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Don’t Get Stranded without a Data Security Action Plan

August 26, 2016
by Mark Shelhart, Sikich LLP
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The cybersecurity challenges that face healthcare providers can seem staggering. Last year, the industry accounted for nearly 70 percent of all records exposed in data breaches, according to the Identity Theft Resource Center, and protected health information breaches impacted more than 113 million individuals, according to the Office for Civil Rights (OCR). Further, with health records increasing in value (surpassing credit card data) for criminals, hacking continues to rise.

Some institutions will report that they are “mostly secure.” And while awareness of threats has increased in the healthcare sector, many providers remain behind the curve on cybersecurity and lack the ability to prevent even common intrusions. Compounding the challenge for providers, state governments have responded to cyberattacks with increased scrutiny. Ever-changing laws dictate what actions a provider must take to both alert patients affected by a breach and offer remediation. Many of these amended laws expand the reach of current notification requirements, add to the definition of “personal information” and increase reporting requirements to state attorneys general.

For example, North Dakota modified its notification law to require any organization that “owns” or “licenses” state residents’ data that includes “personal information” to report the breach to the attorney general if it impacts more than 250 people. This applies even if the organization isn’t based in the state. North Dakota isn’t alone. Several other states, including Connecticut, Nevada, Oregon and Tennessee amended data breach notification laws in 2015 and 2016. And state attorneys general are making it clear that they want to be in the loop early when a breach occurs.

Mark Shelhart

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Navigating this increasingly complex maze of requirements from different states while simultaneously combatting data breaches is not an easy task. That’s why it’s critical for healthcare providers to prepare a comprehensive data security action plan by following these five steps:

1. Benchmark to identify vulnerabilities—A risk assessment is a key first step to help a provider determine where the greatest risks are within the organization. This helps the leadership team then determine what security resources to deploy and where to focus attention.

2. Adopt a consistent security posture—Healthcare providers need to take a consistent security stance across their organizations. This includes thorough application and network penetration testing, vulnerability scanning and ongoing server monitoring and patching. A robust security testing regimen can help reduce vulnerabilities and protect providers’ most important and sensitive information.

3. Evaluate and manage third-party relationships—Hospitals have many vendors that handle everything from payments to data storage. These vital operational relationships can also be perilous if the vendor falls victim to a breach that compromises sensitive hospital and patient data. That’s why it’s crucial to make security a key consideration when selecting vendors and to scrutinize current third-party relationships. Healthcare providers must learn what vendors are legally responsible for in the event of a breach and also do their best to evaluate vendors’ security practices. The bottom line is that all organizations should have a policy requiring their vendors to disclose any security incident.

4. Gain a full understanding of all state and federal regulations—With lawmakers passing new regulations related to breaches on a regular basis, providers need to ensure they have a grasp on their level of legal exposure in different states—well before a breach occurs. Trusted legal advisors, both internal and external, can play a key role in keeping providers up to speed on the latest regulations and should be an integral part of an incident response team.

5. Implement a communications strategy to protect your reputation—Providers also need a reputation management plan and a communications strategy to control their message and handle the flood of press inquiries after a breach. Planning ahead ensures the breached organization is equipped to comply with all relevant authorities and tell a clear and honest story to patients, the general public and the media. Breaches handled poorly can shatter reputations and lead to deteriorating trust. Organizations that invest in thoughtful communications and execute a well-grounded media relations strategy will set themselves up to preserve their reputation and regain their footing for future success.

Healthcare organization leaders should take immediate stock of their security stance. How secure is sensitive data? Is the organization ready to spring into action in case of a breach? With the healthcare industry in the crosshairs, and new laws putting added pressure on providers of all sizes, action can’t be delayed. The companies that adopt an ongoing commitment to security and implement a comprehensive action plan that addresses both pre-breach data security and post-breach reputation management can feel more confident in the face of today’s ever-evolving threats and regulations.

Mark Shelhart is a senior manager for incident response and forensics in the security and compliance practice at Sikich LLP. He can be reached at mark.shelhart@sikich.com.


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4.4M Patient Records Breached in Q3 2018, Protenus Finds

November 7, 2018
by Rajiv Leventhal, Managing Editor
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There were 117 disclosed health data breaches in the third quarter of 2018, leading to 4.4 million patient records breached, according to the Q3 Protenus Breach Barometer report.

Published by Protenus, a cybersecurity software company that issues a Breach Barometer report each month, the most recent data shows that although the number of incidents disclosed in Q3 decreased somewhat from Q2, the number of breached records increased from Q2 to Q3. Also, the number of affected patient records has continued to climb each quarter in 2018—from 1.13 million in Q1 to 3.14 million in Q2 to 4.4 million in Q3.

In Q3, the report noted that the single largest breach was a hacking incident affecting 1.4 million patient records that involved UnityPoint Health, an Iowa-based health system. Hackers used phishing techniques, “official-looking emails”, to gain access to the organization’s email system and capture employees’ passwords. This new incident follows one that took place at the same organization in April when 16,400 patient records were breached as a result of another phishing attack.

