Following a string of high-profile incidents that began earlier this year, the healthcare industry has been highly focused on preventing ransomware attacks. IoT security has also emerged as a growing concern. However, healthcare organizations (as well as businesses in other industries) cannot afford to ignore another growing threat: spear phishing.

Like regular phishing, spear phishing involves sending legitimate-looking but fraudulent emails asking users to provide sensitive information and/or initiate wire transfers. However, while regular phishing emails are sent out en masse to the general public, spear phishing emails are highly targeted and sent to specific, predetermined victims, usually a small group of people working at a specific company.

In a recent press release, the Federal Bureau of Investigation warned of a dramatic rise in a type of spear phishing known as a “CEO email scam” or a “business email compromise scam.” According to the FBI, from October 2013 to February 2016, law enforcement identified 17,642 victims, totaling $2.3 billion in losses. Since January 2015, reports of spear phishing have increased by 270%.

Main Line Health Attack Proves that Employee Data Is at Risk

In February 2016, while everyone’s attention was focused on the Hollywood Presbyterian ransomware attack, Main Line Health, which operates four hospitals near Philadelphia, was hit by a spear phishing scheme. Emails were sent to employees, purportedly from the organization’s CEO and CFO, requesting employee payroll and W2 information. While some employees immediately realized the emails were fraudulent and reported them to management, at least one employee was tricked into sending the requested information to the hacker. As a result, Main Line Health had to notify its employees that their personal information may have been compromised and offer them free credit counseling and monitoring services.

When healthcare organizations think about cyber security, they usually focus on patient data protection. However, the hackers who compromised Main Line Health were not seeking to infiltrate patient data, but employee data, and the attack may have been connected to a very large spear phishing scheme targeting HR and payroll professionals in various industries nationwide. It is suspected that the hackers running the scheme intended to use the stolen data to file fraudulent tax returns.

How to Protect Against Spear Phishing

Email spam filters can be adjusted to recognize emails from suspicious sources and block them before they reach employees’ inboxes. However, some phishing emails will undoubtedly still get through. The best way to protect against spear phishing is to teach employees how to recognize the telltale signs of a spear phishing email, such as:

• The salutation and/or the closing seem odd. For example, management normally refers to you as “William” or “Mr. Doe,” but the email is addressed to “Bill.” In the case of Main Line Health, the closing is what alerted one employee to the fraud; the email message, which purported to be from the CEO, was signed “John Lynch,” but the employee knew that the company’s CEO goes by “Jack.”
• The request is unusual and/or does not follow normal company protocol. For example, the email is asking for employee W2 information, but requests like this are not normally handled through email or by the employee who received the request, or the person who allegedly sent the email has never requested similar information before, or it’s unusual for the person who allegedly sent the email to directly contact that particular employee.
• The wording and tone of the email are stilted. Many spear phishing attacks are launched by foreign hackers who are not fluent in English; the email may be riddled with punctuation, spelling, or grammar errors, be worded oddly, or use British spelling. The wording may also be overly formal – or overly casual.
• The domain the email was sent from is incorrect. Instead of “yourcompany.com,” the email may have been sent from “yourcompany.com-xyz.com” or some other derivative.

Employees should be taught that if something seems “off” about an email, they should consult a supervisor or IT security personnel before responding to it. Additionally, as part of your organization’s overall cyber security plan, a firm protocol should be established regarding requests for sensitive employee and patient data, and employees should be trained not to release sensitive data unless the protocol is followed.

In addition to using email spam filters to intercept suspicious messages, training employees to spot spear phishing emails, and implementing a solid security plan that includes protocol for the release of sensitive data, it’s a good idea for healthcare facilities to enlist the services of a professional cyber security firm such as Lazarus Alliance. The cyber security experts at Lazarus Alliance have deep knowledge of the cyber security field, are continually monitoring the latest information security threats, and are committed to protecting your healthcare organization from security breaches. We offer full-service risk assessment services and Continuum GRC software to protect hospitals and other healthcare organizations from data breaches, ransomware, and spear phishing attacks.

Lazarus Alliance is proactive cyber security®. Call 1-888-896-7580 or book some time with us to discuss your organization’s cyber security needs and find out how we can help your organization protect your patient and employee data.

