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Security Survey: 24 Percent of Physicians Fail to Identify Phishing Emails

February 5, 2018
by Heather Landi
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A recent survey found that doctors were three times worse at identifying phishing emails than their non-physician counterparts, such office workers (24 percent compared to 8 percent). What’s more, 8 in 10 healthcare employees aren’t prepared to protect against common privacy and security threats., according to a survey from MediaPro, a security awareness and compliance training company.

MediaPro released its Healthcare Industry Insights report on the state of privacy and security awareness in order to gauge the average healthcare employee’s knowledge of cybersecurity and data privacy best practices. For the report, MediaPro surveyed 1,009 healthcare employees.

Overall, 78 percent of healthcare employees showed at least some lack of preparedness (scoring “risks” or novices”) to handle the common privacy and security threat scenarios that were presented, compared to 70 percent of employees sampled across all industries, according to the report.

Within healthcare, 37 percent of employees fall into the “risk” category, meaning they could put their organizations at serious risk for a privacy or security incident, and 41 percent fall into the “novice” category, meaning they have a good understanding of the basics, but could stand to learn more. Less than one-fourth (22 percent) of healthcare employees overall scored in the “hero” category, meaning they showed a strong understanding of security and privacy best practices.

What’s more, 24 percent of physicians and other types of direct healthcare providers showed a lack of awareness toward phishing emails, compared with 8 percent of their non-provider counterparts, such as office workers. Half of physicians scored in the “risk” category, meaning their actions could put their organizations at serious threat of a privacy or security incident.

The survey also found that almost double the amount of healthcare employees (24 percent) had trouble identifying a handful of common signs of malware, compared with the respondents in the general population (12 percent) based on a previous, broader survey that MediaPro conducted.

The survey gauged healthcare employees’ awareness of specific threat vectors and how many employees chose incorrect or risky behaviors regarding those threat vectors. Looking at incident reporting, 23 percent of respondents failed to report a variety of potential security or privacy incidents, including unsecured personnel files and potentially malware-infected computers. What’s more, 21 percent of respondents failed to recognize some forms of personally identifiable information. The survey found that doctors and other care providers showed riskier behaviors in this category than did their non-physician counterparts.

With regard to physical security, 30 percent of respondents took unnecessary risks in scenarios related to allowing others access to their office buildings. Specifically, a quarter of respondents said they would simply hold their office door open for a maintenance worker asking for access rather than telling him to wait while his identify was confirmed.

Eighteen percent of employees identified phishing emails as legitimate ones, compared to only 8 percent of the general population. The most mis-identified email of the four examples presented was an email from a suspicious “from” address containing an image attachment, according to the survey. What’s more, as noted above, doctors were three times worse at identifying phishing emails than their non-physician counterparts (24 percent compared to 8 percent).

The survey also gauged employees’ ability to identify malware warnings signs and found that 23 percent of respondents failed to recognize common signs of a malware-infected computer, compared to only 12 percent of the general population. For example, 19 percent of employees failed to recognize that their internet browser repeatedly sending them to the same site, no matter which URL was entered, is likely a sign of malware.

And, almost a quarter (24 percent) of healthcare employees chose risky options when asked about mobile computing or working remotely. Specifically, 26 percent of respondents chose to log on to an unprotected, public Wi-Fi network to complete work tasks, despite the danger it presents. The survey also found that 18 percent of respondents chose risk actions when presented with scenarios involving storing company data or files on personal cloud-based storage or sending work documents via personal email.

Almost one-third of healthcare respondents (30 percent) said they’d take potentially risky actions related to their company on social media, such as re-posting a coworker’s inappropriate social post about a competitor.

The report writers concluded that beyond training geared toward HIPAA compliance, healthcare vemployees need a comprehensive approach to awareness education that includes security and privacy awareness.

“The results of our survey show that more work needs to be done in this regard.  HIPAA courses often do not include information on how to stay cyber-secure in an increasingly interconnected world. Keeping within HIPAA regulations, while vital, does not educate users on how to spot a phishing attack, for example. Additionally, mere compliance does not equate to a fully security-aware culture,” the report authors wrote, noting that multi-faceted and integrated awareness programs are needed to ensure the whole employee population knows the importance of sound security principles.

