HEALTHCARE INCIDENT RESPONSE CHECKLIST

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--- INCIDENT IDENTIFICATION & INITIAL ASSESSMENT ---
[ ] Date of Incident
[ ] Time of Incident Reported
[ ] Incident Category (Data Breach, Ransomware, System Outage, Phishing, Malware Infection, Unauthorized Access, Other)
[ ] Description of Incident
[ ] Initial Severity Level (Preliminary) (Low, Medium, High, Critical)
[ ] Estimated Number of Records Affected (if known)
[ ] Reporting User/Team
[ ] Physical Location of Incident (if applicable)

--- CONTAINMENT & ISOLATION ---
[ ] Affected System(s) Category (Network, Application, Server, Endpoint, Data Storage)
[ ] Description of Affected Systems
[ ] Initial Containment Action (Network Segmentation, System Shutdown, Account Lockdown, Application Blocking, Endpoint Isolation)
[ ] Number of Affected Users (Estimate)
[ ] Date of Containment Action
[ ] Time of Containment Action
[ ] Data Sensitivity Levels Involved (PHI (Protected Health Information), PII (Personally Identifiable Information), Confidential Business Data, Public Data)

--- DATA SECURITY & PRIVACY ---
[ ] Data Type(s) Affected? (Protected Health Information (PHI), Financial Data, Personally Identifiable Information (PII), Other)
[ ] Description of Data Impacted
[ ] Estimated Number of Records Affected
[ ] Which systems/databases were involved? (EHR/EMR, Billing System, Patient Portal, Other)
[ ] Data Encryption Status (at rest) (Encrypted, Unencrypted, Unknown)
[ ] Data Access Controls Compromised? (Yes, No, Unknown)
[ ] Date of Data Breach Discovery
[ ] Description of Data Security Measures Taken

--- INVESTIGATION & ROOT CAUSE ANALYSIS ---
[ ] Detailed Description of Incident Events
[ ] Potential Root Cause Category (Technical Failure, Human Error, Malicious Activity, Process Deficiencies, Vendor Issue)
[ ] Specific Contributing Factors
[ ] Number of Affected Systems/Records (Estimate)
[ ] Security Controls Bypassed/Compromised (Firewall, Antivirus, Access Controls, Encryption, Intrusion Detection System)
[ ] Date of Root Cause Identification
[ ] Time of Root Cause Identification

--- REMEDIATION & RECOVERY ---
[ ] Description of Remediation Actions Taken
[ ] Number of Affected Systems
[ ] System Restoration Date
[ ] Time of System Restoration
[ ] Evidence of Remediation (e.g., logs, screenshots)
[ ] Data Recovery Method Used (Backup Restore, Manual Data Entry, Other)
[ ] Verification of Data Integrity (Visual Inspection, Checksum Verification, Reconciliation with Source, Not Applicable)

--- NOTIFICATION & COMMUNICATION ---
[ ] Incident Severity Level (Low, Medium, High, Critical)
[ ] Stakeholders to Notify (IT Security Team, Legal Counsel, Public Relations, Executive Management, Affected Department Heads)
[ ] Initial Incident Summary for Communication
[ ] Notification Date
[ ] Notification Time
[ ] Communication Method (Email, Phone, Secure Messaging Platform)
[ ] Communication Log (Record of notifications sent and received)

--- DOCUMENTATION & REPORTING ---
[ ] Incident Description Summary
[ ] Date of Incident Report Creation
[ ] Time of Incident Report Creation
[ ] Incident Severity Level (1-5)
[ ] Detailed Incident Timeline
[ ] Supporting Documentation (Screenshots, Logs)
[ ] Report Status (Draft, Submitted, Approved, Closed)

--- POST-INCIDENT REVIEW & IMPROVEMENT ---
[ ] Summary of Incident Response Actions Taken
[ ] Root Cause Analysis Findings
[ ] Contributing Factors (Select all that apply) (Human Error, System Vulnerability, Process Failure, External Threat, Lack of Training)
[ ] Estimated Downtime (in hours)
[ ] Number of Records Potentially Impacted
[ ] Overall Effectiveness of Response (Scale of 1-5, 5 being most effective) (1, 2, 3, 4, 5)
[ ] Recommendations for Process Improvements
[ ] Date of Next Review/Update

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