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Can Healthcare Ransomware Be Stopped? Yes, It Can!

Posted on May 25, 2016 I Written By

The following is a guest blog post by Steven Marco, CISA, ITIL, HP SA and President of HIPAA One®.
Steven Marco - HIPAA expert
As an Auditor at HIPAA One®, my goal is to dot every “i” and cross every “t” to ensure a comprehensive HIPAA Security Risk Analysis.  The HIPAA One® Security Risk analysis is a tool to guarantee compliance, automate risk calculations and identify high-risk technical, administrative, physical and organizational vulnerabilities.

Recently, I was on-site for a client named “Care Health” (name changed to protect their identity). Care Health had invested in the highest level of our SRA (Security Risk Analysis) to cover all aspects of security and protection from Ransomware, malware, and the proverbial “sophisticated malware.”

The HIPAA One® HIPAA Security Risk Analysis and Compliance Interview process guided Care Health through a series of HIPAA citation-based questions and required users to upload documents to demonstrate compliance.  These questions directly addressed the organization’s security controls in place to protect against ransomware and cyber-threats.  You can see a sample of the citation-driven controls HIPAA One required for malware and malicious software below:

Technical Audit Controls 164.312(b)
HIPAA One® Requirement:  Upload screenshots of the systems configuration page(s) detecting malware network communications or ePHI/PII going out/in.
Client Controls:  End-user education on malware and phishing. Cisco IPS/IPS module active to block critical threats and WebSense Filter for deep-packet web-traffic inspection.

Administrative Protection from Malicious Software 164308(a)(5)(ii)(B)
HIPAA One® Requirement:  Provide a document showing a list of all servers, workstations and other devices with updated AV Software versions.
Client Controls: BitDefender Enterprise deployed on all workstations and laptops.

Administrative Procedures to guard against malicious software 164.308(a)(5)(ii)(B)
HIPAA One® Requirement:  Please upload a list of each server and sample of PC devices containing server name, O/S version, Service pack and the most recent security updates as available by the software vendor.  Verify critical security patches are current.
Client Controls:  Microsoft Security Operations Center combined with an exhausting change-management process to test new patches prior to release.

HIPAA Citation:  Administrative Training program for workers and managers 164.308(a)(5)(i) for the HR Director role.
HIPAA One® Requirement: Please upload a screen capture of the HIPAA training system’s grades for individual employees and detail the training/grading system in notes section.  Go through training and verify it efficiently addresses organization’s Policies and Procedures with real-world threats.
Client Controls:  Training that is due and required before bonuses, pay-raises or schedule to work are awarded.  Workforce and IT Helpdesk are trained to forward any calls regarding suspicious activities to the HIPAA Security Officer (HSO).

HIPAA Security Risk Analysis Tool

Back to the Ransomware attack…One day during the project, two staff members’ in the Billing department were going about their daily tasks, which involved working with shared files in a network-mapped drive (e.g. N: drive).  One of them noticed new files were being spontaneously created and the file icons in the network folder were changing. Being attentive, she noticed one was named ransom.txt.

Acting quickly, she contacted the IT Helpdesk who were trained to triage all security-related service-desk requests immediately to the HIPAA Security Officer(HSO).   The HSO logged-into the N: shared drive and found Care Health files were slowly being encrypted!

How do you stop a Ransomware attack?
The Security officer ran Bitdefender full-scans on the Billing department computers and found nothing.  He then installed and ran Windows Defender, which has the most current malicious software removal utilities on Server 2012 and found Tescrypt.  Installing Windows Defender on the two desktops not only detected this, but also removed it.

This Ransomware variant had somehow infected the system and was encrypting these files.  The quick-acting team at Care Health recognized the attack and stopped the Tescrypt variant before patient data were compromised.  Backups were used to restore the few-dozen encrypted files on the network-drive. It was a close call, but Care Health was ready and the Crisis Averted.

