In an Ever-Intensifying Threat Environment, Healthcare CISOs Become Part of the Bigger Picture | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

In an Ever-Intensifying Threat Environment, Healthcare CISOs Become Part of the Bigger Picture

April 19, 2017
by Rajiv Leventhal
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Establishing a culture of security is critically important in healthcare organizations. As such, the CISO is now becoming a senior executive-level position

One of the most significant points of discussion currently taking place in the healthcare sector is how patient care organization leaders are responding and reacting to the growing cybersecurity threat throughout the industry. Indeed, one quick look at the monthly Protenus “Breach Barometer” report— a snapshot of reported or disclosed breaches impacting the healthcare industry, with data compiled and provided by DataBreaches.net—reveals that the trend of cyber attacks in healthcare is certainly not slowing down; in March, the number of breached records was 2.5 times the number of records breached in January and February combined.

The level of sophistication at which healthcare organizations are responding to this problem varies across the U.S., but there does seem to still be a gap in funds allocated to data security. For instance, a HIMSS Analytics and Symantec study released in February found that even though cybersecurity budgets are increasing, 65 percent of surveyed healthcare organizations are still spending less than 6 percent of funds on security. What’s more, those survey findings indicate that the majority of healthcare organizations still have five or fewer employees allocated to IT security, although two-thirds of participating organizations do have a chief information security officer (CISO), which most often report to the CIO.

Indeed, CISOs within healthcare organizations—not too long ago a position with a limited role—have now become a part of the broader senior leadership team, experts say. Nick Giannas, consultant in search firm Witt/Kieffer’s IT practice, and who specializes in executive searches for CISOs in healthcare and education specifically, notes that “There needs to be an executive to oversee security across all of the organization’s business areas and to encourage a culture of information security.”

He adds that organizations are looking for someone who can build that culture, someone who is a strong communicator, and someone who not only has the cybersecurity expertise, but also the business acumen. “You need to have better alignment between cybersecurity and the business so it doesn’t hinder operations,” Giannas says. “All of this together requires a senior executive; it’s an executive level position, so it’s about having those soft skills such as being able to build a relationship, communicate effectively, and translating those cybersecurity concepts in a way that business leaders can understand. The [CISO] has become a trusted advisor,” he says.

However, while the CISO role is clearly now evolving, Giannas does note that there is an industry-wide gap in terms of skilled candidates. “The demand for qualified CISOs far exceeds the supply of top talent for these positions,” he says. And, he adds, “There is a need to expand and look beyond healthcare to find top talent in other industries who can make a difference and who might be coming from much more secure information security environments. Now that’s not to say that there are not strong individuals in this space in healthcare—because there are—but there are just not enough.”

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Throughout his searches, Giannas does find that organizations are now truly realizing the need for a talented executive leading their information security program. And beyond recognizing and recruiting that top talent, there are also other factors to consider in the hiring process, such as compensation and the actual commitment that an organization will make in terms of dollars to information security. “Gaps do remain in [budget allocation for information security], but if you look at the reports out there, with the threats continuing to evolve, we’re starting to pour more money into cybersecurity. Regarding data breaches, it’s not a matter of if, but when. So making sure you have the right tools and programs in place is important,” he says.

Certainly, these are responsibilities that fall on the CISO, and Giannas says that the forward-thinking provider organizations are starting to deploy advanced technologies such as machine learning intelligence software and predictive analytics to help protect their environments. He notes that the commitment and investment that C-suite leaders are now making in security are actually better than what many people think. “If not for organizations dedicating the resources that they are righty now, we could really be much worse off. And that’s not to say that they aren’t still behind, because they are, but the commitment is starting to pay off,” he says, adding that the pressure is on both CIOs and CISOs to look at new tools in this space. “You hear CIOs saying that cybersecurity is both the first and second thing on the list that keeps them up at night. So it really helps when you have a strong CISO in place that you can rely on. I think there is inherent pressure involved with this position, and the talented CISOs out there are really up to that challenge,” he says.

