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<title>Security practices and insider threats in Spanish healthcare centers: a survey-based risk assessment</title>
<creator>Herrera Montano, Isabel</creator>
<creator>Góngora Alonso, Susel</creator>
<creator>Sañudo García, Soledad</creator>
<creator>García Aranda, José Javier</creator>
<creator>Rodrígues, Joel J.P.C.</creator>
<creator>Torre Díez, Isabel de la</creator>
<description>Producción Científica</description>
<description>Introduction: Insider threats pose a critical risk in healthcare environments, where Hospital Information Systems&#xd;
(HIS) manage sensitive patients data. Authorized users may intentionally or accidentally compromise data&#xd;
confidentiality, integrity, and availability. This study assessed information security practices from the perspec-&#xd;
tive of healthcare professionals in Spanish medical centers.&#xd;
Methods: A descriptive, analytical, cross-sectional study was conducted using a survey administered to 41&#xd;
healthcare professionals with access to confidential data. The survey covered access control, encryption at rest&#xd;
and in transit, communication channels, and data usage control. Descriptive statistics, Chi-square tests, and&#xd;
Cram´er’s V were applied to identify significant associations. K-means clustering and Silhouette coefficient were&#xd;
used to define user profiles. Principal Component Analysis (PCA) was used to visualize behavior patterns. A&#xd;
Random Forest model identified the most relevant predictive variables.&#xd;
Results: Critical security gaps were detected, 31.7 % reported no control over data usage. Only 29.3 % encrypted&#xd;
data at rest and 36.6 % during transmission. Over 40 % used personal email or messaging apps to share sensitive&#xd;
data, and 97.6 % relied solely on passwords for authentication. These practices are inadequate to mitigate insider&#xd;
threats.&#xd;
Conclusion: There is an urgent need to strengthen insider data protection. Security strategies should be tailored to&#xd;
user risk profiles. Measures must include strong authentication, full encryption, and stricter control of data&#xd;
transmission to reduce exposure to insider threats (intentionally or unintentionally) in healthcare settings.&#xd;
Additionally, there is a need to promote continuous cybersecurity training.</description>
<date>2025-11-10</date>
<date>2025-11-10</date>
<date>2026</date>
<type>info:eu-repo/semantics/article</type>
<identifier>International Journal of Medical Informatics, 2025, vol. 205, p. 106107</identifier>
<identifier>1386-5056</identifier>
<identifier>https://uvadoc.uva.es/handle/10324/79507</identifier>
<identifier>10.1016/j.ijmedinf.2025.106107</identifier>
<identifier>106107</identifier>
<identifier>International Journal of Medical Informatics</identifier>
<identifier>205</identifier>
<language>eng</language>
<relation>https://www.sciencedirect.com/science/article/pii/S1386505625003247</relation>
<rights>info:eu-repo/semantics/openAccess</rights>
<rights>http://creativecommons.org/licenses/by-nc-nd/4.0/</rights>
<rights>© 2025 The Author(s)</rights>
<rights>Attribution-NonCommercial-NoDerivatives 4.0 Internacional</rights>
<publisher>Elsevier</publisher>
</thesis></metadata></record></GetRecord></OAI-PMH>