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Healthcare · Americas

US health system rebuilds identity on a greenfield Microsoft tenant.

Okta MFA migrated to Entra ID, 18 Conditional Access policies deployed, and identity secure score taken from 0% to 65.87% across a top-ranked hospital network.

// Client overview

A leading non-profit healthcare organisation on the West Coast, recognised among the top-ranked hospitals in the United States, operating acute care hospitals, wellness centres, urgent care facilities and partner networks. With approximately $3.6 billion in annual revenue, 18,000 physicians, 10,500 employees and more than 700,000 patients a year, the organisation is critical to healthcare delivery across its region.

Healthcare remains among the most targeted sectors for cybercriminals, because it holds high-value patient data - social security credentials, medical records and insurance details. As this organisation accelerated its digital transformation, fragmented access controls, limited visibility into SaaS usage and mounting compliance pressure created risk across operations, and it partnered with Inspira to establish a resilient, compliant, Zero Trust-aligned IAM framework.

Sector
Healthcare
Region
Americas
Engagement
Cyber transformation
Services
Identity & access management · MFA platform migration · Hybrid identity enablement · Privileged Access Management (PAM) · Shadow IT discovery & governance · Identity threat detection & audit
Technologies
Microsoft Entra ID · Microsoft Entra Connect Sync · Microsoft Entra Conditional Access · Microsoft Defender for Identity · Privileged Identity Management (PIM) · BeyondTrust · ManageEngine AD Audit Plus
// Key challenges
The greenfield Microsoft tenant lacked foundational identity and security configuration.
Access was fragmented across care facilities, vendors and partner systems.
An existing Okta MFA deployment added complexity and operational cost inside a Microsoft-first environment.
There was limited visibility into unauthorised SaaS usage.
Legacy systems lacked BeyondTrust hardening and Zero Trust alignment.
A low security maturity score and the absence of centralised governance were driving HIPAA and PCI audit issues.
// The solution · highlights
Unified identity architecture: a secure identity foundation established in a greenfield Microsoft Entra ID tenant, integrated with on-premises Active Directory and aligned to Microsoft and CIS security benchmarks.
Okta MFA migration: Okta MFA migrated to Entra ID MFA with seamless user onboarding, minimal operational disruption and Conditional Access enforcement.
Hybrid identity enablement: Entra Connect Sync implemented to bridge on-premises Active Directory with Entra ID, enabling hybrid authentication and centralised identity management.
Standardised access policies: risk-based Conditional Access designed and enforced, standardising identity controls across clinical and administrative environments to strengthen HIPAA and PCI compliance.
Privileged access controls: BeyondTrust integrated with hardened configurations and Privileged Identity Management implemented to reduce standing administrative privilege.
Real-time monitoring and auditing: BeyondTrust and ManageEngine AD Audit Plus integrated for centralised monitoring, real-time alerting and privileged access tracking.
Shadow IT detection and governance: visibility and governance controls implemented for unauthorised SaaS applications, reducing risk from unmanaged cloud services.
// Outcomes
Unified access governance across hospitals, care centres and partner ecosystems.
Enhanced security posture, with robust identity protection and regulatory alignment.
Improved operational resilience through centralised governance and real-time monitoring.
Accelerated digital transformation with secure, scalable identity services.
Increased visibility into identity threats, privileged access activity and Shadow IT risk.
Strengthened Zero Trust posture aligned to healthcare compliance frameworks.
// Key benefits
A secure Entra ID environment with hybrid identities, aligned to Microsoft and CIS benchmarks.
PIM and hardened BeyondTrust configurations enforcing Zero Trust and minimising standing privilege.
Microsoft Defender for Identity integrated for real-time identity threat detection and auditing.
Identity operations streamlined across clinical and administrative environments.
// By the numbers · ROI
Microsoft Secure Score (Identity): 0% → 65.87%
Conditional Access policies deployed: 18
Okta MFA → Entra ID MFA migrated
Domain-joined → hybrid identity framework
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