Cybersecurity Threats in the Healthcare Industry (and how to fight back)
Vulnerable Patient Data: A Prime Target for Hackers
By now, we've all been exposed to alarming stories in the news or in our favorite newsletters about hackers increasingly targeting hospitals, clinics, and community health centers to steal vast amounts of personal data. The ease with which these hackers gain access has reached a concerning level, making healthcare centers a prime target for their activities. In today’s article we explore the various angles of this emerging problem, while highlighting the importance of good cybersecurity practices especially when sensitive data is at stake, providing tips and solutions for healthcare institutions to overcome the difficulties and mitigate the risk of falling victim to these attacks and getting an in-depth tour on the cause and the root of the various problems..
1) The Importance of Patient Data Security
Healthcare institutions are known to handle vast amounts of personal data, mostly because patients are required to fill out forms and questionnaires in order for doctors to accurately assess the situation and meet their patients’ needs, even smaller practices like your local therapist, usually keeps notes of your appointments and your conversations for current or future analysis and other therapisty things (idk, I’m not a therapist). Which is ultimately a good thing, it empowers healthcare workers to be able to do their job more efficiently, and helps reduce the margin of error by having well-documented cases and structured data. However as more and more data is going digital with the adoption of electronic health records1, connected medical devices, telemedicine2, and other digital health technologies, healthcare institutions are starting to fall behind; especially regarding the security of patient data. Consequently, various cybersecurity problems have risen and made the healthcare sector more vulnerable, which brings us to why it’s important to have strong security practices for patient data:
Sensitive Patient Data: Healthcare organizations hold sensitive patient information, including medical histories, personal details, and financial data. A breach of this information can lead to various problems, potentially causing serious harm to patients and eroding trust in the healthcare system.
Personal Identifiable Information (PII): The most immediate and significant consequence of a successful cyber attack is the breach of sensitive medical records and personal information. Patient data often includes personal identifiable information like names, addresses, social security numbers, and contact details. If cybercriminals gain access to this information, patients may become victims of financial fraud or other forms of exploitation.
Patient Safety and Care Continuity: Cyberattacks can disrupt healthcare services, leading to delays in patient care and treatment. Ransomware attacks3, for example, can lock critical systems and prevent healthcare providers from accessing patient records or administering necessary treatments, potentially jeopardizing patient safety.
Medical Device Security: With the proliferation of connected medical devices and the Internet of Things (IoT) in healthcare, there is an increased risk of these devices being targeted by hackers. Compromised medical devices can lead to misdiagnosis, incorrect dosages, or even fatal consequences for patients.
Reputation and Trust: Healthcare organizations rely heavily on their reputation and patient trust. A significant data breach can damage the reputation of a healthcare provider or institution, leading to a loss of patient confidence and potential legal actions.
Financial Loss for Healthcare Organizations: Healthcare organizations that suffer data breaches can face significant financial losses. They may incur costs related to investigating the breach, notifying affected patients, providing credit monitoring services, legal fees, and potential fines or penalties from regulatory authorities.
2) Reasons Behind Targeting the Healthcare Industry
In the recent years, the healthcare industry has become a prime target for hackers due to the following reasons:
Valuable data: Healthcare organizations store vast amounts of sensitive and valuable data, including personal and medical information of patients, and even financial data. This information can be sold on the dark web or used for various malicious purposes, such as identity theft and insurance fraud.
Weaker cybersecurity measures: Healthcare centers may not always prioritize cybersecurity as much as other industries. They might allocate more resources to patient care and medical equipment, leaving potential vulnerabilities in their IT infrastructure and systems - A hospital I have recently visited still uses HTTP on their website, I don’t see how they are still in business tbh -
Legacy systems: Many healthcare facilities still use outdated and legacy systems (hello Windows XP), which are more susceptible to cyberattacks. These systems may not receive regular security updates, making them attractive targets for hackers.
— Windows XP: Why hospitals are still using Microsoft's antique operating system
Ransomware attacks: Ransomware attacks have become increasingly common in the healthcare sector. Cybercriminals encrypt a healthcare organization's data and demand a ransom for the decryption key. Medical facilities may be more likely to pay the ransom quickly to regain access to critical patient data and ensure patient safety.