 

 

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Healthcare’s “RegTech” Opportunity: Avoiding a 2008-Style Crisis

September 21, 2018
by Robert Lord, Industry Voice, Co-Founder and President of Protenus
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In the financial crisis of 2007 to 2009, the financial industry suffered a crisis of trust. A decade later, banks and other financial institutions are still working to regain the confidence of consumers and regulators alike. In 2008 and 2009, while working at one of the world’s top hedge funds, I had a front-row seat to the damage that occurred to our economy, watching as storied corporate institutions fell or were gravely damaged. Today, as co-founder of a health technology company, I see healthcare is approaching a similarly dangerous situation. We must get ahead of the curve to avoid disaster.

Like finance, healthcare is a highly-regulated industry where non-compliance can result in severe financial and reputational consequences for healthcare companies, and severe impact on people’s lives. We deal with HIPAA, MACRA, HITECH, and hundreds of other foreboding acronyms on a daily basis. A lot of attention goes to the terrific and important work of clinical decision support, wellness apps, and other patient care technologies, but problems in the back office of hospitals must be addressed as well. One of these problems is the amount and complexity of healthcare regulation, and our healthcare system’s inability to keep up.

In finance, where I spent the early part of my career, the adoption of what is termed “RegTech” (regulatory technology) was driven by the increasing complexity of financial technology and infrastructure sophistication.  As trades moved faster, and as algorithms, processes and organizations became more complex, the technologies needed to ensure regulatory compliance had to move in tandem.  The crisis we experienced in 2008 was partially the result of the inability of the industry’s regulatory capabilities to keep up with the pace of technological change.  In many ways, the industry is still playing a catch-up game.

As healthcare professionals, looking to the lessons learned by our colleagues in finance can help us predict patterns and stay ahead of the curve. Right now, I’m seeing alarming parallels to challenges faced in finance a decade ago.

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Robert Lord

The burden of regulation across our industry is simply staggering.  Thirty-nine billion dollars of regulatory burden is associated with healthcare annually, which is about $1,200 per patient, per year. Despite this high cost, we still have $1 trillion of fraud, waste and abuse in our healthcare system. With so much regulation, why are we seeing so little yield from that burden? In many cases, it’s because we’re merely checking boxes and not addressing core risks؅. Like finance, there was a great deal of effort on compliance with regulations, but not enough attention on addressing important systemic risks.

This is not to say I am against good regulation; in fact, many regulations serve to protect patients and improve care. The problem is that there are so many demands on healthcare systems, that compliance and regulation is often reduced to checking boxes to ensure that minimum defensible processes are built, and occasionally spot-checking that things look reasonable. We currently have nowhere near 100 percent review of activities and transactions that are occurring in our health systems every day, though our patients deserve nothing less. However, unless overburdened and under-resourced healthcare providers and compliance professionals can achieve leverage and true risk reduction, we’ll never be able to sustainably bend our compliance cost curve.

Systemic problems are often not discovered until something goes horribly wrong (e.g., Wall Street every decade or so, the Anthem data breach, etc.). Today In the financial industry, RegTech provides continual, dynamic views of compliance or non-compliance and allows management, compliance professionals and regulators to check compliance in real-time. They can view every record, understand every detail, and automate investigations and processes that would otherwise go undetected or involve lengthy and labor-intensive reviews.

The real promise of these new capabilities is to allow compliance professionals and regulators to perform the truest form of their jobs, which is to keep patient data secure, ensuring the best treatment for patients, and creating sustainable financial models for healthcare delivery. RegTech will open up lines of communication and help create conversations that could never have been had before—conversations about what’s not just feasible for a person to do, but what’s right to do for the people whom regulation seeks to protect.

No longer bound by limited resources that lead to “box-checking,” compliance officers can use new and powerful tools to ensure that the data entrusted to them is protected. At the same time, healthcare management executives can be confident that the enterprises they manage will be well served by risk reducing technological innovation.  Patients, the ultimate beneficiaries of healthcare RegTech, deserve as much.

