Feb 11, 2021

The threat of ransomware attacks and how to stop them

patient data
healthcare data
Leila Hawkins
3 min
The threat of ransomware attacks and how to stop them
Ransomware attacks in healthcare are rising, we take a look at how these can be prevented...

A recent study by software security firm VMware Carbon Black looked at cyberattacks among their healthcare customers and found an unprecedented figure – almost 240 million attempted attacks in 2020. This demonstrated the dramatic rise in the risk cyber criminals pose to healthcare. 

In October 2020 the US Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency (CISA) warned of the increased threat to healthcare providers and hospitals. They cited a particular group, named UNC1878, who were behind financially motivated attacks where they used ransomware to encrypt their target and extort the owner.  

Ransomware attacks can be extremely damaging. Last year Rangely District Hospital in Colorado suffered an attack whereby the proprietary software used to access medical records was infected. The hospital didn’t pay the ransom, and five years of patient records became inaccessible. 

Perpetuators of these types of attacks often act fast, with organisations sometimes experiencing the full lifecycle of an attack in just two days.

In their report, VMware Carbon Black were able to identify the top five ransomware families currently plaguing the healthcare industry:

  • Cerber: 58% A type of malware that encrypts files and holds them hostage, demanding a ransom payment in exchange for returning them. 
  • Sodinokibi: 16% Ransomware that is highly evasive and takes many measures to prevent its detection by antivirus and other means. 
  • VBCrypt: 14% VBCrypt is a malicious program that may perform a number of actions of an attacker's choice on an affected computer. This virus targets Windows programs.  
  • Cryxos: 8% Cryxos Trojans display false alerts on compromised or malicious websites. The notifications claim that the user's computer is infected with a virus, is blocked, and some personal details have been stolen.
  • VBKrypt: 4% VBKrypt malware may drop files, write to the registry and perform other unauthorised actions on the affected computer system.

What are they stealing?

VMware’s research found “secondary infections,” across the digital healthcare supply chain, which are used to facilitate long-term cyberattack campaigns. This is leading to a surge in extortions and helping to fuel a cybercrime market mostly taking place on the dark web. 

Information that is typically being sold includes personal info and medical records, such as names, patient IDs, home addresses, and health insurance details. In the last year data containing details of patients who have taken a COVID-19 test has also been stolen and sold. 

An example VMware found was doctors’ private information, including home phone number and personnel number, being sold for $500 on the dark net. 

During the speculation last year that Hydroxychlorquine could help treat patients with COVID-19, cybercriminals began selling this on the dark web for about $1. 

How to stop ransomware attacks

Key to preventing these attacks is ensuring staff are informed and taking precautions such as scanning emails for threats, checking firewalls are working, and being mindful of phishing attacks. Staff training on security is essential for this. Additionally the following measures are important: 

  • Back up critical data so it can be restored if needed. Best practice is multiple versions of backups with different recovery points and at different locations. 
  • Use cloud-based “immutable” buckets. These let customers create buckets of data that cannot be altered in any way, for a certain period of time, including encryption by ransomware. 
  • Deploy next-generation Antivirus (AV) software that offers protection for each of the typical stages of a ransomware attack, and can prevent advanced attacks. 
  • Use an endpoint protection solution. As VMware Carbon Black’s report states: “Healthcare organisations need the ability to easily provision access to new users while maintaining data privacy, compliance, and security practices.” 

Lastly Darren Guccione, CEO of password manager app Keeper, recommends that organisations don’t pay ransoms, even if their systems have been compromised. "Cybercriminals frequently don't release access after a ransom is paid” he said. “Don't trust them. Instead, take the necessary precautions and internal control measures regarding file backup, recovery, and incident response."

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Jun 11, 2021

How UiPath robots are helping with the NHS backlog

6 min
UiPath software robots are helping clinicians at Dublin's Mater Hospital save valuable time

The COVID-19 pandemic has caused many hospitals to have logistical nightmares, as backlogs of surgeries built up as a result of cancellations. The BMJ has estimated it will take the UK's National Health Service (NHS) a year and a half to recover

However software robots can help, by automating computer-based processes such as replenishing inventory, managing patient bookings, and digitising patient files. Mark O’Connor, Public Sector Director for Ireland at UiPath, tells us how they deployed robots at Mater Hospital in Dublin, saving clinicians valuable time. 

When Did Mater Hospital implement the software robots - was it specifically to address the challenges of the pandemic? 
The need for automation at Mater Hospital pre-existed the pandemic but it was the onset of COVID-19 that got the team to turn to the technology and start introducing software robots into the workflow of doctors and nurses. 

The pandemic placed an increased administrative strain on the Infection Prevention and Control (IPC) department at Mater Hospital in Dublin. To combat the problem and ensure that nurses could spend more time with their patients and less time on admin, the IPC deployed its first software robots in March 2020. 