— The FBI is investigating a multiple-state hospital ransomware attack
Lack of cybersecurity awareness: Staff members at healthcare centers might not be adequately trained in recognizing and responding to cybersecurity threats, making them more susceptible to phishing attacks and other social engineering techniques.
Disruptions to critical services: Cyberattacks on healthcare centers can have severe consequences, potentially disrupting critical medical services, causing delays in patient care, and even putting lives at risk. This makes them attractive targets for cybercriminals seeking to cause significant harm and gain notoriety.
— Cyberattack disrupts hospitals and healthcare in several states
3) Types of Cybersecurity Threats in Healthcare
There are numerous types of attacks that any company or institution can be hit with, the most famous being:
Ransomware: This type of attack involves encrypting the organization's data, rendering it inaccessible until a ransom is paid to the attackers. Healthcare institutions are often targeted because they rely heavily on patient data, and the disruption of services can have severe consequences.
Social Engineering Attacks: Social engineering is the manipulation of human psychology for one’s own gain. A social engineer can manipulate staff members into giving access to their computers, routers, or Wi-Fi; the social
engineer can then steal Protected Health Information (PHI), Personal Identifiable Information (PII), and/or install malware posing a significant threat to the Health sector. Popular forms of these attacks include:
Phishing: Phishing is a type of social engineering in which an attacker sends a fraudulent message designed to trick a person into revealing sensitive information, or to deploy malicious software onto the victim's infrastructure, such as ransomware.
Vishing: Vishing or "voice phishing," involves some form of a phone call to perform social engineering that involves defrauding people over the phone, enticing them to divulge sensitive information.
Callback Phishing: Callback phishing is a hybrid form of vishing. This type of social engineering attack usually involves sending the target a fake email and calling, before sending a fake subscription/invoice notice.
Business Email Compromise (BEC): A business email compromise (BEC) is when a threat actor sends an email to their target posing as trusted source with the intent to scam a business or defraud a company. This type of attack can be difficult to detect and relies on impersonation, along with other social engineering tactics, to trick people into interacting on the threat actor’s behalf.
Deepfake Software: The use of deepfake software involves a combination of voice cloning and video and allows anyone to take on the identity of trusted persona.
Whaling: Whaling is a phishing attack that involves a fake email masquerading as a legitimate email in order to target senior executives.
Source: The Impact Of Social Engineering on Healthcare
Data breaches: Cybercriminals may target healthcare institutions to steal patient records, financial information, or intellectual property. The stolen data can be sold on the black market or used for other malicious purposes.
Distributed Denial of Service (DDoS) attacks: These attacks overwhelm a healthcare institution's servers and systems with a massive amount of traffic, causing them to become unavailable to legitimate users.
Insider threats: Not all attacks come from external actors. Employees or insiders with access to sensitive data may intentionally or unintentionally cause harm to the organization's systems or leak valuable information.
Malware attacks: Beyond ransomware, healthcare institutions can also be targeted with other types of malware, such as viruses, Trojans, and spyware, which can steal data or disrupt operations.
Man-in-the-Middle (MitM) attacks: In this type of attack, an attacker intercepts communication between two parties, allowing them to eavesdrop or alter the information being exchanged.
Credential stuffing (brute force attack): Attackers use automated tools to try large sets of username and password combinations, exploiting cases where users reuse passwords across multiple sites or have weak credentials.
Internet of Things (IoT) vulnerabilities: As healthcare institutions increasingly use IoT devices for patient monitoring and other purposes, these devices can be susceptible to attacks if not properly secured.
Supply chain attacks: Cybercriminals may target third-party vendors or suppliers connected to healthcare institutions to gain access to the institution's network or sensitive data indirectly.
Zero-day exploits: These attacks take advantage of previously unknown vulnerabilities in software or systems for which no patch or fix is available at the time of the attack.
4) Challenges in Healthcare Cybersecurity and Privacy Protection
Healthcare centers face several challenges when it comes to improving the security and privacy of their systems:
Budget constraints: Healthcare centers often operate on limited budgets, and implementing robust security measures can be costly. This can lead to inadequate investment in cybersecurity infrastructure and staff training.
