Information technology leaders at patient care 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.
As healthcare organization leaders across the country look to ramp up their cybersecurity strategies and implementations, chief information security officers (CISOs) are becoming part of the bigger picture. As Healthcare Informatics Managing Editor Rajiv Leventhal reported back in April, 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. 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.
Mac McMillan, chairman, CEO and co-founder of CynergisTek, an Austin, Texas-based information security and privacy consulting firm focused on the healthcare IT industry, spoke with Healthcare Informatics Associate Editor Heather Landi about the evolving role of the healthcare CISO and the skills and expertise that every CISO should have to be effective, and why that goes beyond just technical expertise in security. Below are excerpts from that interview, edited for length.
How do you see the CISO role in healthcare organizations evolving?
The CISO is an interesting role because, to do it effectively and be successfully, you have to be one part technologist, one part business leader and one part psychologist, in a sense. What I mean by that is that the CISO has to understand the technology and the threats well enough to understand what the organization needs to do to protect its system, operations and its information. But, they also have to be able to translate that into business jargon; they have to be able to speak the language of the business. They should be a business leader because the organizations are not going to spend money on security if they don’t see how it fits into the strategic plan of the business and don’t see how it contributes to the business being successful. You’ve got to be able to go in and say ‘Look, there’s a reason why we need to invest in security and we need to invest in this technology or invest in these people or invest in this service or this process and it’s because it’s going to be make our business more resilient, it’s going to make our business more capable and it’s going to ensure that our business can continue to operate and avoid those risks that are affect our ability to deliver our primary mission in terms of care and earn revenue.’ And at the same time, when I say part psychologist, they should be able to learn how to navigate a senior staff and other business leaders who have their own priorities and their own objectives that they are trying to accomplish and figure out how best to interact and work with those people. You need to be able to motivate these senior leaders as well as the workforce, in general, to just be more aware and more open to the idea of doing things differently as it relates to being more safe or secure in their practices and systems. It’s not just a technologist’s role anymore. It’s not just the smart IT engineer who knows something about security, that’s not going to cut it; you need somebody who is a business leader.
Mac McMillan
Are you seeing changes in the reporting structure with the CISO reporting outside of IT?
We see that in some organizations; we haven’t seen it in a wholesale fashion. I wonder where we have to get to before that happens. Quite frankly, I’m not a huge proponent one way or the other, as long as the CISO is visible and has a reporting chain up through whatever the IT governance process is for security through the audit committee or the board; as long as there is visibility and that person’s voice is not muffled, and they get support, then it can work no matter where they are. But in most organizations, many of the CISOs I talk to around the country say they are still challenged by the fact that they do report within IT, and they do have to compete with the rest of the IT budget. They say that they don’t have a budget of their own, per se, which is something I think organizations should do—they should break their security budget out and understand what their security spend is and understand what that means to the organization.
I came out of an environment in the government, and, as a director of security, I reported to the director of the agency; I didn’t report to IT. The CIO and I were peers, and we had to work together to get the mission done. I personally think that is the best approach. I think we’re at a point now where people should be asking the question, ‘Does the CISO belong in IT, or should they have a separate reporting chain?’ It’s still isn’t happening, in a wholesale fashion. Generally, it’s only in the largest organizations where we see the CISO begin to move out and report up through compliance or some other organization.
You mentioned that the CISO should have business acumen as well. Are you seeing the need to create an alignment between security and the business of the organization?
In some organizations, we absolutely are beginning to see CISOs who are realizing that their job is to be part of the business, not just part of security or IT. And those CISOs are getting out there and are beginning to work with their counterparts and their peers in the organization and recognizing that managing risk is understanding how the workforce is interacting with systems and using systems and what their workflows look like and where those risks really are. And the CISOs that are doing that are being the most effective.
For patient care organizations looking to fill the CISO position, what skills and expertise should they be looking for?
They should be looking for individuals who understand the basic concepts of business planning; they should be looking for folks who understand how to manage a budget; they should be looking for individuals who understand how to manage people; they should look for people who have good skills in writing and communicating orally, because a lot of what you do as a CISO is educating the organization on why it’s important for them to pay attention to the things that they need to pay attention to. There are a lot of skills that are, quite frankly, akin to a business leader that the CISO needs to add to their bag of tricks. They should be looking at individuals with X number of years of experience in managing security with the appropriate certification. Once that individual has learned the technology and once they’ve learned the basics of cybersecurity, they also need to develop those business skills.
There currently is a cybersecurity skills gap in the healthcare industry, right? What can healthcare organizations do to recruit qualified candidates?
There is absolutely way more demand than there is adequate supply. Now that organizations are actively looking for people with these skillsets, and organizations are beginning to understand what that means in terms of what kinds of qualifications these individuals need to have, they are beginning to realize that a lot of people out there are calling themselves CISOs, or calling themselves security people, but they don’t measure up. It’s like anything else; whenever there is a situation that we have now, where you’ve got way more opportunity than you have people, then you going to have a lot of people who are going to try to get into that field. Healthcare organizations need to carefully vet those candidates to make sure you’re getting somebody who is really qualified for that job and not just somebody who’s been in IT for the last 15 years and is looking for a way to move their career along.
I think you’d find that less than 50 percent of healthcare organizations with a true CISO. We still have a lot of organizations with people who are wearing that title as a secondary duty or they are wearing that title and they really don’t have any experience in that role. We see this all the time, where they hire somebody or they move somebody over from IT and name them a CISO, that doesn’t mean that they are a legitimate CISO.
Healthcare organizations can use a qualified recruitment source to help them. Or, if they are going to recruit themselves, then the organization leaders can ask somebody to assist them, such as a security vendor that they already work with, or an outside vendor, to help them look at candidates, look at resumes and review their qualifications.
Are there challenges with healthcare organizations offering competitive compensation in order to recruit and retain qualified CISOs?
That’s a huge challenge right now. This is not an area that healthcare has a lot of experience at recruiting in. Because of the supply and demand situation that we’re in right now and because of the additional certifications and experience that individuals need to have to be truly qualified CISOs, they tend to attract a higher dollar from a compensation perspective. Right now, anybody has the qualification is very mobile; there is a lot of opportunities for individuals with the right skill sets and the right experience. Healthcare organizations have a hard time recruiting them and retaining them because they haven’t accepted the fact that they will have to pay these people more than a regular IT person. The industry is going to have to recognize that this is an advanced skillset that these individuals have. This is somebody who has gone above and beyond the typical IT training and developed these additional skills around cybersecurity. They are very valuable and you’re going to have to pay more for them.
I think, eventually, what we’re going to see is more of an outsourced model, or a service model, around security because we just don’t have enough professionals in this space to fill every job that is out there.
