Will the “Good Guys” Ever Catch Up to the “Bad Guys” When It Comes to Cybercrime in Healthcare?

Feb. 7, 2017
A new, global, cross-industry survey on cybersecurity and cybercrime, produced by Thales e-Security and 451 Research, confirms that the issues are both international and trans-vertical—and menacing

Can the “good guys” ever catch up to the “bad guys” when it comes to data and IT security in healthcare? That most basic of questions seemed to hang over the results of a recent new report on data and IT security that spanned all industries and was international in scope.

As Assistant Editor Heather Landi reported in an article last week, “Eighty-one percent of senior IT security executives at healthcare organizations anticipate IT security spending increases in the next 12 months, yet, at the same time, successful data breaches are also up significantly. These were the findings of a recent survey conducted by Thales, a data security and information systems solutions provider, and in conjunction with 451 Research, which point to an ongoing disconnect between the security solutions organizations spend money on and the ability of those solutions to protect sensitive data.”

As Landi noted, “The report findings present a glass half-full or half-empty dilemma. The projected increase in IT security spending could potentially be good news for healthcare IT leaders dealing with budget constraints, however, the findings seem to indicate that organizations continue to focus their spending on strategies and tools that are not effectively preventing data breaches.”

Across all industries, the report found, 88 percent of business organizations feel vulnerable to data and IT security threats; 68 percent have experienced a data breach; and 73 percent have increased their spending in order to fight the scourge of breaches and hacking.

In addition, the Thales 2017 Data Threat Report, issued in conjunction with analyst firm 451 Research, found that, across all industries, business organizations are still prioritizing network and endpoint solutions over encryption despite the rise in data breaches. While 30 percent of respondents classify their organizations as “very vulnerable” or “extremely vulnerable” to data attacks (and the number of breaches continues to rise), the two top spending priorities are network (62 percent) and endpoint (56 percent) protection solutions. In contrast, spending on data-at-rest solutions (46 percent) comes last.

The press release announcing the report and the survey results on which it was based, included a statement from Garrett Bekker, senior analyst, information security, at 451 Research, and author of the report. “One possible explanation for this troubling state? Organizations keep spending on the same solutions that worked for them in the past but aren’t necessarily the most effective at stopping modern breaches,” Bekker said. “Data protection tactics need to evolve to match today’s threats. It stands to reason that if security strategies aren’t equally as dynamic in this fast-changing threat environment, the rate of breaches will continue to increase.”

What’s more, as Landi’s report last week noted, “Overall, 68 percent of survey respondents, across all industries, have experienced a breach with 26 percent experiencing a breach in the last year – both numbers that rose from last year. According to Andy Kicklighter, director of product strategy at Thales e-Security, within the healthcare segment, the number of organizations that reported having a breach in the past year increased from 18 percent to 20 percent. ‘So, that’s one in five who said they had been breached just in the last year,’ he said.”

Kicklighter also noted that the cybersecurity threat landscape continues to evolve and is becoming more sophisticated with the prevalence of spear phishing attacks combined with the availability of malware for use by cybercriminals. “Zero-day malware is not detectable with anti-virus, and you can buy it on a black market website for $4,000 or $5,000. So, if you are really determined, you are going to find a way to get credentials and get inside. If you don’t put in place technology that enables you to safeguard and control access to the sensitive data inside your organization, that’s a problem,” he noted.

A number of points are worth making here. Of course, it comes as no surprise that business organizations not only in the United States, but around the world, are being hit by malware and every other kind of cyberattack now. And the same is true in terms of these threats hitting all industries, not just healthcare. What’s more, organizations in many industries remain behind the curve, because the threats are indeed becoming more and more sophisticated, and in some cases simply different or new, every day, as Thales’s Andy Kicklighter has noted.

But healthcare remains particularly vulnerable in two very distinct contexts. First, it is still catching up to other industries such as the financial services, retailing, and transportation industries, in terms of building core data and IT security infrastructure, as well as in terms of core spending on, and staffing up for, data and IT security. So there’s that.

