Within a month after the All India Institute of Medical Sciences (AIIMS) announced their plan of digitizing and going paperless starting in January 2023, they encountered a massive cyberattack leading to outages and data breaches. The hacked databases included Personally Identifiable Information (PII) of patients and healthcare professionals, administrative data on blood donors, ambulances, vaccinations, healthcare workers, and employee login credentials. It was reported that the cyberattack “affected outpatient and inpatient digital hospital services, including smart lab, billing, report generation, appointment scheduling.”
CloudSEK, an AI company that has been tracking cyber threats, stated that the Indian healthcare business was second in terms of the number of attacks, accounting for 7.7% of all attacks on the global healthcare industry in 2021 and 29.7% of attacks in the Asia-Pacific region. With 28% of all attacks on the global healthcare sector in 2021, the U.S. is undoubtedly the most targeted country. This is a result of the increased digitization that is occurring, particularly in light of the COVID-19 pandemic.
This study also mentioned that “the number of cyberattacks against the healthcare industry has increased by 95.34% in the first four months of 2022 as compared to the number of cyberattacks in 2021 during the same period.”
Data confidentiality and security have been a concern for both individuals and healthcare organizations. Healthcare data, including personal health information (PHI) and electronic medical records (EMR), is more sensitive and critical than any other kind of data as even the slightest data tampering can lead to a faulty treatment or wrong diagnosis, with fatal and irreparable losses for patients. In case of a ransomware attack or data theft, healthcare organizations often end up paying heavy ransom amounts to restore data quickly. Unlike other industries, disruptions in healthcare operations can risk the lives of patients, and criminals know this well.
Threat Landscape of the Connected Healthcare Ecosystem
The global IoT-driven healthcare market size is predicted to witness a tremendous upsurge from $180.5 billion in 2021 to $960.2 billion in 2030 at a CAGR of 20.41%. The colossal jump within the decade hints towards the bright future ahead for the booming smart healthcare ecosystem.
Technological advancements, growing awareness concerning self-health monitoring, patient engagements, and improved diagnosis contribute to the growing IoT or IoMT (Internet of Medical Things) market size. The pandemic and internet explosion (with 5G being rolled out) gave the final push to modern healthcare providers to design IoT roadmaps. But, as we know, all that glitters isn’t gold!
Underneath the glamorous eHealthcare, lies the dark reality of severe security threats. Vulnerabilities in healthcare devices and corporate systems compromise data security, paving the way for cybercriminals to exploit sensitive information. Resisting such threats requires a responsible approach and implementation of multi-level strategies like Identity and Access Management (IAM), along with robust management of Public Key Infrastructure (PKI), digital keys, and certificates.
However, most organizations face challenges in implementing safe practices due to large record volumes, widespread use of telemetry, and third-party healthcare services like pathology labs, scan centers, and healthcare insurance providers requiring access to patient records. Furthermore, healthcare organizations are among the biggest consumers of IoT devices, increasing their threat landscape and making them vulnerable to attacks.
Cybersecurity Best Practices for Improved Security Posture in Healthcare
Implement Identity and Access Management (IAM): With the emergence of digital transformation and the popularity of cloud services, most medical devices are connected to the Internet. IAM allows organizations to ensure that the right people have the required access to specific systems and applications, thus reducing risks of data exposure. Role-based access control (RBAC) assigns access permissions to users based on their organizational roles and responsibilities.
IAM helps in tightening cybersecurity by adding multiple layers of identity-based authentication procedures. By using multi-factor authentication (MFA) tactics like passwords and time-based one-time passwords (TOTP), and single sign-on (SSO), healthcare organizations can verify the identity and credibility of the employees and the patients before authenticating login attempts. With IAM, you can eliminate human error, by implementing automated tools to streamline operations and reduce additional costs.
IAM allows you to integrate self-service functionality, thus allowing healthcare professionals to request for accessing particular resources. The ability to employ self-service functionality in the IAM approach is important because it allows users to perform their tasks independently and securely, without involving any other department or help desk.
An integrated IAM solution automates identity creation, authentication processes, access control, and management of role and attribute-driven policies. Automated processes are efficient, less time-consuming, and boost operational efficiency. IAM also automates and facilitates the provisioning of user accounts and workflow management, thus fueling productivity.
Embrace Efficient PKI Management: Healthcare businesses must build a strong security policy based on the capability to accurately identify all connected devices in order to safeguard patient data and defend against cyberattacks. The most efficient technique to lower the risks involved with information exchange between medical devices is identity verification and authorization.
PKI is useful in this situation as it is a well-known technology that offers several benefits and provides encryption and authentication to any form of connected device. PKI-based digital certificates are used to verify the identity of connected devices and provide identity assurance.
