Identity is the backbone of healthcare digital transformation

At a glance

What this is: This is an independent analysis of how digital identity is becoming the core control for healthcare transformation, with usability and clinician workflow now as central as security.

Why it matters: It matters because IAM teams in healthcare must secure people, devices, and third-party access without introducing login friction that degrades care delivery or pushes users around controls.

By the numbers:

• IT budget allocations for digital initiatives nearly doubled from 4.8% to 9.7% year over year in the 2024 Digital Health Most Wired report.

👉 Read Imprivata's analysis of identity-led healthcare digital transformation

Context

Healthcare digital transformation is now a care-delivery issue, not just an IT modernisation project. As more clinical workflows move into digital systems, identity becomes the control plane that determines who can access what, when, and from which device, while still preserving speed at the point of care.

The security problem is not simply stronger authentication. It is the mismatch between rising cyber risk, especially ransomware and data breaches, and a clinical environment where extra steps can delay treatment, increase burnout, and encourage workarounds unless IAM is designed around workflow reality.

Key questions

Q: How should healthcare organisations reduce login friction without weakening security?

A: They should align authentication strength to the clinical workflow, not apply one universal login pattern. Passwordless methods, frictionless MFA, and strong session management can reduce repeated prompts while preserving assurance. The goal is to limit delays for clinicians, avoid shared-secret reuse, and keep higher-risk actions gated by step-up checks.

Q: Why does identity matter so much in healthcare digital transformation?

A: Identity determines whether clinicians can access systems quickly enough to support care while still preserving security, auditability, and compliance. As workflows become more digital, IAM becomes the mechanism that connects users, devices, and third parties to clinical systems without turning security into a productivity bottleneck.

Q: What do healthcare teams get wrong about third-party access?

A: They often treat vendor access as temporary or exceptional, which leads to weak lifecycle control and poor visibility. Third-party identities should be inventoried, approved, time-bounded, and monitored like any other privileged access population because they can create the same operational and security risk as internal accounts.

Q: How can teams tell whether access controls are helping rather than hindering care?

A: They should measure whether authentication and access steps increase delays, prompt workarounds, or create inconsistent use across shifts and devices. If controls are frequently bypassed or cause clinicians to lose time at the point of care, the design is out of balance and needs to be reworked.

Technical breakdown

Why healthcare identity has become infrastructure

In healthcare, identity now sits between clinical usability and operational resilience. When access to EHRs, shared workstations, mobile devices, and third-party systems must happen continuously, IAM is no longer a perimeter add-on. It becomes the mechanism that ties authentication, authorisation, and auditability to care delivery. If identity is slow or fragmented, clinicians experience it as friction; if it is too loose, the organisation absorbs risk through over-broad access and weak accountability. The practical challenge is to treat identity as part of the care path, not as a separate security step.

Practical implication: design identity controls around clinical workflows, not around generic enterprise login patterns.

Passwordless and frictionless MFA in shared clinical environments

Shared workstations and high-turnover clinical spaces create conditions where conventional password-based access performs poorly. Passwordless methods and frictionless MFA reduce the repetitive credential burden that contributes to burnout, but they still need strong binding between the person, the device, and the session. In healthcare, the technical question is not whether authentication is stronger in theory. It is whether the method fits the cadence of bedside work, handoffs, and shift changes without creating unsafe delays or shared-secret leakage.

Practical implication: prioritise passwordless access and step-up controls where clinicians repeatedly authenticate across shared devices.

Third-party access and user behaviour analytics

Vendor access is a persistent identity risk in healthcare because external support and integration partners often need broad operational reach. Burleson-Davis points to third-party access and user behaviour analytics because healthcare needs both stronger governance of non-employee access and better detection of abnormal use. Behaviour analytics does not replace IAM controls, but it can expose unusual access timing, device patterns, or privilege use that signal abuse or misconfiguration. That matters when patient systems are distributed across many teams, vendors, and support channels.

Practical implication: separate third-party access governance from staff access and monitor behavioural anomalies for overreach.

NHI Mgmt Group analysis

Identity has moved from a security function to a healthcare operating constraint. The article’s core point is that digital transformation in care delivery now depends on access architecture as much as on application architecture. When identity controls slow clinicians, they affect throughput, burnout, and even safety. The implication for the field is that healthcare IAM must be judged by operational fit, not only by control strength.