Technological complexity: Healthcare systems are becoming increasingly digitized and interconnected, making them more vulnerable to cyber threats. Managing and securing this complex technological landscape requires specialized expertise and resources.
Legacy systems: Many healthcare centers still rely on outdated legacy systems that may not have been designed with modern security considerations in mind. Retrofitting these systems for enhanced security can be challenging and expensive.
Human factors: The healthcare sector involves a large number of employees and contractors who may have varying levels of cybersecurity awareness and training. Insider threats or unintentional human errors can pose significant risks to data security.
Regulatory compliance: Healthcare centers must comply with various regulations and standards, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States. Meeting these requirements and maintaining compliance while implementing security measures can be complex.
Balancing accessibility and security: Healthcare centers need to strike a delicate balance between providing quick and convenient access to patient data for authorized personnel while ensuring that unauthorized access is prevented.
Constantly evolving threats: Cyber threats and attack methods are constantly evolving. Healthcare centers need to keep up with the latest security measures and techniques to stay ahead of potential attackers.
Lack of cybersecurity expertise: The healthcare industry, like many other sectors, faces a shortage of skilled cybersecurity professionals. This scarcity can make it difficult for healthcare centers to recruit and retain qualified experts to manage their security efforts effectively.
Interoperability challenges: Healthcare centers often need to share patient data with other healthcare providers and systems. Ensuring secure data exchange and interoperability between different systems can be complex.
5) Solutions for Healthcare Institutions
For healthcare institutions and employees seeking effective solutions, here are 20 crucial steps to safeguard your organization:
Implement Backups with Best Practices: Regularly back up all critical data, including patient records and medical information, to a secure offsite location. Automated backups are preferable to minimize the risk of human error. Consider the privacy implications of data backups and ensure that appropriate encryption is used because backups can become a target for hackers too.
Have a Structured Program for Regular Software Updates: Staying updated is critical to protect against cyberattacks, establish a formal patch management process4 to ensure all software, operating systems, and applications are up to date with the latest security patches. Schedule regular updates and patches during non-critical hours to minimize disruptions to patient care.
Use Modern Hardware: Modern hardware typically comes with the latest security features and firmware, and manufacturers provide regular updates and patches to address emerging threats and vulnerabilities. This helps ensure that the organization's systems remain protected against potential cyberattacks. Subsequently, get rid of all end-of-life hardware5.
Rollout sensible restrictions: Implement the principle of least privilege6, ensuring that staff members only have access to the information and systems necessary for their roles. Disable unnecessary services and applications to reduce the attack surface.
Network Segmentation and Access Controls: Implement network segmentation7 to separate different systems and restrict access to sensitive data on a need-to-know basis. Regularly review and update access control policies to reflect changes in staff roles and responsibilities.
Implement Strong Authentication: Use strong authentication methods such as multi-factor authentication (MFA) to ensure only authorized personnel can access patient data.
Impose proper credential tracking: Enforce strong password policies8, including complex passwords and regular password changes for employees and customers.
Train staff to be alert and cautious: Conduct regular cybersecurity and privacy training sessions for all employees, including medical staff and administrative personnel. Ensure they understand the importance of protecting patient data and the potential consequences of a breach.
Train staff to verify all requests: Establish clear policies and procedures for handling sensitive information and ensure all staff members are aware of and follow these protocols. Emphasize the significance of identifying and reporting phishing attempts, social engineering tactics, and suspicious activities.
Data Minimization9: Follow the principle of data minimization and only collect, store, and retain the minimum amount of patient data necessary for the organization's operations. Regularly review and purge outdated or unnecessary data to reduce the risk of data exposure in case of a breach.
Regular Security and Privacy Impact Assessments: Conduct regular security assessments, penetration testing, and vulnerability scanning to identify and address potential weaknesses in the organization's systems and network. Perform privacy impact assessments (PIAs)10 to understand how data is collected, used, stored, and shared within the organization, identifying potential privacy risks and ensuring compliance with data protection regulations.
Secure Communication and Encryption: Enforce the use of secure communication channels, especially when transmitting sensitive data. Utilize encrypted email and messaging services to protect patient information in transit, especially among employees. Encrypt stored data to protect patient records and other sensitive information from unauthorized access in case of a data breach, make sure to use the latest encryption protocols.
