Cybersecurity threats continue to grow by the day in U.S. healthcare, alarming patient care organization leaders, and compelling healthcare IT leaders to step up their cybersecurity efforts. That subject, the mushrooming of cyber threats, was top of mind on Thursday in San Jose, California, during a panel discussion on the topic at the Health IT Summit in San Jose, being held at the Westin San Jose in downtown San Jose.
The discussion, under the title “A Deeper Dive: Understanding and Preventing the Next Generation of Cyber Threats,” was moderated by Tom Andriola, vice president and CIO of the University of California Health. He was joined by Rao Mikkilineni, Ph.D., a professor of IT security at Golden Gate University; Ari Entin, CIO at Natividad Medical Center; M.K. Palmore, an assistant agent in charge in the San Francisco field office of the FBI; and Rich Campagna, senior vice president of products and marketing at Bitglass.
Early on in the discussion, in explaining why the healthcare industry has become the most targeted of U.S. industries, Mikkilineni noted that “The biggest threat has shifted away from the financial services industry to healthcare, as credit cards have become more secure, and as the internal landscape in healthcare has shifted and become much more difficult to secure.”
panelists (l. to r.) Entin, Palmore, Campagna,
Mikkilineni, and Andriola, at the HIT Summit
“Banks say the biggest area of vulnerability for them is working with affiliate banks and other partners,” Andriola said. “We talk about the healthcare world and interoperability; we haven’t built the walls and responses that financial services has,” which could better secure our data.
“We’ve had high-profile attacks on us,” Andriola said, noting the large number of hacks of healthcare organizations in the past couple of years. “What does this look like from your perspective?” he asked FBI agent Palmore. “Rao talked about an expansion of threats,” Palmore said. “There are new technologies being developed to make patients’ lives better, but the attack surface is expanding to increased vulnerabilities. And to cyber-criminals, these vulnerabilities become something that they spend quite a bit of time and effort on,” he said.
“I go to a lot of conferences like this,” Palmore continued, “and we spend a lot of time talking about the technology piece and very little time talking about the human piece of this. I will tell you that in 20 years of law enforcement, I have never seen criminals more diligent than cyber-criminals. They are very diligent, and very good at what they do. They’ve figured out how to hack and how to quickly monetize things via the dark web; they’ve created an ecosystem via the dark web. Criminal enterprises used to be man-made and man-operated systems. Now, criminal enterprises span the globe. The actors typically don’t know each other and have never met face to face; they’ve figured out how to interact and pay each other, typically through the use of digital currencies. But the ecosystem they’ve developed, quite frankly, is one that law enforcement has not developed an effective response for.”
In that context, Palmore said, “It’s not uncommon for a cybercriminal to very effectively monetize. The other threat you guys have to worry about, frankly, is nation-states. Nation-state actors have figured out how to exploit your information systems, get access to data, and use it. And so as you’re building these new technologies and exploring new ways to bring new benefits to your patients and certainly to your staffs, you’d better have people to help you figure out how to secure your systems, because there’s someone out there working to” hack them.
What community hospital CIOs need to do
The incentives for cybercriminals to flock to attacking healthcare targets are simply too powerful to leave the healthcare industry unscathed, Entin emphasized. “When the pot at the end of the rainbow is like a swimming pool of gold for some of these ventures, the motivation is huge” for cybercriminals to take on the healthcare industry, he said. So understanding that you can’t completely protect yourself, is important,” he said. “Especially as a 172-bed county hospital, we can’t afford a huge team of experts,” he said. Instead, “We need to be able to evaluate risks and get really informed about how we can mitigate risks and control them, and to some extent, transfer your risks. There are certain things I can put in place to control my risks or reduce my footprint,” he said.
Importantly, Entin noted, the cybercriminals out there are “looking for that quick hit, sending you the phishing email that leads to encryption, while also ranging up to the more sophisticated attacks. I’ve seen them come in through email, and many are very carefully targeted,” he testified. “And they’re looking for easy targets. They’re looking for organizations that haven’t done all the security work they’ve needed to. We’re not Target or Anthem, we’re a community hospital,” he said. But, he added, “If you’re fully patched, they’re going to move on to easier targets. So for me, it’s about looking at those most common threat vectors, and making yourself secure enough.”
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