Upon a configuration review of all of Care Health’s security appliances, WebSense had been configured to allow “zero-reputation” websites through.  Zero-reputation websites are new sites without a known reputation and are commonly used by hackers to send these types of attacks. At Care Health, the Ransomware apparently came from a valid website with an infected banner ad from a zero-reputation source. The banner ad was configured to trigger a client-browser download prior to the user being allowed to see the valid web page.  This forced visitors to this website to download the executable virus from the banner-ad and unknowingly installing the Ransomware on their local computer.  When downloaded, the Ransomware would start encrypting files in high-lettered network-drives first.

Lesson Learned
Ransomware is here to stay and attacks are rising.  Healthcare organizations need to have policies and procedures in place to prevent these attacks and a comprehensive user training and awareness program.  The HIPAA One® software is one of the most secure ways to implement a HIPAA Security Compliance Program.  But a risk analysis is only one step… Ultimately, organizations must build top line end-user awareness and training programs. So like at Care Health, the employees know to quickly report suspicious activities to the designated security officer to defend against Ransomware, Phishing and “sophisticated malware attacks”.

To learn more about stopping Malware and using HIPAA One® as your HIPAA Security Risk Analysis accelerator, click to learn more, or call us a 801-770-1199.

HIPAA One® is a proud sponsor of EMR and HIPAA.

OCR Cracking Down On Business Associate Security

Posted on May 13, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

For most patients, a data breach is a data breach. While it may make a big difference to a healthcare organization whether the source of a security vulnerability was outside its direct control, most consumers aren’t as picky. Once you have to disclose to them that the data has been hacked, they aren’t likely be more forgiving if one of your business associates served as the leak.

Just as importantly, federal regulators seem to be growing increasingly frustrated that healthcare organizations aren’t doing a good job of managing business associate security. It’s little wonder, given that about 20% of the 1,542 healthcare data breaches affecting 500 more individuals reported since 2009 involve business associates. (This is probably a conservative estimate, as reports to OCR by covered entities don’t always mention the involvement of a business associate.)

To this point, the HHS Office for Civil Rights has recently issued a cyber-alert stressing the urgency of addressing these issues. The alert, which was issued by OCR earlier this month, noted that a “large percentage” of covered entities assume they will not be notified of security breaches or cyberattacks experienced by the business associates. That, folks, is pretty weak sauce.

Healthcare organizations also believe that it’s difficult to manage security incidents involving business associates, and impossible to determine whether data safeguards and security policies and procedures at the business associates are adequate. Instead, it seems, many covered entities operate on the “keeping our fingers crossed” system, providing little or no business associate security oversight.

However, that is more than unwise, given that the number of major breaches have taken place because of an oversight by business associates. For example, in 2011 information on 4.9 million individuals was exposed when unencrypted backup computer tapes are stolen from the car of a Science Applications International Corp. employee, who was transporting tapes on behalf of military health program, TRICARE.

The solution to this problem is straightforward, if complex to implement, the alert suggests. “Covered entities and business associates should consider how they will confront a breach at their business associates or subcontractors,” and make detailed plans as to how they’ll address and report on security incidents among these group, OCR suggests.

Of course, in theory business associates are required to put their own policies and procedures in place to prevent, detect, contain and correct security violations under HIPAA regs. But that will be no consolation if your data is exposed because they weren’t holding their feet to the fire.

Besides, OCR isn’t just sending out vaguely threatening emails. In March, OCR began Phase 2 of its HIPAA privacy and security audits of covered entities and business associates. These audits will “review the policies and procedures adopted and employed by covered entities and their business associates to meet selected standard interpretation specifications of the Privacy, Security, and Breach Notification Rules,” OCR said at the time.