Up until now, healthcare cyber security has been focused on protecting patient data, ensuring HIPAA compliance, and, more recently, protecting systems from ransomware attacks. However, as healthcare technology advances, a new threat is emerging: the potential for hackers to attack smart medical devices such as insulin pumps and pacemakers. If IoT security is not taken seriously, innovation will be stunted and, in the case of healthcare, lives will be lost.

What is the Internet of Things?

The Internet of Things (IoT) refers to the growing number of “smart,” internet-connected devices that are infiltrating every part of our lives, such as fitness wearables, smart TVs, connected cars, smart thermostats, and even smart buildings. Business Insider estimates that over the next five years, $6 trillion will be spent developing IoT technology, and by 2020, 24 billion IoT devices will be in use.

The healthcare industry, which has historically been slow to implement new IT technology, has enthusiastically embraced IoT devices, which can be wearable (such as a fitness monitor) or implantable (such as an insulin pump). Allied Market Research predicts that the world IoT healthcare market will reach $136.8 billion by 2021, more than doubling its $60.4 billion value in 2014.

Despite this rapid growth, IoT security is severely lacking. IoT devices may be smart, but they have far weaker security controls than regular computers. IoT passwords are often hard-coded and freely available online, and some devices are very difficult to patch or update. There are a myriad of device manufacturers, with more entering the market every day – but no common security controls or best practices, and no procedures to track devices as they move through the supply chain from the manufacturer to the end user. This results in IoT devices having numerous vulnerabilities that are just waiting to be exploited.

IoT security vulnerabilities aren’t purely hypothetical. Recently, cyber security experts demonstrated how Nest’s smart thermostat and Ring’s smart doorbell could be breached and turned into entry points into a home network. (Ring’s manufacturer has since issued a firmware update to address the vulnerability.) While there have been no reported attacks involving either device, logically, it’s only a matter of time before an IoT device is targeted.

And if hackers can get into thermostats and home security devices, why couldn’t they breach a pacemaker or an insulin pump? Especially since someone has already done it.

Healthcare IoT Security: The Next Ransomware Threat

As we’ve reported in previous blogs, the healthcare industry has suffered from a number of major ransomware attacks in the past few months, beginning in February, when Hollywood Presbyterian Hospital, after being locked out of their system for a week, paid hackers the equivalent of $17,000.00 in Bitcoin to get back in. Some security experts feel that by caving in and paying up, the hospital inadvertently proved to hackers that using ransomware to attack healthcare facilities means fast money. If a hospital will part with large sums of money to get back into its computer system, how much would a patient be willing to pay to keep a life-sustaining medical device working?

Again, such a scenario is not hypothetical. TechTarget reports that two patients in a hospital in Austria figured out how to hack into their own medication infusion pumps because they felt their pain was not being managed properly. Frighteningly, to get in, the patients simply went online, looked up the hard-coded passwords for their pumps, then used them to log in and adjust their doses. The patients ended up overdosing and suffering respiratory problems.

If a layperson with no computer science training can manage to figure out how to hack into an IoT medical device, imagine what a money-motivated hacker with advanced technical skills could accomplish. A hacker could access a pacemaker or an insulin pump, begin draining the battery, and refuse to stop until the victim pays a ransom. The only obstacle would be determining how to deliver the ransom demand to the victim, but with reams of personal information easily available online, it would not be difficult for a hacker to obtain a victim’s mobile phone number or email address and use these to deliver the ransom demand.

What Can Healthcare Providers Do to Protect Patients?

The recent ransomware attacks on medical facilities have proven that hackers have no regard for human life and are fully willing to put fragile patients at risk in their quest to make a quick buck. The healthcare industry needs to take IoT security every bit as seriously as other forms of cyber security, and industry leaders must put pressure on IoT device manufacturers to establish security controls and best practices, such as eliminating hard-coded passwords and ensuring that IoT devices are as easy to patch and update as computers and mobile phones.

Healthcare facilities can take proactive security measures right now by developing a robust information security policy to include security awareness among all healthcare personnel and, from a technical perspective, continuous monitoring of systems so that baseline user patterns can be determined and deviations that may indicate possible attacks can be detected.

