It was very intriguing to read an op-ed article that appeared in InfoWorld in June. Written by Roger A. Grimes, under the headline “The days of long complicated passwords are over,” it brings up some of the most current thinking around password use and protection within organizations and information networks. Among other things, Grimes challenges his readers’ assumptions about the usefulness of passwords, or at least of passwords alone, as a protective mechanism for networks, saying that, while “Traditional password recommendations, as implemented by most companies, typically call for passwords at least eight to 12 characters long, complexity that includes at least three different character sets (letters, uppercase, lowercase, numbers, symbols, and so on), and the stipulation that passwords should be changed at least every 90 days,” the emerging reality is that password complexity, or lack of it, is no longer a significant issue, in his view. Instead, he notes that, “[O]ver the last decade, hackers have changed the way they attack passwords. Back in the day, most password attackers literally guessed at user’s passwords. They found an externally accessibly portal where they could guess using manual or automated methods -- or they found the password hash and used rainbow tables to convert passwords back to the plaintext equivalents.”
Indeed, Grimes tells the readers of InfoWorld, “Today, almost all password attacks are one of two types. Users are either socially engineered (phished) out of their password, or the attacker steals their hash and uses it during other authentication attempts. In both scenarios, long and complex passwords offer little protection. Yes, some attackers and malware still try to guess passwords, but they're now in the minority.” Instead, he says, “New password attack methods require new policies.”
Here is a summary of Grimes’s recommendations:
1. Keep passwords for end-users to 8 to 12 characters—requiring more inevitably leads to end-users coming up with passwords that are unnecessarily complicated and difficult to remember. In fact, he says, “You can add complexity requirements, but it doesn’t increase protection by much anymore.”
2. Further, he says, organizations should change their policies that require end-users to change their passwords an average of every 45 to 90 days, instead to spans of 120 to 180 days. Indeed, he says, “I’ve seen a few companies push forced password changes to one year without any increase in password hacking issues. That said,” he adds, “I still think highly privileged accounts should have their passwords changed very frequently, perhaps as often as once per day or once per use. It virtually assures you’ll need additional software to accomplish this, but since those accounts are the ones attackers target, it makes sense.”
3. On the other hand, Grimes urges his readers to establish a rule that the end-users in their organization cannot use the same password anywhere else—a requirement that he admits is essentially impossible to enforce. “This recommendation is huge—and hard to enforce,” he writes. “When you reuse passwords across security domains, websites, or various services, you increase your hacking risk exponentially. Many big, recent hacks have occurred due to password reuse.” Further, he adds, “Many companies even download (or subscribe to a commercial service that downloads) illegally obtained website password databases to see if their employees' passwords are located in them. If so, the employee gets a warning –and may even get fired.”
4. Finally, Grimes urges his IT executive readers to move towards multi-factorial authentication. “I’m particularly enthusiastic about the recommendation to implement risk-based, multifactor authentication challenges. It makes sense that higher-risk scenarios should require greater authentication assurance. For instance,” he says, “if you log into your email account from your normal computer from your normal location, it may even be OK to allow some sort of auto logon using a stored, simple password. But if you try to log on to the same email account from a new computer in a new country, you need stronger measures. Hotmail works this way for me right now: I use a simple password on my own computer at home, but if I log on to the same account from a new hotel, I need to enter a PIN sent via text to my phone. Microsoft’s risk-rating mechanism is even smart enough to recognize that I’m a frequent traveler, so I don’t get asked for the second-factor PIN all the time now -- only when I’m in high-risk areas or if I’ve traveled very far, very quickly from my last logon location.”
OK, so, per #3 above, I doubt that many CISOs at patient care organizations would—or should—subscribe to commercial services that scan password databases whose scans were illegally obtained, to see whether their staff members’ passwords are in them. But, setting that rather extreme thought aside, do Grimes’s recommendations make sense in healthcare?
Largely, yes. Now, one important thing to note is that the use of key fobs can be very problematic, given how mobile many healthcare professionals are, most particularly physicians, who may have privileges at several hospitals, and who may be scurrying in between multiple clinic sites as well. But, Grimes’s recommendations on shorter passwords, combined with “risk-based, multifactor authentication challenges,” makes a lot of sense. All of us as consumers are used to putting into a system a series of answers to questions, pieces of information that no one but family members or very close friends would know the answers to, such as mother’s maiden name, grandmother’s maiden name, father’s middle name, first pet’s name, name of elementary school, etc., etc. Those authentication challenge-based pieces of information, stored securely (and of course, that is another huge issue), could potentially help a lot, as physicians and other clinician end-users in particular, tire of having to make up long, complex passwords every month, in many different places.
Now, one important thing to keep in mind in all this is that healthcare is in many ways a unique industry—or at the very least, certainly an unusual one, compared to others. A bank teller, for example, will largely be working in one place 90 percent of the time; and even most people who work in manufacturing have only a small number of physical locations they need to log into. In contrast, physicians, nurses, and many other clinicians and healthcare professionals are almost constantly on the move, and as absolutely vital as data security is, the exceptional mobility of clinician end-users in particular always has to be kept in mind.
Also, given the hacking and other threats that are intensifying by the day in healthcare, there’s no question that all of these issues will continue to remain top-of-mind for CIOs, CISOs, CMIOs, and everyone else who bears any responsibility for helping to manage the immense complexity of data security management in healthcare, with the almost unique reality of end-users in our industry being nearly pervasive sources of security vulnerability.
In that regard, what about getting physicians, nurses, and other clinicians more involved in (relatively brief, discrete) discussions about password management? After all, clinicians are the ones most impacted, day to day, but whatever password rules, policies, and other norms are established and maintained in patient care organizations. And they so often feel oppressed by all the different log-in and identity management regimens that they’re asked to comply with. Now, obviously, very few physicians and other clinicians in practice are genuinely experts in identity management; even most CMIOs would acknowledge that they are not. But what could prove quite valuable, in my view, is to get a sense from clinicians, and especially from practicing physicians in any organization, what their biggest day-to-day challenges are with identity management, and to try to craft both a new or revised set of policies, as well as a new or revised set of identity management practices, around an understanding of those challenges.
And, given all the challenges facing healthcare IT leaders in the present operating environment, and all the changes to the current landscape that could emerge in the next few years, certainly, it would behoove the IT leaders at all patient care organizations to take a good, long look at their organizations’ identity management policies and practices, and work to refresh them both to enhance data and IT security in today’s operating environment as it evolves forward, and to make it easier for clinicians and other end-users to help support best practices in this area, understanding that the two concepts are not inherently opposed.
