IMAGING CONNECTORS

Security, Governance & Audit

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Secure imaging data exchanges with strong access control, encryption, consent management, audit trails, provenance and deployment-specific compliance controls.

SecurityPrivacyConsentAuditDICOM TLSmTLSRBACPHI ProtectionCompliance

Security Principles

Privacy by design and by default

Least-privilege access

End-to-end encryption

Patient consent and data minimization

Complete auditability and traceability

Data integrity and non-repudiation

Secure configuration and hardening

Continuous monitoring and alerting

Authentication & Authorization

OAuth 2.1 / OpenID Connect for application and user context

mTLS for system-to-system imaging calls

RBAC with fine-grained imaging scopes

Tenant and organization isolation

Short-lived tokens and rotation

IP allowlisting and network policies where required

Data Protection

Encryption in transit

TLS 1.2+ / mTLS across supported imaging exchanges

Encryption at rest

Encrypt stored images, metadata, reports and caches

PHI / PII protection

Mask or pseudonymize data for logs, exports and analytics

Secure key management

Use managed KMS / HSM-backed secrets where appropriate

DICOM TLS

Secure DICOM C-STORE, C-MOVE and related DIMSE services

Patient Consent & Access

Consent capture and management

Granular consent for imaging data when required

Purpose limitation and expiry

Break-the-glass emergency access with audit

Patient access to their images and reports

Consent audit and history

Compliance

GDPR / EU data-protection requirements

HDS requirements for France where applicable

EHDS-aligned interoperability and access principles

ISO 27001 / 27701-oriented controls

NIS2-related security governance where applicable

Local country and organization requirements

Compliance depends on actual deployment, contracts, operational controls and country-specific obligations; documentation must not imply certification that has not been obtained.

Audit Trail & Provenance

Who accessed what, when and from where

Query / retrieve / store / export events

Modality worklist access

Image retrieval and downloads

Report creation, amendments and sign-offs

AI result generation and use

Administrative and configuration changes

jsonCopy

{
  "eventType": "IMAGE_RETRIEVAL",
  "timestamp": "2026-09-06T00:42:31Z",
  "actor": { "membershipId": "mem_123", "role": "radiologist" },
  "tenantId": "tenant_imaging_01",
  "studyInstanceUID": "1.2.840.113619...",
  "source": "PACS-A",
  "action": "WADO-RS",
  "correlationId": "req_abc123"
}

Data Governance

Data classification — PHI / metadata / derived data

Retention policies configurable per tenant

Legal holds and litigation support

Data residency and sovereignty controls

Cross-border transfer controls

Data-quality and integrity rules

Periodic access reviews

Policy-as-code and enforcement

Network & Infrastructure Security

Private networks and segmentation

Firewall rules and micro-segmentation

DICOM TCP/IP port restrictions

Intrusion detection and prevention

Centralized logging / SIEM integration

Vulnerability management and patching

Backup encryption and disaster recovery

High availability and failover

DICOM Security

Feature	Description
DICOM TLS	Encrypts DIMSE services such as C-STORE, C-MOVE and C-FIND
mTLS authentication	Mutual TLS for system authentication
AE Title allowlisting	Allow only trusted AE Titles
User identity negotiation	Associate users with actions when supported
Audit of DICOM operations	Record imaging operations without logging PHI unnecessarily

Roles & Permissions

Role	Typical capabilities
Radiologist	Search, view, download, report and annotate
Technologist	Worklist access, MPPS updates, send images
Referring clinician	View studies and reports
Medical physicist	QA images, dose reports and technical review
IT / Admin	Manage connections, monitor and troubleshoot
AI service	Process images using scoped service permissions

Monitoring & Alerting

Real-time system and connector health

Failed operations and error thresholds

DICOM association failures

Image-transfer and storage issues

Unusual access patterns

Certificate expiry and security alerts

Audit-log anomalies

Custom alerts via email / webhook / SMS where configured

Incident Response

Detect & classify

Identify incident and severity

Contain

Limit impact and isolate affected path

Investigate

Root-cause and evidence analysis

Communicate

Coordinate reporting and stakeholders

Remediate

Recover and restore services

Review

Post-incident lessons and actions

Best Practices

Enforce TLS / mTLS for all supported connections

Use least privilege and scoped tokens

Regularly review access and audit logs

Keep systems and certificates up to date

Validate and sanitize all inputs

Encrypt backups and exports

Implement retention and purge policies

Test disaster-recovery plans

Document and review security controls

Train teams on imaging-specific security risks

Shared Responsibility

Mediloop

Secure platform and connector architecture

Encryption and key-management integration

Audit logging and monitoring

Patching and availability of Mediloop-managed components

Customer / Partner

Access-control and user management

Device / PACS network security

Data-governance and retention policies

Local policies and compliance

Incident reporting and collaboration

Common Use Cases

Secure cross-organization imaging exchange

Patient-portal access to images

AI processing with strict governance

Research data sharing with de-identification

Tele-radiology and remote collaboration