While Giannas says that in most places, the CISO is reporting to the CIO—a trend that’s in line with what the above-mentioned HIMSS Analytics survey reported—he is hearing organizations talk about moving the reporting structure to someone outside of the IT part of the organization. “I think just as cybersecurity incidences and threats evolve, thus forcing cybersecurity programs to evolve, the CISO position will also evolve. It’s an enterprise function, so you could see a trend in the future that the position will not be reporting into IT. That makes logical sense; it’s the evolution of the position. But that isn’t happening yet,” he says.

As the CISO position indeed continues to grow, a key to that evolution will be how the person in this role establishes a culture of security within the patient care environment. Adam Tallinger, vice president at consulting firm Impact Advisors, says that creating a culture of security carries equal weight to everything else that an organization dedicates culture to. He says, “If you have a culture where someone feels comfortable to reporting some [wrongdoing] or a breach in security, then you will be able to mitigate that, and restrict access to that data a lot quicker than if you have someone who tries to ignore it. Bad news never gets better with age,” Tallinger says.

In the end, just like with anything else in healthcare IT, some organizations are further along than others, so CISOs being able to create a culture of security “is an ongoing process,” Giannas says. “It’s not just about IT, and it’s not just about the information security departments. It’s about everyone playing a role across the organization, at all levels. All CISOs, even in mature environments, would say that they’re still continuing to grow in the area of establishing the right culture.”


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Assessing the New Cybersecurity Practices Publication: Why Small and Medium-Sized Care Organizations Have Reason to Rejoice

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A new set of voluntary cybersecurity practices just released by HHS offers practical advice and conceptual supports that fill information gaps
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How helpful will the new set of voluntary cybersecurity practices that the Department of Health and Human Services (HHS) released in late December, be, to the leaders of patient care organizations? Only time will tell, as part of the value of the release will only be made manifest as the leaders of patient care organizations move forward to implement some of those practices, and the potential success of such implementations is in some way measured and benchmarked.

But the release is a first start, at least. As Healthcare Informatics Associate Editor Heather Landi reported on January 2, HHS released the set of practices in the form of a publication “that marks the culmination of a two-year effort that brought together over 150 cybersecurity and healthcare experts from industry and the government under the Healthcare and Public Health (HPH) Sector Critical Infrastructure Security and Resilience Public-Private Partnership.”

“Cybersecurity is everyone’s responsibility. It is the responsibility of every organization working in healthcare and public health.  In all of our efforts, we must recognize and leverage the value of partnerships among government and industry stakeholders to tackle the shared problems collaboratively,” Janet Vogel, HHS Acting Chief Information Security Officer (CISO), said in a statement published with the release of the new publication.

Health Industry Cybersecurity Practices: Managing Threats and Protecting Patients (HICP), the primary publication of the Cybersecurity Act of 2015, Section 405(d) Task Group, aims to raise awareness, provide vetted cybersecurity practices, and move organizations towards consistency in mitigating the current most pertinent cybersecurity threats to the sector,” HHS officials stated. “It seeks to aid healthcare and public health organizations to develop meaningful cybersecurity objectives and outcomes. The publication includes a main document, two technical volumes, and resources and templates.”

The overall publication consists of several sections, the first being the HICP, which “examines cybersecurity threats and vulnerabilities that affect the healthcare industry. It explores five current threats and presents 10 practices to mitigate those threats; “Technical Volume 1: Cybersecurity Practices for Small Health Care Organizations,” which offers cybersecurity practices for small healthcare organizations; “Technical Volume 2: Cybersecurity Practices for Medium and Large Health Care Organizations”; the “Resources and Templates” portion, which “includes a variety of cybersecurity resources and templates for end users to reference”; and a Cybersecurity Practices Assessments Toolkit, which “helps organizations prioritize their cyber threats and develop their own action plans using the assessment methodology outlined in the Resources and Templates volume”—that last section being still under development as of Jan. 2.

