How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.
The role of tech in public healthcare
Patient backlogs, aging populations, increasing amounts of data, the COVID-19 pandemic and a workforce experiencing burnout are just some of the challenges the world's hospitals are experiencing.
Switching to cloud-based digital systems provided by a third party, like electronic health records (EHR) and e-prescriptions, is an obvious solution. According to Peter Springfield, Cloud Product Manager at Node4, all healthcare providers will need to make this change eventually. "Over time, as legacy technology gets older and the demands placed on it increase, storage systems often can’t keep up" he says. "There comes a point for every healthcare organisation when existing IT simply won’t meet its needs anymore. Instead, healthcare facilities need full, near-instant availability of data to make effective decisions and provide good patient care."
Patient data must be readily accessible when needed, stored in a regulation-compliant environment, while remaining cost effective. But how does a paper-based hospital with an overstretched workforce manage this process, while keeping data safe from cyber attacks? By finding a company that can provide the right solution, and working in partnership with them.
Moving to the cloud
The challenge in healthcare, Springfield says, is that many organisations have siloed pools of data stored in separate repositories. "Often, these systems don’t scale well and don’t have the security protections necessary to meet today’s requirements."
"Cloud-based storage can scale as high as required. The best cloud vendors also assure high availability and good performance. And because organisations pay only for the capacity they use with cloud-based storage, costs can be lower. As a result, the cloud model also allows healthcare organisations to store and access all data associated with a specific patient, procedure or business unit in one place."
Another option is to choose Storage as a Service (STaaS). "This is where a third-party provider owns and manages the storage infrastructure, while the healthcare facility can dictate rules on storage, retention and access, along with service level requirements. This structure means that healthcare facilities can access storage on-demand, paying only for the amount they use, without worrying about buying, managing and maintaining physical devices."
Most healthcare providers are choosing a hybrid model, which allows them to use the cloud for everything except the most sensitive data. "Because security and privacy are critical issues for healthcare organisations, the temptation is to keep everything on-premises" Springfield says. "While that can make sense for especially sensitive workloads and applications because it provides tighter controls, it may not be viable for the longer term, as the amount of data that must be managed and stored continues growing."
Keeping patient data secure is not just crucial for the patients, but for the healthcare provider too. Ransomware attacks - where a hacker demands money in exchange for not releasing private data - have risen dramatically in recent years, particularly since the COVID-19 pandemic began. In 2020 alone these rose by 55%, costing almost $21 billion in downtime.
Healthcare providers' inhouse IT departments may not have the knowledge or the resources needed to combat sophisticated attacks, making it necessary to partner with trusted cybersecurity companies.
"Healthcare organisations are moving away from doing everything themselves and doing a lot of outsourcing in the cloud" says Terry Ray, Senior Vice President at cybersecurity firm Imperva. "They may have been running Cerner as their electronic medical record system for 15 years for example, but many are now shifting to say, "why am I running Cerner? Why don't I just pay Cerner to run Cerner? They can enter their data into Cerner's EMR and let it be their problem."
"The field is getting larger and larger, and the enterprise and scope of what needs to be secured is getting bigger" he adds. "You can't have gaps in security. Organisations must look at everything."
While security and data storage are two typical areas where public healthcare providers lean on the tech sector, another has been emerging since the pandemic: telehealth. As well as providing access to doctor appointments during the successive lockdowns caused by COVID-19, telemedicine can help deliver healthcare to remote or rural locations that lack health facilities.
Virtual care solutions are wide-ranging, from Vodafone supplying the connectivity for IoT devices that help elderly people living on remote Greek islands to monitor their diabetes, to TytoCare's portable device that enables doctors to travel to remote regions and examine the heart, lungs, throat, and body temperature of patients using artificial intelligence.
Busy doctors' surgeries are using digital platforms to help them triage patients - such as eConsult, a digital platform used by the British National Health Service (NHS) in primary and emergency care to assess which patients need to urgently speak to a clinician.
As with all tech solutions, security and data privacy are vital. "The potential for technology to improve healthcare is almost limitless" Springfield says "The key is remembering where it starts and ends - with data."
- This article appears in the August issue of Healthcare