Passwordless access is becoming a workflow requirement, not a convenience feature. Shared workstations, mobile clinician programmes, and time-sensitive patient interactions make repeated password entry a structural liability. The real governance issue is whether the access model reduces friction without creating uncontrolled sessions or weak assurance. Practitioners should treat authentication design as part of clinical usability engineering.

Third-party access is one of healthcare’s most under-governed identity surfaces. The article correctly places vendor access alongside clinician access because support relationships often outlive the original security assumptions. In a sector built on interconnected systems, external identities need lifecycle control, monitoring, and clearly bounded privilege. The practitioner takeaway is to treat vendor access as a governed identity population, not a temporary exception.

Clinical access analytics: the next governance layer is not just who authenticated, but whether their access pattern fits the care context. User behaviour and access analytics can reveal misuse, but only if the organisation first defines what normal clinical access looks like across shifts, devices, and departments. Without that baseline, analytics become noise. The practical conclusion is to build identity observability around clinical operations, not around generic enterprise baselines.

From our research:

• Companies are dedicating an average of 32.4% of their security budgets to secrets management and code security, with US organisations leading at 40.8%, according to The State of Secrets in AppSec.
• The average estimated time to remediate a leaked secret is 27 days, despite 75% of organisations expressing strong confidence in their secrets management capabilities.
• That gap between confidence and remediation speed is why identity programmes need lifecycle controls and visibility, which is explored in Ultimate Guide to NHIs , Key Challenges and Risks.

What this signals

Healthcare identity programmes are moving into the same category as clinical infrastructure, which means access design has to be measured against usability as well as assurance. The organisations that get this right will reduce friction at the point of care without surrendering control over staff, vendor, and device access.

Clinical access context: the useful question is no longer whether access is authenticated, but whether the pattern of access matches the clinical environment. That shift will push more hospitals toward behaviour-aware identity controls and tighter governance for third-party accounts.

With 43% of security professionals concerned about AI systems learning and reproducing sensitive information patterns from codebases, per The State of Secrets in AppSec, identity teams should expect more scrutiny on how digital workflows expose sensitive context across systems.

For practitioners

• Map IAM controls to clinical workflows Review where authentication interrupts bedside work, shift handoffs, shared workstation use, and mobile access. Prioritise the paths where delay or repeated prompts create the most user friction and the highest likelihood of workarounds.
• Expand passwordless access for shared clinical devices Use passwordless authentication and frictionless MFA where clinicians repeatedly access shared endpoints. Keep strong session binding and step-up checks for higher-risk actions instead of forcing the same credential pattern everywhere.
• Govern third-party access as a separate identity class Inventory vendor and support accounts, define their approval path, and assign explicit expiry or review points. Do not let external access inherit staff assumptions about duration, privilege, or monitoring.
• Baseline normal clinical behaviour for detection Define expected access timing, device patterns, and role-based usage by unit or department so analytics can flag true anomalies. Tie alerting to care context rather than generic enterprise thresholds.

Key takeaways

• Healthcare digital transformation depends on identity design that fits real clinical work, not generic enterprise access assumptions.
• Shared devices, third-party access, and repeated authentication demands are the main pressure points where security and usability collide.
• Teams that treat identity as part of clinical infrastructure can reduce friction, support compliance, and limit avoidable security workarounds.

Key terms

• Clinical identity governance: The discipline of controlling access in healthcare so clinicians, patients, and vendors can use systems safely without disrupting care. It combines authentication, authorisation, auditability, and usability so identity decisions support clinical operations instead of interfering with them.
• Passwordless authentication: An access method that verifies a user without requiring a traditional password. In healthcare, it reduces repeated credential entry on shared devices and can improve workflow speed, but it still needs strong session binding and appropriate step-up controls for risky actions.
• Third-party access: Access granted to external vendors, service providers, or support partners who need to interact with healthcare systems. It should be treated as a governed identity population with defined scope, expiry, monitoring, and review because it can create lasting risk if left unmanaged.
• Behaviour analytics: The analysis of access patterns to identify activity that does not fit normal usage. In healthcare, the value comes from comparing timing, device, and role-based behaviour against real clinical context so security teams can spot misuse without drowning in false alerts.

Deepen your knowledge

NHI governance, agentic AI identity, and machine identity lifecycle are core topics in our NHI Foundation Level course, the industry's only accredited NHI security programme. If you are responsible for identity security strategy or NHI governance in your organisation, it is worth exploring.

This post draws on content published by Imprivata: Tech Leader Highlights the Role of Identity in Securing Digital Transformation in Healthcare. Read the original.