit Reporting

Every review is logged in PIAM, including:

• Reviewer name, role, and decision

• Time and date of review

• Actions taken (e.g., approval, revocation, exception handling)

• Notes and supporting documentation

These logs are:

• Immutable and audit-ready

• Searchable by reviewer, zone, or user

• Exportable for regulators during inspections

Healthcare organizations using CloudGate PIAM report up to 70% faster audit response times during access reviews.

6. Exception Management with Built-In Policy Controls

Sometimes access is needed outside of standard policies. PIAM supports:

• Exception workflows that allow for temporary or conditional approvals

• Time-bound access escalation with automatic rollback

• Policy-based reviews of all exceptions within the next cycle

This allows flexibility—without compromising governance.

Use Cases: Access Reviews Simplified with PIAM

1. Reviewing ICU Access for Rotating Nurses

• Nurses rotating out of ICU are automatically flagged for access deprovisioning.

• Department head approves revocation in a single click.

2. Contractor Review Post-Project Completion

• At the end of a facilities upgrade project, all vendor credentials are reviewed.

• Credentials are deactivated automatically upon project completion.

3. Pharmacy Staff DEA Clearance Validation

• DEA license expiration triggers a review of all access to controlled substance zones.

• Staff without current licensure are denied entry until credentials are updated.

Business Benefits of Automating Access Reviews with PIAM

1. Reduced Risk of Privilege Creep

• Access permissions stay aligned with actual job roles.

• Eliminates security gaps caused by manual oversights.

2. Higher Review Completion Rates

• Automated reminders and intuitive dashboards increase reviewer engagement and accountability.

3. Smoother Compliance and Audits

• Every decision and action is documented and exportable.

• Reduces preparation time and increases audit confidence.

One 10-hospital system saw a 91% increase in review completion rates and eliminated 4,500 stale credentials after its first 90-day cycle using CloudGate PIAM.

Case Study: Scaling Access Reviews Across a Multi-Facility Network

A health system with:

• 45,000 employees and contractors

• 30+ facilities

• Annual Joint Commission reviews

Previously:

• Conducted access reviews using emailed spreadsheets and phone call confirmations

• Struggled with inconsistent revocation processes

• Could not prove timely access governance to auditors

After implementing CloudGate PIAM:

• Review cycles were standardized and automated across all facilities

• Department heads could complete reviews in under 30 minutes

• Time to audit readiness dropped from 3 months to 2 weeks

The Future of Access Reviews: Continuous, Predictive, and Risk-Based

With ongoing evolution, PIAM platforms like CloudGate will enable:

• AI-driven review suggestions based on access patterns and role drift

• Continuous access reviews that happen in real time—not just quarterly

• Integration with risk engines to prioritize reviews based on behavioral anomalies

Access reviews will shift from administrative overhead to strategic risk prevention.

Conclusion: Simplify the Process, Strengthen the Policy

Access reviews don’t need to be painful. With Soloinsight’s CloudGate PIAM, healthcare organizations can:

• Automate review workflows from start to finish

• Enforce least-privilege policies at scale

• Satisfy auditors with zero guesswork

If your healthcare system is ready to simplify and strengthen access governance, contact Soloinsight today for a CloudGate PIAM demo.

Schedule a Demo