How PIAM Supports Healthcare’s Transition to Zero Trust Security Architecture

Introduction: In Healthcare, Trust Is Not a Security Strategy

The healthcare industry has long operated under implicit trust models—granting broad access to systems and physical spaces based on job titles, departmental assignments, or badge issuance alone. But as cyber threats rise, insider risks grow, and hybrid work becomes the norm, that model is no longer sustainable.

The shift toward Zero Trust Security Architecture (ZTSA)—where no person, device, or system is inherently trusted—is now a critical step for healthcare providers. While most conversations around Zero Trust focus on digital systems, the physical layer is just as important. You can’t achieve Zero Trust if someone can physically walk into your data center, pharmacy vault, or ICU floor without real-time validation.

That’s where Physical Identity and Access Management (PIAM) platforms like Soloinsight’s CloudGate PIAM become essential. PIAM operationalizes Zero Trust principles in the physical environment, aligning doors, badges, biometric readers, and mobile credentials with risk-aware, policy-driven access decisions.

In this blog, we explore how PIAM supports healthcare’s transition to Zero Trust Security Architecture, reinforcing cyber-physical resilience across people, places, and systems.

What Is Zero Trust in Healthcare Security?

Zero Trust is a framework built on the principle of “never trust, always verify.” It replaces the outdated perimeter security model with continuous validation of every access request—based on:

• Identity

• Context

• Device posture

• Location

• Risk level

In healthcare, applying Zero Trust means:

• Validating not just who someone is, but whether they should have access right now, in that location, and under those conditions.

• Enforcing least-privilege access across clinical, operational, and physical environments.

• Auditing and verifying every access interaction—whether digital or physical.

The Gap: Why Zero Trust Fails Without Physical Security

Healthcare systems spend millions on firewalls and endpoint protection but often overlook:

• Badge-based access systems with static permissions

• Unlogged visitor and vendor entries

• Shared credentials or unreturned badges

• Lack of real-time identity validation at doors

These gaps leave organizations vulnerable to:

• Insider threats

• Data center breaches

• Unauthorized medication access

• Physical movement that undermines digital segmentation

Zero Trust must extend beyond the network—and into every hallway, server room, and clinical space.

How PIAM Supports Healthcare’s Transition to Zero Trust Security Architecture

Soloinsight’s CloudGate PIAM turns healthcare’s physical access infrastructure into an active participant in Zero Trust strategy, enforcing continuous identity validation and contextual access control.

1. Identity-Centric Access Provisioning

CloudGate ties physical access to verified identity attributes:

• Role

• Department

• Licensure and credentialing status

• Active schedule or shift

• Training completion

Unlike traditional access systems, PIAM does not grant access once and forget—it re-evaluates access eligibility in real time, based on identity signals.

For example, if a radiology tech’s license expires, their access to imaging suites is automatically suspended—without requiring manual intervention.

2. Context-Aware and Risk-Based Access Control

Zero Trust requires continuous risk assessment. PIAM supports:

• Location-based access enforcement (e.g., ICU, OR, pharmacy, data center)

• Time-based rules (e.g., access only during scheduled shifts)

• Health or compliance status (e.g., denied access if training incomplete or screening fails)

Access is granted only when all contextual conditions align. Otherwise, it’s blocked or escalated for review.

3. Dynamic Policy Enforcement and Revocation

With PIAM:

• Access rights change dynamically as roles, schedules, or risk levels evolve.

• Temporary access (e.g., emergency override) is automatically revoked after the use case expires.

• Exceptions are logged, reviewed, and subject to re-certification.

This ensures no access persists beyond necessity—a cornerstone of Zero Trust.

4. Real-Time Identity Verification at the Edge

CloudGate supports:

• Biometric authentication (face, palm, fingerprint) for high-security areas

• Mobile credentials linked to individual identity and geolocation

• Multi-factor authentication at physical entry points

This enforces Zero Trust principles at every door—not just at the login screen.

5. Unified Monitoring and Correlation with Digital Events

PIAM integrates with:

• Identity governance platforms (e.g., SailPoint, Okta)

• Security Information and Event Management (SIEM) systems

• Video surveillance and threat detection tools

This enables:

• Cross-domain visibility between physical and digital environments

• Correlation of physical presence with system access (e.g., was the person who accessed the EMR also on-prem at that time?)

• Alerts when physical and digital identities don’t match—a sign of credential misuse

6. Continuous Auditing and Compliance Automation

PIAM automatically logs:

• Who accessed what zone, when, for how long, and under what conditions

• Denied access attempts and policy violations

• Credential issuance, expiration, and revocation timelines

Audit logs are immutable, time-stamped, and formatted for:

• HIPAA

• DEA

• Joint Commission

• CMS and state health agencies

These logs support Zero Trust’s auditability requirement, providing evidence of continuous enforcement.

Use Cases: Zero Trust in Action with PIAM

1. Remote Contractor Support

• Contractors receive mobile credentials valid only for pre-approved days and zones.

• Credentials deactivate automatically after the engagement ends.

• Any abnormal activity is flagged in real time.

2. Nurse Rotation Across Multiple Campuses

• Access rights are assigned based on active schedule and location.

• If a nurse tries to badge into a non-assigned campus or off-hours, access is denied.

3. Biometric-Only Access to Server Rooms

• Entry granted only via facial recognition and real-time license validation.

• PIAM logs identity, device used, and location for each event.

Business Benefits of PIAM as a Zero Trust Enabler

1. Unified Access Governance

• One system for managing both digital and physical identity lifecycle.

• Eliminates silos between HR, security, and compliance.

2. Reduced Attack Surface

• No persistent access rights.

• Fewer privileged users with uncontrolled movement.

3. Real-Time Threat Mitigation

• Immediate detection of access anomalies.

• Quicker response to insider risks or badge misuse.

Hospitals using CloudGate PIAM as part of Zero Trust strategy saw a 68% reduction in

access policy violations, and faster incident resolution during internal investigations.

Case Study: Zero Trust Physical Access at an Academic Medical Center

Challenges:

• Broad badge access based on job titles, with little contextual enforcement.

• Shared credentials among night-shift contractors.

• Inconsistent policy enforcement across campuses.

After deploying CloudGate PIAM:

• Access tied to real-time schedule, licensure, and departmental approval.

• Biometric authentication used in pharmacy and research labs.

• Physical and digital access logs were unified for internal audits.

Result:

• Improved cyber-physical threat correlation.

• Passed federal audit with commendation on access policy enforcement.

• Reduced average access recertification time by 80%.

The Future: Autonomous and Adaptive Zero Trust Environments

With AI and continuous authentication, PIAM will soon:

• Predict and adjust access permissions based on behavior and location

• Integrate with smart building systems to auto-rezone based on patient flow

• Enable just-in-time access provisioning—access granted only when requested and approved in real time

Zero Trust won’t be a goal. It will be a default operating model—powered by intelligent physical access systems like CloudGate.

Conclusion: Zero Trust Begins at the Door

In a healthcare world where trust must be earned—not assumed—Soloinsight’s

CloudGate PIAM enables Zero Trust from the ground up. It helps healthcare systems:

• Continuously validate identity and context before granting access

• Enforce dynamic policies across all physical environments

• Correlate physical presence with digital behavior for complete risk visibility

If your organization is planning or executing a Zero Trust strategy, now is the time to bring physical access into the fold. Contact Soloinsight today for a CloudGate PIAM demo.

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