While PKI has traditionally been used in hospitals to secure sensitive patient records, cryptography finds new applications in wearable and remote IoT-enabled medical devices. With such devices capturing user information and relaying it back to healthcare professionals by the minute, it is essential to ensure that the line of communication is not intercepted. It is also crucial to keep the device up-to-date via regular updates for optimum security. PKI makes this possible by providing a device identity and a layer of protection to medical devices.
A robust PKI, where certificate lifecycle management follows well-established policies and practices, is not vulnerable to common brute force or man-in-the-middle attacks targeting precious medical data. At the same time, PKI encrypts sensitive information while in transit, protecting it from malicious actors even in the event of a data breach or compromise. A robust PKI solution is scalable enough to secure heterogeneous connected medical device environments, which vary in size, complexity, and security needs.
Stay Compliant with Evolving Data Protection Laws and Regulations: For healthcare organizations, it is imperative to meet the requirements for being Health Insurance Portability and Accountability Act (HIPAA) compliant. Being HIPAA compliant gives your organization a competitive advantage. The majority of healthcare organizations have implemented SaaS services in their workflow and by maintaining HIPAA standards, you can achieve business diversification in the trillion-dollar healthcare industry.
The HIPAA Security Rule dictates that healthcare entities must implement safeguards, such as encryption, that render electronic Protected Health Information (ePHI) “unreadable, undecipherable or unusable” so any “acquired healthcare or payment information is of no use to an unauthorized third party.”
Physicians and hospitals use electronic health records (EHR) and it is mandatory to meet the HIPAA standards for availing any cloud service. Besides HIPAA, Health Information Technology for Economic and Clinical Health Act (HITECH) ensures the privacy of sensitive medical information and the security of Personal Health Information (PHI) from unauthorized access and data misuse.
Develop Threat Detection and Disaster Recovery Plans: For automated threat detection, healthcare cybersecurity teams can rely on vulnerability scanning technology, such as the tools made available by the Cybersecurity and Infrastructure Security Agency (CISA). The organization may better track cyber threats and foster a culture of security awareness by clearly defining risk and designating certain individuals to be responsible for risk management. Re-evaluating security measures on a regular basis might assist find potential weaknesses before they have an impact on the organization.
It is crucial to have a disaster recovery strategy in place with the growing amount of medical data being stored electronically so that your healthcare facility can continue to operate even if its data is lost or corrupted. Following any kind of data loss, an efficient disaster recovery plan enables you to quickly restore your medical data and carry on with your regular operations. In the event of any severe data loss, your company may experience a delayed recovery or possibly fail without a disaster recovery plan.
Improve Network Security: Network security is essential for safeguarding client data and information, maintaining the security of shared data, guaranteeing dependable network performance, and protecting against online threats. Ensuring legitimate access to systems, applications, and data facilitates corporate operations and customer service. You can improve network security by implementing: firewalls, network segmentation, Remote Access VPN, Zero Trust Network Access (ZTNA), Data Loss Prevention (DLP), and Intrusion Prevention Systems (IPS). Software-defined Networking (SDN) and Software-defined Wide Area Network (SD-WAN) solutions enable network security solutions in private, public, hybrid, and multi-cloud environments.
Embrace Automated Certificate Lifecycle Management (CLM): Digital certificates will proliferate as new business use cases arise. Manually managing these certificates on a spreadsheet can lead to mistakes and increase overhead. The solution is to use an automated certificate management solution to discover, issue, renew, revoke, and install certificates, and also to get proactively notified of certificate validity and expiration. Since you may acquire certificates from multiple public certificate authorities (CAs), the automated CLM solution should support multiple public and private CAs. It should also give you the crypto agility to respond to new security vulnerabilities and easily perform migration activities (such as SHA1 to SHA2 migration). By investing in an automated CLM solution now, you can reduce the overall complexity of your digital certificate infrastructure.
How the AppViewX Platform Helps
It’s critical to realize that manual key and certificate discovery is no longer an option given the prevalence of connected medical devices and their digital identities. Manual certificate management is a flawed and time-consuming method that gives healthcare businesses a false sense of security while leaving them vulnerable to damaging cyberattacks. To reduce the risk of certificate-related failures and data breaches, enterprises must automate and centralize their PKI management.
AppViewX CERT+ automates certificate lifecycle management end-to-end, from discovery to enrollment, renewal, and revocation, with native, out-of-the-box automation workflows. Its advanced monitoring and alerting mechanism, coupled with protocol-based automation, eliminate outages and breaches due to unplanned certification expirations and weak policies.
As the requirement for certificates grows, especially certificates that need to be trusted within the organization, enterprises have to set up their internal PKI so that private CAs can be created internally. AppViewX PKI+, a scalable and compliant PKI-as-a-Service, allows you to simplify and centralize your private PKI architecture and set up private CAs in minutes while meeting the highest standards of security and compliance.
PKI+ with AppViewX CERT+ combines modern private PKI with end-to-end certificate lifecycle management automation for provisioning and managing private trust certificates as well as public trust certificates from external CAs, all from a centralized console.