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A Modern Villain

May 19, 2017
by John Nye, vice president, cybersecurity strategy, CynergisTek
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The threat that The Dark Overlord and the rest of the criminal world poses to modern healthcare organizations is as real as it gets

When one considers fiction about hackers, it is easy to see a typical villain lurking in the basement, threatening people and companies, and generally acting menacing. The Dark Overlord (TDO), for instance, has a name and mode of operating that sounds like something straight out of modern-day cyber thriller. TDO as one example has been getting a lot of press lately, mostly because TDO is stealing information people want to keep hidden and then, unlike other hackers, being very vocal about it. Recently this mysterious figure (or figures) even took yet-to-be-released episodes of a favorite show on Netflix and released them on the dark web.

Why Healthcare?

The previously mentioned antics had little to do with healthcare, except the patients and workers that wanted to watch “Orange is the New Black.” However, there is an impact from even this one incident that should have healthcare IT professionals paying attention. For one, this shows that TDO is not nearly as worried about making money as they are about calling out poor security practices and embarrassing their victims in the most public way they can.

The biggest and most obvious reason that healthcare IT professionals should pay attention are the most recent activities for which TDO is gaining recognition. Why? Because in mid-2016 TDO stole around 180,000 individual patient health records from several small healthcare providers. Almost immediately TDO contacted the hospitals and demanded a ransom if they wanted to protect their files. Because none of the affected organizations were willing to be extorted in this manner, TDO released these records to the public earlier this month.

Extortion for Data is the New Kidnapping

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No surprise, attackers are using extortion for financial gain and notoriety, and, unfortunately, the tactics seem to be working. Ransomware, which is just automated extortion, is on the rise year over year. Just this last weekend there was a major ransomware outbreak called WannaCry, which you can read more about here, here and here. If you look at the latest Internet Security Threat Report (ISTR) from Symantec, you will see that ransomware attacks increased 36% in 2016 in addition to the average ransom increasing from $294 in 2015 to $1,077 in 2016.

We see from the above statistics that ransomware infections are increasing at the same time as demands to decrypt the data are rising too. TDO has just taken this to a new level and is using a slightly different approach. Both attacks have similar results: a breach, public awareness of the offense, and a significant loss to the victim. The loss an organization suffers can come in the form of a monetary fine from a regulatory body (such as the Office for Civil Rights) for having a breach, loss of time and operational abilities, and reputational damage after the breach is identified and publicized.

What Can Healthcare Do?

These attacks are only possible because of human mistakes and poor security controls. If an organization wants to better protect themselves from extortion-based attacks, they need to do several things. All of the actions that will help mitigate the threat of these types of attacks are in the Center for Internet Security (CIS) top 20 critical controls. When an organization maintains a strong information security program and implements controls uniformly, they can markedly reduce the attacker's ability to be successful.

But, what about the human factor? People are the vector that most of these attacks use to gain control of an organization's sensitive data. Typically, ransomware or attacks like those carried out by TDO are initiated through social engineering. Meaning that someone in your organization fell for a scam, clicked a link, downloaded a file, or carried out some other insecure action that allowed the malicious code or attacker to access the target data. These issues are just further evidence that the current models of user awareness training are not as effective as they need to be.

Awareness Training

Implementing awareness training is a big job, bigger than any one organization. Fortunately, there are several consortiums out there working to improve the situation. SANS Institute has its Securing the Human program available, and it is widely regarded as the industry leading solution. The SANS program includes all the training, tools, and extensive guidance needed to support security awareness programs.

OWASP (the Open-Source Web Application Project) has started work on their user awareness training project as well as several projects for developers and security professionals. On the OWASP project portal there are several applicable projects such as the OWASP Security Shepard program for IT pros, and the OWASP Top 10 project that is key to awareness training for developers and web administrators.

In Conclusion

Despite the seemingly farcical nature of the recent actions of TDO, the threat this entity and the rest of the criminal world poses to modern healthcare organizations is as real as it gets. Ensuring that users are aware of risks and know how to act in a secure manner will take your organization a long way toward being safer. Also, making sure the necessary controls (CIS Top 20) are assessed and implemented will take security to an even greater level. Finally, it’s crucial to have a plan in case of an extortion demand, and have offline backups and a recovery plan in place so these criminals can’t easily take advantage of you and your organization.

John Nye has spent nearly a decade in information security which includes time with the U.S. Army, CSG International, Peter Kiewit and Sons, First Data Corp, and KPMG LLP before joining CynergisTek. John has been working exclusively as a professional penetration tester for the last four years and has presented at numerous local conferences for developers and other IT professionals.


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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.

 

Related Insights For: Cybersecurity

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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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