Guest post by Donald Voltz,MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room, Assistant Professor of Anesthesiology, Case Western Reserve University and Northeast Ohio Medical University.
As Halloween approaches, the usual spate of horror movies will intrigue audiences across the US, replete with slashers named Jason or Freddie running amuck in the corridors of all too easily accessible hospitals. They grab a hospital gown and the zombies fit right in. While this is just a movie you can turn off, the real horror of patient data theft can follow you.
(I know how terrible this type of crime can be. I myself have been the victim of a data theft by hackers who stole my deceased father’s medical files, running up more than $300,000 in false charges. I am still disputing on-going bills that have been accruing for the last 15 years).
Unfortunately, this horror movie scenario is similar to how data thefts often occur at medical facilities. In 2015, the healthcare industry was one of the top three hardest hit industries with serious data breaches and major attacks, along with government and manufacturers. Packed with a wealth of exploitable information such as credit card data, email addresses, Social Security numbers, employment information and medical history records, much of which will remain valid for years, if not decades and fetch a high price on the black market.
Who Are The Hackers?
It is commonly believed attacks are from outside intruders looking to steal valuable patient data and 45 percent of the hacks are external. However, “phantom” hackers are also often your colleagues, employees and business associates who are unwittingly careless in the use of passwords or lured by phishing schemes that open the door for data thieves. Not only is data stolen, but privacy violations are insidious.
The problem is not only high-tech, but also low-tech, requiring that providers across the continuum simply become smarter about data protection and privacy issues. Medical facilities are finding they must teach doctors and nurses not to click on suspicious links.
To thwart accidental and purposeful hackers, organizations should implement physical security procedures to secure network hardware and storage media through measures like maintaining a visitor log and installing security cameras. Also limiting physical access to server rooms and restricting the ability to remove devices from secure areas. Yes, humans are the weakest link.
Medical data theft is a growing national nightmare. IDC’s Health Insights group predicts that one in three healthcare recipients will be the victim of a medical data breach in 2016. Other surveys found that in the last two years, 89 percent of healthcare organizations reported at least one data breach, with 79 percent reporting two or more breaches. The most commonly compromised data are medical records, followed by billing and insurance records. The average cost of a healthcare data breach is about $2.2 million.
At health insurer Anthem, Inc., foreign hackers stole up to 80 million records using social engineering to dig their way into the company’s network using the credentials of five tech workers. The hackers stole names, Social Security numbers and other sensitive information, but were thwarted when an Anthem computer system administrator discovered outsiders were using his own security credentials to log into the company system and to hack databases.
Investigators believe the hackers somehow compromised the tech worker’s security through a phishing scheme that tricked the employee into unknowingly revealing a password or downloading malicious software. Using this login information, they were able to access the company’s database and steal files.
Healthcare Hacks Spread Hospital Mayhem in Diabolical Ways
Not only is current patient data security an issue, but thieves can also drain the electronic economic blood from hospitals’ jugular vein—its IT systems. Hospitals increasingly rely on cloud delivery of big enterprise data from start-ups like iCare that can predict epidemics, cure disease, and avoid preventable deaths. They also add Personal Health Record apps to the system from fitness apps like FitBit and Jawbone.
Banner Health, operating 29 hospitals in Arizona, had to notify millions of individuals that their data was exposed. The breach began when hackers gained access to payment card processing systems at some of its food and beverage outlets. That apparently also opened the door to the attackers accessing a variety of healthcare-related information.
Because Banner Health says its breach began with an attack on payment systems, it differentiates from other recent hacker breaches. While payment system attacks have plagued the retail sector, they are almost unheard of by healthcare entities.
Guest post by Santosh Varughese, president, Cognetyx.
The U.S. healthcare industry is under siege from cyber criminals who are determined to access patient and employee data. Information security think tank Ponemon Institute’s most recent report on healthcare cyber security, published in May 2016, revealed some sobering statistics:
In the past two years, 89 percent of healthcare organizations – and 60 percent of their business associates (or BAs) – experienced at least one data breach, with 79 percent experiencing two or more breaches. The most commonly compromised data are medical records, followed by billing and insurance records. These breaches have not declined since Ponemon began tracking them in 2010.
The average cost of a healthcare data breach is about $2.2 million.
Criminal attacks, from outside the organization or from malicious insiders, account for half of all healthcare data breaches, the other half being due to mistakes by employees or BAs.
The majority of respondents (69 percent of healthcare organizations and 63 percent of BAs) feel that the healthcare industry is at greater risk of breaches than other industries. Despite these concerns, the majority of respondents reported that their organizations had either decreased their cyber security budgets or kept them the same.
Another study conducted in April by IBM, found similar problems, as well as insufficient employee training on cybersecurity best practices and a lack of commitment to information security from executive management.
With only about 10 percent of healthcare organizations not having experienced a data breach, hackers are clearly winning the healthcare data security war. However, there are proactive steps that the healthcare industry can take to turn the tide in its favor.
Data Security Starts with a Culture of Security Awareness
Both the IBM and Ponemon studies highlight an issue that experts have been talking about for some time: despite increasing dangers to information security, many healthcare organizations simply do not take cybersecurity seriously. Digital technologies are relatively new to the healthcare industry, which was very slow to adopt electronic records and when it finally did so, it implemented them rapidly without providing employees adequate training on information security procedures.
Unfortunately many front-line employees feel their only job is to treat patients and that information security is “the IT department’s problem.” These employees fail to grasp the importance of data security, and are not educated on the dangers of patient data breaches, reflected in Ponemon’s findings that employee mistakes account for half of all healthcare data breaches.
The healthcare industry needs to adjust this attitude toward cybersecurity and implement a comprehensive and ongoing information security training program, and cultivate a culture of security awareness. Information security should be included in every organization’s core values, right beside patient care. Employees should be taught that data security is part of everyone’s job, and all supervisors – from the C-suite down to the front line – should model data security best practices.