Hold every department accountable for security: Make cybersecurity and privacy a shared responsibility across all departments, from administrative staff to medical professionals.
Secure Wi-Fi Networks: Secure all Wi-Fi networks with strong encryption (e.g. WPA2 [AES] or WPA3) and use separate networks for guests and employees. Regularly update Wi-Fi passwords and access credentials to prevent unauthorized access.
Increase physical security: Control access to sensitive areas within the healthcare facility through the use of access cards, biometric authentication, or security personnel. Make sure physical locations are well-guarded, especially places where physical or digital data is stored such as server rooms or archive rooms.
Employ a disaster recovery plan: Develop and test disaster recovery plans to ensure that in the event of a cyber incident or natural disaster, the organization can recover its systems and data quickly and securely. Establish a dedicated security incident response team to swiftly respond to and manage cybersecurity incidents effectively.
Vendor Management: Evaluate the security and privacy practices of third-party vendors who have access to patient data. Ensure they meet the necessary security standards and comply with data protection regulations.
Secure Remote Access: If remote access to the organization's systems is necessary, implement secure and trusted Virtual Private Networks with strong encryption and multifactor authentication to protect data during transmission.
Regulatory Compliance: Stay informed about the latest data protection and privacy regulations relevant to the healthcare industry, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States, and ensure compliance with all applicable requirements.
Take advantage of resources: Stay informed about the latest cybersecurity trends and best practices by participating in industry conferences, webinars, and workshops. Collaborate with cybersecurity information sharing organizations or governmental agencies to receive timely threat intelligence.
BONUS:
Hire a consultant: Engage with cybersecurity consultants or firms specializing in healthcare to perform thorough security assessments and provide expert guidance on strengthening the organization's security and privacy posture.
— In conclusion, the healthcare sector faces a growing threat from cybercriminals targeting patient data and critical systems. To address these challenges, healthcare institutions should prioritize cybersecurity measures and privacy protection, including strong authentication, network segmentation, regular software updates, and employee training. Adopting best practices and seeking expert guidance can help build robust defenses against cyber threats. See you in our next post, ShieldUp!
Electronic Health Records: An Electronic Health Record (or EHR) is a digital file that contains all of your important health information. Instead of keeping your medical history on paper files scattered in different doctors' offices, hospitals, or clinics, an EHR puts everything together in one place. It includes things like your medical history, test results, medications you've taken, allergies, immunizations, and details about past doctor visits and treatments.
Telemedicine: Telemedicine refers to the use of technology to connect patients with healthcare professionals remotely. Instead of visiting a doctor's office or hospital in person, patients can receive medical consultations, diagnoses, and even treatment from the comfort of their homes or other locations.
Formal Patch Management Process: A formal patch management process is a structured way for organizations to keep their software and systems secure and up-to-date. It involves identifying vulnerabilities, prioritizing patches, testing before deployment, and continuous monitoring to ensure everything works smoothly and safely. By following this process, organizations can reduce the risk of cyber threats and maintain the stability of their systems.
End-of-life Hardware: Hardware that no longer receives security patches and updates is often referred to as "End-of-Life" (EOL) hardware. End-of-life refers to the stage in a product's life cycle where the manufacturer or vendor has discontinued support for the product, including the release of updates, patches, and technical assistance. This means that any vulnerabilities or security flaws discovered after the EOL date will not be fixed by the manufacturer, leaving the hardware potentially exposed to security risks and threats.
Principle Of Least Privilege: The principle of least privilege states that a user or process should only be given the minimum level of access necessary to perform their required tasks, reducing the risk of potential security breaches or accidental misuse.
Network Segmentation: Network segmentation -in healthcare- involves dividing the computer network into separate zones, like rooms with different access controls. Each zone contains specific devices and data, ensuring that sensitive patient information is isolated and accessible only to authorized personnel. This practice enhances security by containing potential threats, making it harder for attackers to move freely across the network. It also improves performance and management as network traffic is better controlled and directed to specific areas.
Privacy Impact Assessment: Privacy Impact Assessments (PIAs) are evaluations that identify and minimize privacy risks by assessing how personal information is collected, used, and protected in a project or system.