As Landi reported, “The HICP publication aims to provide cybersecurity practices for this vast, diverse, and open sector to ultimately improve the security and safety of patients. The main document of the publication explores the five most relevant and current threats to the industry. It also recommends 10 cybersecurity practices to help mitigate these threats.”

What’s more, she wrote, “The main document presents real-life events and statistics that demonstrate the financial and patient care impacts of cyber incidents.  It also lays out a call to action for all industry stakeholders, from C-suite executives and healthcare practitioners to IT security professionals, that protective and preventive measures must be taken now. The publication also includes two technical volumes geared for IT and IT security professionals, one focusing on cybersecurity practices for small healthcare organizations, and one focused on practices for medium and large healthcare organizations.”

Among the salient statistics reported in the HICP:

  • Fifty-eight percent of malware attack victims are small businesses.
  • In 2017, cyber-attacks cost small and medium-sized businesses an average of $2.2 million.
  • Sixty of small businesses go out of business within six months of an attack.
  • And, 90 percent of small businesses do not use any data protection at all for company and customer information.

How does that translate into impacts on smaller healthcare organizations? Among other incidents, the HICP notes that:

  • A popular orthopedic practice announced that its computer system was hacked via breach of a software vendor’s log-in credentials. This breach put just under a half-million people at risk of identity theft. Of those, 500 patient profiles appeared for sale on the dark web. The information for sale included names, addresses, social security numbers, and other personally identifiable information (PII). Although not posted for sale, pertinent PHI such as X-ray results and medical diagnoses were also stolen.

 

  • A rural hospital had to replace its entire computer network after a ransomware cyber-attack froze the hospital’s electronic health record (EHR) system. Doctors were unable to review their patients’ medical histories or transmit laboratory and pharmacy orders. Officials were unable to restore essential services and could not pay the ransom for the return of their system. After consultations with the Federal Bureau of Investigation and cybersecurity experts, hospital officials made the difficult decision to replace the entire system.
  •  

Of particular practicality is some of the very basic advice given to the leaders of smaller healthcare organizations. To wit: “Doctors and nurses know that hand sanitizing is critical to prevent the spread of germs. That does not mean health care workers wash up as often as they should. Similarly, we know that cybersecurity practices reduce the risk of cyber-attacks and data breaches. Just as we are able to protect our patients from infection, we should all work towards protecting patient data to allow physicians and caregivers to trust the data and systems that enable quality health care. Just as health care professionals must wash their hands before caring for patients, health care organizations must practice good ‘cyber hygiene’ in today’s digital world, including it as a part of daily universal precautions,” the HICP notes. “Like the simple act of hand-washing, a culture of cyber-awareness does not have to be complicated or expensive for a small organization. It must simply be effective at enabling organization members to protect information that is critical to the organization’s patients and operations. Your organization’s vigilance against cyber-attacks will increase concurrently with your and your workforce’s knowledge of cybersecurity. This knowledge will enable you to advance to the next series of cybersecurity Practices, expanding your organization’s awareness of and ability to thwart cyber threats.”

Meanwhile, both smaller and larger patient care organizations will benefit from the technical supports, including a Security Risk Assessment Tool, a set of recommendations on medical devices and cybersecurity, and an incident response risk management handbook.

What this set of resources does is to fill a gap between theory and technical practice in a key area. Will it shift the entire landscape of cybersecurity for patient care organizations? No, that would be a far-too-ambitious goal. But the healthcare IT leaders of smaller and medium-sized patient care organizations in particular, will welcome practice advice and supports, as they move forward in their journeys around cybersecurity. Any such journey is inherently challenging, and federal publications and resources like these will be of real value in moving patient care organization HIT leaders forward.

 

 

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HHS Releases Voluntary Healthcare Cybersecurity Practices

January 2, 2019
by Heather Landi, Associate Editor
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In late December, the Department of Health and Human Services (HHS) released voluntary cybersecurity practices to the healthcare industry with the aim of providing practice guidelines to cost-effectively reduce cybersecurity risks.