Second, because of the near-universalization of electronic health records (EHRs) that has occurred just in the past few years in U.S. healthcare, U.S. patient care organizations are now under unprecedented threat in terms of being potential and actual targets of malware, including ransomware, of every type. As has been noted frequently in recent months, the value of an individual’s credit card on the black market or on the street is probably only about $1.00 at this point, given that credit card companies and banks have put in very robust systems and processes to immediately shut off spending capability, and given that consumers have gotten very good at immediately notifying their banks and credit card companies of the theft or compromise of their bank and credit cards. But in healthcare, the situation is far more complex and compromised. For one thing, experts are finding that the average gap between the moment when ransomware enters a patient care organization, most often through a staff member’s opening a phishing-infected e-mail or clicking on a link, to when a clinical information system is completely encrypted and someone receives the ransom note, is around eight months. And a tremendous amount of damage can occur during that time.

What’s more, as experts are telling us, the value of a patient’s record in the U.S. averages at least $75.00, compared to the $1.00 value of a consumer’s credit card. That mostly has to do with the tremendous amount of demographic information embedded in a patient’s electronic record. Hacking someone’s EHR allows the hacker the opportunity to potentially construct a new, false identity, with all that demographic and other personal information. So is it any wonder that hospitals, medical groups, and health systems in the U.S. are collectively an enormously alluring target for data hackers from all over the world?

I remember just five or six years ago, when people were still worried about needing to shred the credit card offers they received in their junk mail loads in their home mailboxes (not that one shouldn’t still rip up those mailings into little pieces upon receipt, as a small precaution). That almost seems like a period of innocence now, relatively speaking.

In any case, back to the bigger picture: while on one level, it might perhaps be heartening to see that U.S. healthcare organizations are far from alone in their vulnerability to the cresting wave of data and IT security threats hitting them like a gigantic tsunami—this really is a global and all-industry phenomenon—on the other hand, the fact that U.S. healthcare leaders are coming to this from a position of having to rapidly catch up, is disconcerting, to say the least.

And, two more important points: first, as I mentioned above, healthcare is a uniquely alluring target to the hackers and cybercriminals, because of the monetary value of the data in EHRs and other clinical information systems, to the criminals. And second, and this is important: while there have been spectacular breaches in the past couple of years of health insurance companies, some of them involving millions of insureds, those large health insurers also have access to financial and organizational resources, simply because of their size and scope, that hospitals, medical groups, and health systems do not have. Even the largest patient care organizations in the U.S. are very small organizations compared to large (or even medium-sized) health plans. So there is a size differential there that works tremendously to the disadvantage of the healthcare IT leaders at patient care organizations, that simply can’t be discounted.

As Mac McMillan, CEO of the Austin, Texas-based CynergisTek consulting firm, emphasizes in all of his speeches and presentations, the stark reality is that CISOs, CIOs, and everyone else in healthcare IT will always be playing catch-up to some extent around these issues, because the moment that they, the good guys, begin to get a handle on an emerging or new threat, the bad guys, the cybercriminals, are already a few steps ahead of them.

So the short answer to the question I posed at the beginning of this blog—whether the “good guys” can ever catch up to the “bad guys”—is, put very simply and bluntly, no. That simply won’t be possible. But what will be possible, and must be attempted, is for healthcare IT leaders at patient care organizations to continue to build the processes, systems, and teams needed to be as up-to-date as humanly possible, going forward. That includes engaging in leading-edge data and IT security strategies, such as behavioral monitoring; advanced network segmentation and securitization processes; advanced backup and auditing processes; and, in many cases, the engagement of outside consulting firms, particularly of security operations centers (SOCs), to provide round-the-clock services at advanced levels of proficiency and capability.

I’ll be addressing these questions on Thursday, March 23, when I moderate a panel on the subject of “A Deeper Dive: Understanding the Next Generation of Cybersecurity Threats,” at our Health IT Summit in Cleveland, which will be held at the Ritz-Carlton in that city (the full agenda for our Cleveland Health IT Summit can be found here). I’ll have the honor and privilege to be surrounded by industry experts for that discussion, including FBI supervisory special agent Bryan P. Smith of the FBI’s Cleveland office; Pamela Banchy, CIO and vice president of clinical information at the Western Reserve Health System; Matthew Junod, CISO at the Unviersity of Toledo; and Karen Martinko, IT security manager at MetroHealthSystems. Those industry leaders will help our assembled Summit participants think through what the leading-edge strategies and options are in this area, and which ones healthcare IT leaders should be pursuing in their organizations.

So the reality is that this cybersecurity battle is going to be an unending war, going into the future. But the good news is that patient care organizations in the U.S. are beginning to catch up in terms of putting in the core foundations—in terms of funding, staffing, governance, and above all, strategy—in this area of essential importance to everyone. And that is significant—and worth noting.

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