What are the key recommendations for developing a secure e-health application?

Developing an e-health application means entering a very specific field. As you already know, simplicity is not necessarily part of the package—you will have to deal with technical complexity as well as with strict regulations, which are inevitable in a sector that deals with people’s health. What does health represent at its core? Health touches individuals at the most intimate level, impacting their lives and responsibilities.

Creating an application in the e-health field means navigating through medicine as a top priority, followed by ethics, empathy, and technology. Several key challenges must be addressed:

• Regulatory and ethical requirements,
  
• The human and empathetic dimension,
  
• The high standards imposed by scientific and medical rigor,
  
• The protection of highly sensitive data.
  

So clearly, when we talk about security in e-health, we’re not just talking about strong passwords or encrypting a database, we’re talking about establishing a trust ecosystem into which your application will integrate.

Here are some best practices we recommend implementing as early as possible, at the beginning of your e-health project. If you’re also interested in IT outsourcing to develop your medical application, feel free to contact Quentin Breton, our customer relations manager, who can assist you with launching your project.

Good Practice No 1: Choose a secure architecture from the start

Adopt a Zero Trust architecture: This is a cybersecurity framework where, by default, no entity—user, application, device, or service—is trusted.

Practice segmentation: Strengthen your system by subdividing your network into smaller segments, improving both performance and security. This is also known as network isolation, partitioning, or segregation.

Use end-to-end encryption to protect against data breaches and minimize your app’s attack surface. This is also recommended under the NIS 2 Directive, which aims to strengthen cybersecurity across the EU.

To encrypt your data, use at least AES-256 encryption, an advanced encryption standard. This powerful encryption works with symmetric blocks. With AES, the same key is used for both encrypting and decrypting data. A 256-bit key is used to encrypt and decrypt your health data. This level of encryption is considered virtually unbreakable.

These best practices are deployed from the start of your e-health application project —not as an afterthought at the end of development.

Prioritise using an HDS server (Health Data Hosting) to host ultra-sensitive health data. This also boosts your credibility with end-users and partners. It is an infrastructure dedicated to hosting highly sensitive health data.

Choose a microservices-based architecture if possible. In this model, each entity functions independently, enhancing both security and stability. A failure or attack in one service won’t affect the entire system. Dividing the application into smaller autonomous systems ensures that each component has its own security and functions independently. As a result, in the event of a failure or attack, the incident is contained and does not affect the entire application.

Good Practice No 2: Implement fine-grained access and identity management

Your technical specification should include a detailed section on access control—who has access to what, and how. We recommend that you integrate multiple aspects and elements.

Mandatory two-factor authentication (2FA) for all users. This method manages identities and requires the user to authenticate in two different ways to access resources and data. This widely used method protects the most vulnerable information and applications.

When deciding on the role management framework of your future health application, take the time to clearly define the specific roles and permissions associated with each type of user. The description of role management must be detailed, with a level of granularity that should not be left to chance. This level of detail will give your software greater reliability and robustness, especially from the perspective of the various users who will interact with it. Each role and its corresponding tasks and data access should be carefully planned to maintain security and integrity.

Implement a logging strategy. Full logging of your application involves recording “log files,” commonly referred to as “logs”.This is required under Article 5 of the GDPR and helps identify potential security breaches or functional issues. The logs then would be regularly checked and this eagles the detection of any potential security incidents or other operational irregularities.

IT outsourcing can be a very interesting alternative for the development and security of your health application according to industry best practices. Feel free to call us to discuss it, or send us an email at [email protected].

Best Practice No 3: Comply with regulations and health sector standards

It is important to know that health data is governed and protected by the GDPR, the Public Health Code, and the Data Protection and Freedom of Information Act. The latter states that health data is considered special and that its processing is expressly prohibited, except in specific cases that allow it. In other words, only a healthcare professional bound by a duty of professional confidentiality is authorized to process the health data collected by the application.

The 6 Legal Grounds under GDPR:

1. Consent – The user explicitly agrees to data processing.
   
2. Contract – Processing is required to fulfill a contract with the user.
   
3. Legal Obligation – Required for compliance with the law.
   
4. Vital Interests – To protect someone’s life or health (e.g., medical emergency).
   
5. Public Interest – For tasks of general public interest or public authority.
   
6. Legitimate Interests – Permits processing for the organization’s legitimate needs, as long as it doesn’t override user rights.
   

In e-health, security is far from optional. Security is the foundation of trust, compliance, and the success of your application. If you’re looking for inspiration for developing your e-health application, we’ve written other articles on the topic.