The “Health Industry Cybersecurity Practices (HICP): Managing Threats and Protecting Patients” publication aims to provide guidance to healthcare organizations of all types and sizes, ranging from local clinics to large hospital systems.

The industry-led effort was in response to a mandate set forth by the Cybersecurity Act of 2015 Section 405(d), to develop practical cybersecurity guidelines to cost-effectively reduce cybersecurity risks for the healthcare industry.

According to HHS, the publication marks the culmination of a two-year effort that brought together over 150 cybersecurity and healthcare experts from industry and the government under the Healthcare and Public Health (HPH) Sector Critical Infrastructure Security and Resilience Public-Private Partnership.

“Cybersecurity is everyone’s responsibility. It is the responsibility of every organization working in healthcare and public health.  In all of our efforts, we must recognize and leverage the value of partnerships among government and industry stakeholders to tackle the shared problems collaboratively,” Janet Vogel, HHS Acting Chief Information Security Officer (CISO), said in a statement.

While technologies are vital to the healthcare industry and help provide life-saving treatments and improve patient care, these same technologies are vulnerable to myriad attacks from adversaries, ranging from criminals and hacktivists to nation-states, according to HHS. These technologies can be exploited to gain access to personal patient data or render entire hospital systems inoperable. Recent cyber-attacks against the nation’s healthcare industry continue to highlight the importance of ensuring these technologies are safe and secure.

“The healthcare industry is truly a varied digital ecosystem. We heard loud and clear through this process that providers need actionable and practical advice, tailored to their needs, to manage modern cyber threats. That is exactly what this resource delivers; recommendations stratified by the size of the organization, written for both the clinician as well as the IT subject matter expert,” Erik Decker, industry co-lead and Chief Information Security and Privacy Officer for the University of Chicago Medicine, said in a statement.

The HICP publication aims to provide cybersecurity practices for this vast, diverse, and open sector to ultimately improve the security and safety of patients. The main document of the publication explores the five most relevant and current threats to the industry. It also recommends 10 cybersecurity practices to help mitigate these threats.

The main document presents real-life events and statistics that demonstrate the financial and patient care impacts of cyber incidents.  It also lays out a call to action for all industry stakeholders, from C-suite executives and healthcare practitioners to IT security professionals, that protective and preventive measures must be taken now. The publication also includes two technical volumes geared for IT and IT security professionals, one focusing on cybersecurity practices for small healthcare organizations, and one focused on practices for medium and large healthcare organizations.

 

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CynergisTek, Protenus Partner on Privacy Monitoring Programs

December 26, 2018
by Heather Landi, Associate Editor
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CynergisTek, Inc., an Austin, Texas-based healthcare cybersecurity firm, is partnering with Protenus, a healthcare compliance analytics company, to combine the companies’ technology tools and services with a focus on patient privacy monitoring programs.

The partnership will grant health systems access to Protenus’ analytics platform that leverages artificial intelligence to gather data related to potential patient privacy risks, along with CynergisTek’s patient privacy monitoring services.

According to the Protenus research, insider incidents accounted for 23 percent of all breaches that occurred at health systems in Q3 2018. This figure will only continue increasing, indicating that now more than ever, health systems need a cost-effective solution to meet the daily challenges of managing patient privacy.

To address this need, CynergisTek and Protenus formed a preferred partnership to combine CynergisTek’s healthcare consulting experience and privacy programs with Protenus’ healthcare analytics technology to offer health systems both the people, processes, and technology components of a strong patient privacy monitoring program, according to the companies.

“As health systems face mounting challenges in creating and maintaining robust patient privacy monitoring programs, we identified a need to partner with a company offering complementary services so that health systems can act on the insights uncovered by our analytics,” Nick Culbertson, CEO and co-founder of Protenus, said in a statement.

 “Data privacy is evolving as a dominate theme in conversations, both in healthcare and other industries, and health systems need to take an end-to-end approach to patient privacy to truly address this complex and mission-critical challenge,” Mac McMillan, CEO and president of CynergisTek, said in a statement.

 

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