The Cybersecurity and Infrastructure Security Agency (CISA), the Federal Bureau of Investigation (FBI), and the U.S. Department of Health and Human Services (HHS) have announced an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers.  
 
CISA, FBI, and HHS have released AA20-302A Ransomware Activity Targeting the Healthcare and Public Health Sector that details both the threat and practices that healthcare organizations should continuously engage in to help manage the risk posed by ransomware and other cyber threats. The advisory references the joint CISA MS-ISAC Ransomware Guide that provides a ransomware response checklist that can serve as a ransomware-specific addendum to organization cyber incident response plans. 

It has been noted that hackers are using Ryuk ransomware — malicious software used to encrypt data and keep it locked up — and the Trickbot network of infected computers to steal data, disrupt health care services and extort money from health care facilities. Such data hijacking often cripples online systems, forcing many to pay up to millions of dollars to restore their services.

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General cybersecurity guidance would suggest that Health IT breach should not be considered a matter of “if”, but rather a matter of “when”. How Health Centers prepare and respond to an episode of a breach is just as important as defending itself from the breach.

It is of critical importance to motivate and educate healthcare professionals on current critical privacy and security concepts and methods for defense of health data. Aspects of security awareness training, breach protection, incident response, and related topics all play a role toward organization-wide information protection. Healthcare cybersecurity is the ultimate team sport. The responsibility goes beyond the IT staff and includes front and back office staff, doctors and nurses, patients, executives, and the board of directors. The attached presentation is directed to all levels of the healthcare organization so that they may be proactive and aware.

The HIPAA Security Rule establishes the requirements for protection of electronic patient health information. The safeguards identified are made up of three domains that include administrative, physical, and technical safeguards that need to be addressed. The technical safeguards as defined within 45 CFR §164.312 of the HIPAA Security Rule can be some of the most difficult to comprehend and implement for smaller Health Centers with lower levels of IT and security staffing. Resources and tools that help Health Centers better process and implement these security requirements are much needed and require well-documented methods for planning and maintaining critical security controls.

Since 2010, the healthcare industry has seen a remarkable increase in the use of technology in the administration and delivery in healthcare. This has led to a mass migration of data from paper charts and isolated systems to Electronic Medical Records (EMRs) and interconnected systems that transmit patient health and financial information across trusted and untrusted networks. While this has been a boon for the industry in its ability to provide timely information to those who need it the most, this transition has introduced a great deal of risk to the confidentiality and integrity of the information. Coupled with the fact that the information can be quickly monetized by criminals through insurance fraud and identity theft, the ecosystem is target-rich.

Data breaches in healthcare are consistently high in terms of volume, frequency, impact, and cost. High-level breaches are increasingly occurring in a more targeted manner toward health centers. This presentation provides Health Center leadership and trainers with a template to use to build out their own organization-specific presentation on breach.

Healthcare providers have become a lucrative target for cyber criminals and many reported breaches are occuring at health centers. Since 2009, when the Department of Health and Human Services started tracking breaches that involved protected health information exposure of 500 patients or more, upwards of 1700 cases have been reported. These breach incidences are highlighted on the U.S. Department of Health and Human Services, Office for Civil Rights Breach Portal.

The HHS Office for Civil Rights has started its next phase of audits of covered entities and their business associates. The 2016 Phase 2 HIPAA Audit Program will review the policies and procedures adopted and employed by covered entities and their business associates to meet selected standards and implementation specifications of the Privacy, Security, and Breach Notification Rules. 

It is common practice today to encrypt data at rest, that is, data stored on servers. This is especially applicable to health centers who are less frequently actively transporting data across disparate networks. Like many smaller healthcare organizations, Health Centers are particularly vulnerable to potential attack and infiltration by data hackers for several reasons: they tend to have fewer technical support staff, resource limitations make it harder to assess, implement, and maintain safe data practices, and organizational inertia limits preventive action when no threat is perceived. 

This YouTube video provides an exciting ransomware re-enactment that helps explain how a ransomware incident occurs, common mistakes and methods for mitigation. It also includes a link to a Ransomware Readiness Assessment by the security vendor TrendMicro.