In addition to establishing an internal culture of security awareness, implementing a solid security plan, and monitoring systems for suspicious activity, it’s a good idea for healthcare facilities to enlist the services of a professional cyber security firm such as Lazarus Alliance. The cyber security experts at Lazarus Alliance have deep knowledge of the cyber security field, are continually monitoring the latest information security threats, and are committed to protecting your healthcare organization from security breaches. We offer full-service risk assessment services and Continuum GRC software to protect hospitals and other healthcare organizations from data breaches and ransomware attacks.

Lazarus Alliance is proactive cyber security®. Call 1-888-896-7580 to discuss your organization’s cyber security needs and find out how we can help your organization prevent ransomware attacks and data breaches.

In a previous blog, we discussed the recent epidemic of ransomware attacks on U.S. healthcare organizations and the importance of the industry taking this very serious cyber security threat – and healthcare cyber security in general – seriously. The good news is that although a ransomware attack can bring a healthcare facility to its knees, ransomware attacks can be prevented by taking precautionary measures.

Following are five tips for healthcare organizations to protect themselves against ransomware and other healthcare cyber security attacks.

1. Build a Culture of Healthcare Cyber Security Awareness in Your Organization

Ransomware usually doesn’t make its way onto a network through an automated attack but through simple social engineering techniques, such as employees clicking on phishing emails or inadvertently installing malware. Many facilities simply do not take healthcare cyber security seriously. Unlike many other industries, healthcare was very slow to go digital, and as a result, many healthcare employees look at information technology as more of a hindrance than a benefit. They may also feel that information security is “the IT department’s job,” and that their focus should be solely on treating patients. Employees must be taught that preventing cyber attacks is every bit as important as preventing infections and biohazard exposure incidents, and that cyber security is everyone’s “job,” regardless of their position within the organization.

Among the ways to change your employees’ attitude and instill a culture of healthcare cyber security awareness:

• Include information security in your organization’s core values, right next to patient care.
• Provide comprehensive security training at regular intervals. Having new hires watch one “training video” isn’t enough.
• Ensure that all supervisors model information security best practices and remind employees that everyone is responsible for preventing cyber attacks.

2. Secure Mobile Devices

Due to the advent of electronic health records (EHRs), mobile devices are becoming very popular in healthcare facilities. However, because of their portability, these devices are subject to loss or theft. They are also susceptible to electromagnetic interference, which can corrupt the data stored on them.

Best practices for mobile device use in a healthcare setting include:

• Ensure that all mobile devices used within the facility are equipped with multi-factor authentication and access controls, including strong passwords that are changed regularly.
• Avoid storing electronic health information on mobile devices. In cases where data must be stored on them, the data should be encrypted.
• Mobile devices should be physically tracked. They should not be permitted to leave the facility except under specific circumstances outlined in your organization’s policy.
• Patients and other visitors to your facility should never be allowed to access your organization’s secure network.

3. Back Up Your Data and Your System

This step may seem obvious, but many organizations (healthcare and otherwise) do not regularly conduct secure backups of their data. In addition to backing up data, organizations should also create a system and configuration backup, known in the IT industry as a “gold image.” Regular backups are essential because, should a facility fall victim to a ransomware attack, it can restore its data and systems instead of paying the ransom.

4. Control Physical Access to Your Data and Network

In addition to securing your digital data and files, make sure you also secure your organization’s physical devices and storage media (such as flash drives, CD’s, and portable hard drives) through such measures as:

• Limiting physical access to server rooms and all areas where computers are used. Employees and visitors who do not have a compelling need to access the server room shouldn’t be allowed to do so.
• Restricting the ability to remove devices from secure areas and from the facility in general.
• Maintaining a visitor log and installing security cameras.

5. Enlist the Services of a Professional Healthcare Cyber Security Firm

In addition to internal security personnel, a culture of security awareness, and a solid security plan, it’s a good idea for facilities to also enlist the services of a professional cyber security firm such as Lazarus Alliance. The cyber security experts at Lazarus Alliance have deep knowledge of the cyber security field, are continually monitoring the latest threats and technologies, and are committed to protecting your healthcare organization from attacks. We offer full-service risk assessment services and Continuum GRC software to protect hospitals and other healthcare organizations from data breaches and ransomware attacks. Lazarus Alliance is proactive cyber security®. Call 1-888-896-7580 to discuss your organization’s cyber security needs and find out how we can help your organization prevent ransomware attacks and data breaches.