Robert Lord is the co-founder and president of Protenus, a compliance analytics platform that detects anomalous behavior in health systems.  He also serves as a Cybersecurity Policy Fellow at New America.

 


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HIPAA Settlements: Three Boston Hospitals Pay $1M in Fines for “Boston Trauma” Filming

September 20, 2018
by Heather Landi, Associate Editor
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Three Boston hospitals that allowed film crews to film an ABC documentary on premises have settled with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) over potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.

According to OCR, the three hospitals—Boston Medical Center (BMC), Brigham and Women’s Hospital (BWH) and Massachusetts General Hospital (MGH)—compromised the privacy of patients’ protected health information (PHI) by inviting film crews on premises to film "Save My Life: Boston Trauma," an ABC television network documentary series, without first obtaining authorization from patients.

OCR reached separate settlements with the three hospitals, and, collectively, the three entities paid OCR $999,000 to settle potential HIPAA violations due to the unauthorized disclosure of patients’ PHI.

“Patients in hospitals expect to encounter doctors and nurses when getting treatment, not film crews recording them at their most private and vulnerable moments,” Roger Severino, OCR director, said in a statement. “Hospitals must get authorization from patients before allowing strangers to have access to patients and their medical information.”

Of the total fines, BMC paid OCR $100,000, BWH paid $384,000, and MGH paid $515,000. Each entity will provide workforce training as part of a corrective action plan that will include OCR’s guidance on disclosures to film and media, according to OCR. Boston Medical Center's resolution agreement can be accessed here; Brigham and Women’s Hospital's resolution agreement can be found here; and Massachusetts General Hospital's agreement can be found here.

This is actually the second time a hospital has been fined by OCR as the result of allowing a film crew on premise to film a TV series, with the first HIPAA fine also involving the filming of an ABC medical documentary television series. As reported by Healthcare Informatics, In April 2016, New York Presbyterian Hospital (NYP) agreed to pay $2.2 million to settle potential HIPAA violations in association with the filming of “NY Med.”

According to OCR announcement about the settlement with NYP, the hospital, based in Manhattan, violated HIPAA rules for the “egregious disclosure of two patients’ PHI to film crews and staff during the filming of 'NY Med,' an ABC television series.” OCR also stated the NYP did not first obtain authorization from the patients. “In particular, OCR found that NYP allowed the ABC crew to film someone who was dying and another person in significant distress, even after a medical professional urged the crew to stop.”

The OCR director at the time, Jocelyn Samuels, said in a statement, “This case sends an important message that OCR will not permit covered entities to compromise their patients’ privacy by allowing news or television crews to film the patients without their authorization. We take seriously all complaints filed by individuals, and will seek the necessary remedies to ensure that patients’ privacy is fully protected.” 

OCR’s guidance on disclosures to film and media can be found here.

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Independence Blue Cross Notifies 17K Patients of Breach

September 19, 2018
by Rajiv Leventhal, Managing Editor
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The Philadelphia-based health insurer Independence Blue Cross is notifying about 17,000 of its members that some of their protected health information (PHI) has been exposed online and has potentially been accessed by unauthorized individuals.

According to an article in HIPAA Journal, Independence Blue Cross said that its privacy office was informed about the exposed information on July 19 and then immediately launched an investigation.

The insurer said that an employee had uploaded a file containing plan members’ protected health information to a public-facing website on April 23. The file remained accessible until July 20 when it was removed from the website.

According to the report, the information contained in the file was limited, and no financial information or Social Security numbers were exposed. Affected plan members only had their name, diagnosis codes, provider information, date of birth, and information used for processing claims exposed, HIPAA Journal reported.

The investigators were not able to determine whether any unauthorized individuals accessed the file during the time it was on the website, and no reports have been received to date to suggest any protected health information has been misused.

A statement from the health insurer noted that the breach affects certain Independence Blue Cross members and members of its subsidiaries AmeriHealth HMO and AmeriHealth Insurance Co. of New Jersey. Fewer than 1 percent of total plan members were affected by the breach.

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