For incidents disclosed to HHS (the Department of Health & Human Services) or the media, insiders were responsible for 23 percent of the total number of breaches in Q3 2018 (27 incidents). Details were disclosed for 21 of those incidents, affecting 680,117 patient records (15 percent of total breached patient records). For this analysis, insider incidents are characterized as either insider-error or insider-wrongdoing. The former includes accidents and other incidents without malicious intent that could be considered “human error.” 

There were 19 publicly disclosed incidents that involved insider-error between July and September 2018. Details were disclosed for 16 of these incidents, affecting 389,428 patient records. In contrast, eight incidents involved insider-wrongdoing, with data disclosed for five of these incidents.

Notably, when comparing each quarter in 2018, there has been a drastic increase in the number of breached patient records as a result of insider-wrongdoing. In Q1 2018, there were about 4,600 affected patient records, in Q2 2018 there were just over 70,000 affected patient records, and in Q3 there were more than 290,000 affected patient records tied to insider-wrongdoing.

What’s more, the report found that hacking continues to threaten healthcare organizations, with another increase in incidents and affected patient records in the third quarter of 2018. Between July and September, there were 60 hacking incidents—51 percent of all Q3 2018 publicly disclosed incidents. Details were disclosed for 52 of those incidents, which affected almost 3.7 million patient records. Eight of those reported incidents specifically mentioned ransomware or malware, ten incidents mentioned a phishing attack, and two incidents mentioned another form of ransomware or extortion. However, it’s important to note that the number of hacking incidents and affected patient records have dropped considerably when comparing each month between July and September 2018.

Meanwhile, of the 117 health data breaches for which data was disclosed, it took an average of 402 days to discover a breach from when the breach occurred. The median discovery time was 51 days, and the longest incident to be discovered in Q3 2018 was due to insider-wrongdoing at a Virginia-based healthcare organization. This specific incident occurred when an employee accessed thousands of medical records over the course of their 15-year employment.

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Survey Reveals Disconnect Between Perception and Reality of Medical Device Security

November 6, 2018
by Heather Landi, Associate Editor
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A recent survey of healthcare IT professionals found a troubling disconnect between IT leaders’ confidence in the visibility and security of their connected medical devices and the effectiveness of legacy solutions to secure connected medical devices.

The vast majority of healthcare IT professionals (87 percent) feel confident that the connected medical devices in their hospitals are protected in case of a cyberattack. However, the survey also revealed a contradiction between the confidence that healthcare professionals have in the visibility of connected medical devices and security of their networks, and the inefficient and ineffective legacy processes many still rely on to keep them secure.

The survey from Zingbox, a provider of Internet of Things (IoT) security solutions, is based on responses from 400 U.S.-based healthcare IT decision-makers and clinical and biomedical engineers and indicates that there continues to be a widespread misconception that traditional IT security solutions can also adequately secure connected medical devices.

Seventy-nine percent of respondents say their organization has real-time information about which connected medical devices are vulnerable to cyber attacks. And, 69 percent feel traditional security solutions for laptops and PCs are adequate to secure connected medical devices.

“Most organizations are thinking about antivirus, endpoint protection and firewalls, but there are many devices — like medical monitoring equipment — and no one is thinking about securing them,” Jon Booth, Bear Valley Community Hospital District IT director and Zingbox customer, said in a statement. Additionally, as noted in a Gartner report, Market Trends: Five Healthcare Provider Trends for 2018 published in November 2017 notes: “Generally, medical devices are not replaced for at least 10 years, with many running old software that has not been updated or patched.”

And there are other challenges: the Zingbox survey revealed 41 percent of healthcare IT professionals do not have a separate or sufficient budget for securing connected devices.

When asked about inventory of connected medical devices, majority of clinical and biomedical engineers (85 percent) were confident that they have an accurate inventory of all connected medical devices even though many rely on manual audits, which are prone to human error and quickly become outdated.

What’s more, close to two-thirds (64 percent) of responses from clinical and biomedical engineers indicate reliance on some form of manual room-to-room audit or use of static database to inventory the connected devices in their organization. Just 21 percent of responses say their devices receive preventative maintenance based on device usage as opposed to some kind of fixed schedule.

The survey also shows that more than half (55 percent) of responses indicate clinical/biomedical engineers must walk over to the device or call others to check on their behalf whether a device is in-use before scheduling repairs. Many make the trip only to find out that the device is in-use by patients and must try again in the future hoping for better luck, according to the survey.

“Despite the recent progress of the healthcare industry, the survey exemplifies the continued disconnect between perception of security and the actual device protection available from legacy solutions and processes. Unfortunately, much of the current perception stems from the use of traditional solutions, processes and general confusion in the market,” Xu Zou, CEO and co-founder of Zingbox, said in a statement. “Only by adopting the latest IoT technology and revisiting decade-old processes, can healthcare providers be well prepared when the next WannaCry hits.”

 

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