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Operate - Healthcare Industry Lens
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Operate

HCL_OPS5. How do you demonstrate continuous compliance?

Partition workloads involving sensitive data into separate environments

Minimize access to sensitive data by isolating workloads to separate environments requiring additional controls for access. Segmenting can be done by AWS accounts, VPCs, or Amazon Simple Storage Service buckets. Minimize using sensitive data in non-production environments.

Architect and build with the ability to generate evidence that demonstrate continuous compliance

Healthcare organizations must be able to demonstrate their compliance posture.  Evidence that includes the safeguards used to protect sensitive healthcare data, as well as the documented policies and procedures, can all be used to demonstrate compliance. The cloud services used to architect a compliant foundation in the cloud, can also be used to gather the necessary evidence to demonstrate compliance posture. For example, using infrastructure as code, coupled with a software development lifecycle, can demonstrate a mature change management process, which is an important compliance control. Being able to demonstrate the full scope of a compliance posture is critical for all stakeholders, whether that is an organizations leadership, shareholders, customers, and patients.

There are several key concepts to consider when building out a continuous compliance posture. While AWS cannot assure compliance for your environment per the shared responsibility model, the following approach will make it easier for your organization to demonstrate compliance on AWS. In general, use managed services from AWS or third-party solutions, such as those available in AWS Marketplace, to simplify your approach.

Identify resources in the cloud environment

An accurate representation of your cloud environments is necessary to demonstrate continuous compliance. Understand what AWS resources exist and how they interact with each other. AWS Config will help you identify these resources and how they are configured. Use distributed tracing solutions, such as AWS X-Ray, to understand how components of your system interact, and to map network accessibility between different resources in your environment.

Restrict resources and applications to pre-defined configurations

Coupling AWS Config with infrastructure as code will allow you to test application configurations before they are deployed in your environment. Apply governance to your AWS deployments using infrastructure as code tools like AWS CloudFormation, AWS Cloud Development Kit (AWS CDK), Terraform, and Service Catalog. Verify that all configurations are secure-by-default with best practices around encryption, logging, and least privilege.

Implement compliance-as-code for configuration

For each configuration you specify, test the controls you put in place. Use AWS Config as the central location to evaluate configuration changes. Where possible, use AWS Config managed rules, but also implement custom evaluations with AWS Lambda, fully capturing environment configuration. Configuration triggers will also shorten the time to identify AWS resources that are out of compliance compared to periodic triggers. This helps you demonstrate your compliance posture by automatically building and maintaining a list of resources within your AWS environment. It also allows you to continuously evaluate your compliance posture against the technical controls identified by your organization. For example, you can create an AWS Config rule that marks an Amazon S3 bucket as non-compliant if server-side encryption is not enabled or the Amazon S3 bucket policy allows unencrypted uploads. AWS provides sample rules bundled into conformance packs that align with many common regulatory frameworks and best practices, allowing you to start creating a compliance monitoring solution.

Centralize security and compliance findings

Many customers will use multiple AWS accounts (such as development, test, and prod, or department-specific accounts). Configuration management, while important, is not the only set of technical controls you may require. For example, you may combine your configuration posture with additional findings, from third-party solutions or AWS security services like Amazon GuardDuty. Technical controls and findings should be grouped together as evidence using a solution such as AWS Security Hub.

Map technical controls to compliance requirements using automation.

Simplify maintaining a complete view of your compliance posture by automatically mapping controls and findings to your internal policies. For example, if you have a compliance policy around encryption at-rest, you may have individual controls on the configuration of each AWS resource to verify encryption is enabled.

AWS Audit Manager helps automate evidence collection from a variety of sources within AWS, including Security Hub and Config. Bundling multiple pieces of evidence together under a single policy makes it easier to demonstrate compliance with a specific framework or regulation. You can use Audit Manager’s prebuilt frameworks, and you can manually specify a list of controls and policies that are important to your organization.

Use up-to-date artifacts.

The creation of artifacts that document the compliance posture of a cloud environment should be automated. Use services such as AWS Config, AWS Audit Manager, and AWS Security Hub to automatically collect and report the compliance state of a cloud environment.

HCL_OPS6. How do you automate remediation of compliance violations?

There are several key concepts to consider when creating an automated remediation solution. While your organization is responsible for compliance for your environment, per the shared responsibility model, the following approach will make it easier to demonstrate compliance on AWS. In general, use managed services either from AWS or a third-party solution, such as one available in AWS Marketplace, to simplify your approach.  Similar to the recommendations for demonstrating continuous compliance, define compliance requirements and create associated policies and procedures for remediation before creating the remediation solution.

Automate remediation actions for non-compliant resources

Automate remediation of configurations that are out of compliance with your technical controls for rapid, consistent application of your policies. Event-driven architectures improve remediation times. Not everything can be predicted ahead of time. Certain remediations may be manual at first, but investigated when they occur and automated when possible in future occurrences.

In developing automated remediations, there are several steps you can follow:

  1. Specify controls: Define the evidence and configuration you want to track. Use AWS Config and Security Hub to identify and surface findings.

  2. Identify when configuration changes happen: Use AWS services that support event-driven architectures for identification. For example, AWS Config can monitor resource changes and Amazon EventBridge can serve as an event bus for additional resource changes.

  3. Implement remediation: Services such as AWS Lambda and AWS Systems Manager can implement configuration changes.

  4. Rerun evaluation: Verify remediation was implemented and the environment is back in compliance.

For example, you can create an AWS Config rule that marks an Amazon S3 bucket as non-compliant if the server-side encryption is not enabled. That rule can invoke a corresponding remediation Lambda function that configures server-side encryption on the bucket, bringing the bucket to a compliant state. For more information, refer to Remediating Noncompliant AWS Resources by AWS Config Rules. AWS also provides sample AWS Config rules with remediation actions for Amazon DynamoDB and Amazon S3.

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