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25/06/2026 5:13 pm
TL;DR: Healthcare organisations are still struggling to balance clinician friction, complex identity populations, and EHR access controls, while over 80 health systems were hit by breaches in a single month aimed at patient data, according to SailPoint and Becker’s Health IT. The problem is less about access speed than about whether identity governance can keep up with highly manual clinical onboarding and break-glass pressure.
NHIMG editorial — based on content published by SailPoint: Cybersecurity in Healthcare: The Value of Leveraging Identity Security to Manage EHR Access
By the numbers:
- The average health system has no less than three authoritative feeds, with extensive academic medical systems having 10+ authoritative feeds.
- The article cites Becker’s Health IT reporting that over 80 health systems were hit by cybersecurity breaches in August alone.
Questions worth separating out
Q: How should healthcare teams govern EHR access for clinicians with changing roles?
A: Healthcare teams should treat EHR access as a lifecycle governance problem, not a one-time provisioning task.
Q: Why do manual onboarding processes create risk in clinical identity programmes?
A: Manual onboarding creates risk because multiple teams have to approve access across different systems before a clinician can work.
Q: What breaks when break-glass access becomes routine in healthcare?
A: When break-glass access becomes routine, the organisation loses the distinction between exceptional and normal access.
Practitioner guidance
- Map every clinical identity source Inventory HR, contractor, learning, credentialing, and affiliate feeds that can create or update EHR access.
- Separate emergency access from routine entitlement design Define break-glass access as a time-bounded exception with stronger logging and post-use review.
- Replace static role templates with dynamic role modelling Rebuild clinical access models so that job function, department, credential status, and application scope can change without manual rework.
What's in the full article
SailPoint's full blog covers the operational detail this post intentionally leaves for the source:
- Step-by-step clinical onboarding flow spanning HR, credentialing, learning, and application validation
- Details on how the standards-based API approach maps to Epic, Cerner, and MEDITECH access models
- Examples of how dynamic role modelling can reduce manual access decisions in healthcare environments
- The vendor's own explanation of why fine-grained permissions matter for day-one clinical access
👉 Read SailPoint's analysis of EHR access governance in healthcare →
EHR access governance: what healthcare IAM teams are missing?
Explore further
25/06/2026 5:46 pm
Clinical IAM fails first at the trust boundary, not at the login screen. The article shows that healthcare access risk begins when multiple upstream systems compete to define who a clinician is and what stage of onboarding they are in. That makes identity validation a governance problem across HR, credentialing, learning, and clinical application teams. When those sources are not synchronised, access decisions become slow, inconsistent, and easy to bypass, which is exactly why human identity lifecycle discipline belongs inside clinical security design.
A few things that frame the scale:
- 1 in 4 organisations are already investing in dedicated NHI security capabilities, with an additional 60% planning to do so within the next twelve months, according to The State of Non-Human Identity Security.
- The same research found that 85% of organisations lack full visibility into third-party vendors connected via OAuth apps, which is a reminder that identity governance failures often begin in delegated access paths.
A question worth separating out:
Q: Who should own EHR access decisions across HR, credentialing, and clinical teams?
A: EHR access decisions should be jointly owned, but not ambiguously shared. HR, credentialing, learning, and clinical application teams each control a different part of the lifecycle, while IAM or IGA should enforce the access decision workflow. Without clear ownership, no team is accountable for the final access state that reaches the EHR.
👉 Read our full editorial: EHR access governance shows why healthcare IAM still fails