Additionally, organizations should implement physical security procedures to secure network hardware and storage media (such as flash drives and portable hard drives) through measures like maintaining a visitor log and installing security cameras, limiting physical access to server rooms, and restricting the ability to remove devices from secure area. Continue Reading
A stolen credit card record can be sold for as low as a quarter while a medical record can be sold for $50. Why is that? When a credit card is stolen, the owner is able to cancel it as soon as he/she notices fraudulent activity and then they are also able to dispute the charges. But think about a medical record – changing your Social Security number, birth date, home address and medical history isn’t that simple, even impossible.
The problem becomes much bigger than just financial identity theft. Think about what would happen to a person whose medical record is stolen and being used to obtain free healthcare and subscriptions. Then think about the customer going in for an emergency with the wrong records on file and getting the wrong blood transfusion.
Protecting patients’ medical records should be every hospital’s and physician’s office’s concern. But with many issues in the healthcare industry vying for attention, security may fall through the cracks.
Keystroke logger malware was recently discovered on Muhlenberg Community Hospital computers in Kentucky—but it could have gone undetected for nearly four years. Potentially compromised data includes patient names, addresses, telephone numbers, dates of birth, Social Security numbers, driver’s license/state identification numbers, health plan information, financial account numbers, payment card information and employment information.
Though there’s currently no evidence the information has been used maliciously, it’s just another reminder that medical information is an intriguing target for hackers. Netsurion, a provider of remotely-managed data and network security services for multi-location business, just released this infographic on the value of a medical record. It’s insightful.
Guest post by Joseph Schorr, director of advanced security solutions, Bomgar.
Moving into 2016, healthcare organizations will continue to be one of the most attractive targets for hackers. Last year, attacks against healthcare organizations were up 125 percent from 2010 and cost the industry $6 billion, according to the Ponemon Institute.
As illustrated in the Anthem and Excellus Blue Cross Blue Shield data breaches, hackers are moving beyond phishing attacks and random malware drops, and adopting methods that are more sophisticated. By leveraging third-party access and privileged account credentials (such as those held by IT security professionals, IT managers and database administrators) to exploit IT systems, hackers can gain an unrestricted and unmonitored attack foothold on the network. Once they have this foothold, they are remaining inside the victim’s environment for an incredible span of time – on average more than 200 days.
With this trend continuing, healthcare organizations can expect to see an uptick in these types of attacks within the industry. To combat this rise, healthcare organizations will need to focus on shoring up IT security around vendors and other third parties in the year ahead. The following are areas where they can concentrate attention to aid in this effort:
Reevaluate the legacy
In particular, third parties such as vendors are particularly juicy targets because they often use VPN and other legacy access methods to access systems. Examining and implementing more secure, sophisticated remote access and privileged access solutions is a good place to start strengthening IT security for the new year.
It’s a common misconception that VPN is a secure way to provide third-party vendors with network access. The problem lies in that an organization cannot ensure that third-party vendors’ security policies and practices are as strenuous as internal practices. If a criminal compromises a valid VPN connection, they have an open tunnel to an organization’s network and the sensitive data within.
Be in control
For too many healthcare organizations, vendors have more access than they need or their access can’t be monitored or restricted. It’s a scary question: Does your IT department know who their privileged users are and what level of IT permissions they have? If not, taking stock of those users, the systems to which they need access, and when they must access them is a critical undertaking for 2016. Following that, the organization can set access parameters that allow those privileged users to be productive and gain access to tools, data and systems they need to do their jobs, while limiting risk. Proactively controlling and monitoring access to critical systems can help tighten IT security within healthcare organizations.
According to a 2014 Identity Theft Resource Center Report, the healthcare industry has officially surpassed other major industries and now accounts for 42.3 percent of all data breaches recorded last year. As the number of patient medical records transitions to a digital sharing model, the potential cost of data breaches is now substantially higher than for those less regulated, like retail and public services. It’s clear that the industry is increasingly vulnerable to sophisticated cyberattacks; hackers are after vital patient information such as social security numbers and past medical records. With limited budgets and priorities often, and rightfully, placed on patient care, many healthcare organizations lack the resources to implement stronger security levels. Despite these constraints, with the right technology and best practices in place healthcare organizations can position themselves for success.
The costs associated with “damage control” for many healthcare providers is steep with the annual cap on fines for violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and HITECH Act of 2009, up from a maximum of $25,000 per year to $1.5 million. And fines are only part of the financial burden. Investigation and legal efforts, business downtime and decreased credibility all drive up costs even further.
Unfortunately, many healthcare organizations are still facing challenges when it comes to effectively communicating and collaborating on security. In many of these healthcare organizations, there is a department for privacy and compliance and then a separate department for enterprise IT security. Functional groups are often siloed and share very little information with each other. This becomes a major issue in the event of a breach as neither side is able to understand the full spectrum of the threat without the others’ data.
The consequences of the gap between compliance and IT security becomes evident when dealing with insider threats. An individual’s actions may look legitimate but when correlated against other activity, could indicate that malicious activity is occurring. A workstation that has always previously accessed clinical data or some other patient information doesn’t raise suspicion. But a subtle, steady increase in traffic, say of five or ten percent, correlated with communication to an unauthorized or new IP address, likely indicates a breach. The same example could apply to an external threat with a malicious actor using social engineering methods to entice an unwitting user to download malware. Once inside the network, the malware can replicate the very same scenario. Either way, a breach has occurred. The IT security department may discover the situation, investigate and handle it and move on to the next task. But without visibility into this type of data, how would the compliance department learn about possible data leakage and take the necessary steps to investigate and report?