The IPC at Mater plans to continue using robots to manage data around drug resistant microbes such as MRSA once the COVID-19 crisis subsides. 

What tasks do they perform? 
In the IPC at Mater Hospital, software robots have taken the task of reporting COVID-19 test results. Pre-automation, the process created during the 2003 SARS outbreak required a clinician to log into the laboratory system, extract a disease code and then manually enter the results into a data platform. This was hugely time consuming, taking up to three hours of a nurse’s day. 

UiPath software robots are now responsible for this task. They process the data in a fraction of the time, distributing patient results in minutes and consequently freeing up to 18 hours of each IPC nurse’s time each week, and up to 936 hours over the course of a year. As a result, the healthcare professionals can spend more time caring for their patients and less time on repetitive tasks and admin work. 

Is there any possibility of error with software robots, compared to humans? 
By nature, humans are prone to make mistakes, especially when working under pressure, under strict deadlines and while handling a large volume of data while performing repetitive tasks.  

Once taught the process, software robots, on the other hand, will follow the same steps every time without the risk of the inevitable human error. Simply speaking, robots can perform data-intensive tasks more quickly and accurately than humans can. 

Which members of staff benefit the most, and what can they do with the time saved? 
In the case of Mater Hospital, the IPC unit has adopted a robot for every nurse approach. This means that every nurse in the department has access to a robot to help reduce the burden of their admin work. Rather than spending time entering test results, they can focus on the work that requires their human ingenuity, empathy and skill – taking care of their patients. 

In other sectors, the story is no different. Every job will have some repetitive nature to it. Whether that be a finance department processing thousands of invoices a day or simply having to send one daily email. If a task is repetitive and data-intensive, the chances are that a software robot can help. Just like with the nurses in the IPC, these employees can then focus on handling exceptions and on work that requires decision making or creativity - the work that people enjoy doing. 

How can software robots most benefit healthcare providers both during a pandemic and beyond? 
When the COVID-19 outbreak hit, software robots were deployed to lessen the administrative strain healthcare professionals were facing and give them more time to care for an increased number of patients. With hospitals around the world at capacity, every moment with a patient counted. 

Now, the NHS and other healthcare providers face a huge backlog of routine surgeries and procedures following cancellations during the pandemic. In the UK alone, 5 million people are waiting for treatment and it’s estimated that this could cause 6,400 excess deaths by the end of next year if the problem isn’t rectified.

Many healthcare organisations have now acquired the skills needed to deploy automation, therefore it will be easier for them to build more robots to respond to the backlog going forwards. Software robots that had been processing registrations at COVID test sites, for example, could now be taught how to schedule procedures, process patient details or even manage procurement and recruitment to help streamline the processes associated with the backlog. The possibilities are vast. 

The technology, however, should not be considered a short-term, tactical and reactive solution that can be deployed in times of crisis. Automation has the power to solve systematic problems that healthcare providers face year-round. Hospital managers should consider the wider challenge of dealing with endless repetitive work that saps the energy of professionals and turns attention away from patient care and discuss how investing in a long-term automation project could help alleviate these issues. 

How widely adopted is this technology in healthcare at the moment?
Automation was being used in healthcare around the world before the pandemic, but the COVID-19 outbreak has certainly accelerated the trend.  

Automation’s reach is wide. From the NHS Shared Business Service in the UK to the Cleveland Clinic in the US and healthcare organisations in the likes of Norway, India and Canada, we see a huge range of healthcare providers deploying automation technology. 

Many healthcare providers, however, are still in the early stages of their journeys or are just discovering automation’s potential because of the pandemic. I expect to see the deployment of software robots in healthcare grow over the coming years as its benefits continue to be realised globally. 

How do you see this technology evolving in the future? 
If one thing is certain, it’s that the technology will continue to evolve and grow over time – and I believe there will come a point in time when all processes that can be automated, will be automated. This is known as the fully automated enterprise. 

By joining all automation projects into one enterprise-wide effort, the healthcare industry can tap into the full benefits of the technology. This will involve software robots becoming increasingly intelligent in order to reach and improve more processes. Integrating the capabilities of Artificial Intelligence and Machine Learning into automation, for example, will allow providers to reach non-rule-based processes too. 

We are already seeing steps towards this being taken by NHS Shared Business Service, for example. The organisation, which provides non-clinical services to around two-thirds of all NHS provider trusts and every clinical commissioning organisation in the UK, is working to create an entire eco-system of robots. It believes that no automation should be looked at in isolation, but rather the technology should stretch across departments and functions. As such, inefficiencies in the care pathway can be significantly reduced, saving healthcare providers a substantial amount of time and money. 

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