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One Healthcare CISO’s View: CISOs Need to be True Business Partners

January 9, 2018
by Heather Landi
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Healthcare organizations are facing an evolving cybersecurity threat landscape, with accelerating threats in the wake of recent, massive attacks on organizations worldwide. The need for stronger cybersecurity is now on most healthcare organizations’ radars, more so than even just a few years ago.

Chief information security officers (CISOs) at patient care organizations face complex and challenging issues with respect to information security, including rapidly evolving mal­ware threats, insider data breaches and the increasing use of medical Internet of Things (IoT) devices across their organizations.

At the same time, while the CISO position requires technical expertise in security, the role continues to evolve as healthcare CISOs have now become a part of the broader senior leadership team. Top healthcare security leaders from across the country will explore many of these topics at Healthcare Informatics’ San Diego Health IT Summit on Feb. 1-2. Brian Kreitzer, CISO, information services and solutions at UCLA Health, leads cybersecurity strategy at the four-hospital, 2,000-physician integrated health system in Los Angeles. Kreitzer recently spoke with Healthcare Informatics’ Associate Editor Heather Landi about the evolving role of the CISO, the challenge of strengthening legacy systems and the security threats he is most concerned about. Below are excerpts from that interview.

Legacy systems, from electronic health records to billing platforms, can pose a security risk. What is your perspective on strengthening legacy systems?

My thoughts are to get rid of them. I say that jokingly, but there is some truth to that as well. It’s not necessarily getting rid of them, but getting rid of them in their current state. If they are old enough to where they have security vulnerabilities, an organization needs to ensure that they have proper planning to be able to upgrade those systems, so that they can still make use of those feature and functionalities in a more secure way. So, typically that means upgrading both the infrastructure and application, because the application may rely on older versions of other third-party software, like JAVA as an example of one that is always vulnerable. The way that access management is handled is another possible security vulnerability in legacy applications and whether they can integrate well with some of the latest and greatest security best practices in that space, such as multi-factor authentication.

How would you describe the state of healthcare cybersecurity right now?

We are making progress as an industry from what I’m seeing, but there is still a long way to go and we’re still not where we need to be from a straight security perspective. But if you’re taking a risk-based approach then there are certainly some arguments that could be made that perhaps we are where we need to be because the more security controls you put in place then the less likely it is that you do get breached. And, it’s about trying to figure out what is that percentage and what is that real estimated value there, which nobody can do, and that’s the problem. Nobody knows what that expected value is so we keep addressing what we consider high and critical and hopefully some medium vulnerabilities and threats. I think we’re making progress, and we’re much more secure as an industry than we were probably 12 months ago.

Within the healthcare industry, are you seeing more engagement and support for cybersecurity strategies from senior executive and board-level leaders?

It seems like that is very company-dependent on the level of exposure and influence or engagement of boards and/or senior leadership. I’ve seen some organizations take a more check-the-box, compliance approach. But, others may have the CISO reporting directly to the CEO. And so, to me, the reporting structure definitely goes a long way and says a lot about how seriously a company is taking security.

How do you see the reporting structure impacting an organization’s security strategy?

It really depends, partly, on the level of engagement and the knowledge of those people in those reporting relationships. What I mean by that is I, personally, think it’s okay for the CISO to report into the CIO, but only if the CIO has a good understanding of risk and finances and the rest of the business to be able to measure that and make those risk-based decisions. If the CIO is strictly technical, then that might not the best place for a CISO and maybe they should be more on the risk side of the house, or even under the CFO. Obviously, if you are trying to drive change, then the higher in the organization you put that person, the more influence they can have around driving that change. If you’re organization is in a spot where you need a change agent to come in and shake things up a little bit, then reporting to the CEO, or maybe even directly to the board, might be the way to go.

How is the role of the CISO evolving?


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