The Need for Speed (In Breach Protection)

Posted on April 26, 2016 I Written By

The following is a guest blog post by Robert Lord, Co-founder and CEO of Protenus.
Robert Protenus
The speed at which a hospital can detect a privacy breach could mean the difference between a brief, no-penalty notification and a multi-million dollar lawsuit.  This month it was reported that health information from 2,000 patients was exposed when a Texas hospital took four months to identify a data breach caused by an independent healthcare provider.  A health system in New York similarly took two months to determine that 2,500 patient records may have been exposed as a result of a phishing scam and potential breach reported two months prior.

The rise in reported breaches this year, from phishing scams to stolen patient information, only underscores the risk of lag times between breach detection and resolution. Why are lags of months and even years so common? And what can hospitals do to better prepare against threats that may reach the EHR layer?

Traditional compliance and breach detection tools are not nearly as effective as they need to be. The most widely used methods of detection involve either infrequent random audits or extensive manual searches through records following a patient complaint. For example, if a patient suspects that his medical record has been inappropriately accessed, a compliance officer must first review EMR data from the various systems involved.  Armed with a highlighter (or a large excel spreadsheet), the officer must then analyze thousands of rows of access data, and cross-reference this information with the officer’s implicit knowledge about the types of people who have permission to view that patient’s records. Finding an inconsistency – a person who accessed the records without permission – can take dozens of hours of menial work per case.  Another issue with investigating breaches based on complaints is that there is often no evidence that the breach actually occurred. Nonetheless, the hospital is legally required to investigate all claims in a timely manner, and such investigations are costly and time-consuming.

According to a study by the Ponemon Institute, it takes an average of 87 days from the time a breach occurs to the time the officer becomes aware of the problem, and, given the arduous task at hand, it then takes another 105 days for the officer to resolve the issue. In total, it takes approximately 6 months from the time a breach occurs to the time the issue is resolved. Additionally, if a data breach occurs but a patient does not notice, it could take months – or even years – for someone to discover the problem. And of course, the longer it takes the hospital to identify a problem, the higher the cost of identifying how the breach occurred and remediating the situation.

In 2013, Rouge Valley Centenary Hospital in Scarborough, Canada, revealed that the contact information of approximately 8,300 new mothers had been inappropriately accessed by two employees. Since 2009, the two employees had been selling the contact information of new mothers to a private company specializing in Registered Education Savings Plans (RESPs). Some of the patients later reported that days after coming home from the hospital with their newborn child, they started receiving calls from sales representatives at the private RESP company. Marketing representatives were extremely aggressive, and seemed to know the exact date of when their child had been born.

The most terrifying aspect of this story is how the hospital was able to find out about the data breach: remorse and human error! One employee voluntarily turned himself in, while the other accidentally left patient records on a printer. Had these two events not happened, the scam could have continued for much longer than the four years it did before it was finally discovered.

Rouge Valley Hospital is currently facing a $412 million dollar lawsuit over this breach of privacy. Arguably even more damaging, is that they have lost the trust of their patients who relied on the hospital for care and confidentiality of their medical treatments.

As exemplified by the ramifications of the Rouge Valley Hospital breach and the new breaches discovered almost weekly in hospitals around the world, the current tools used to detect privacy breaches in electronic health records are not sufficient. A system needs to have the ability to detect when employees are accessing information outside their clinical and administrative responsibilities. Had the Scarborough hospital known about the inappropriately viewed records the first time they had been accessed, they could have investigated earlier and protected the privacy of thousands of new mothers.

Every person seeks a hospital’s care has the right to privacy and the protection of their medical information. However, due to the sheer volume of patient records accessed each day, it is impossible for compliance officers to efficiently detect breaches without new and practical tools. Current rule-based analytical systems often overburden the officers with alerts, and are only a minor improvement from manual detection methods.

We are in the midst of a paradigm shift with hospitals taking a more proactive and layered approach to health data security. New technology that uses machine learning and big data science to review each access to medical records will replace traditional compliance technology and streamline threat detection and resolution cycles from months to a matter of minutes. Making identifying a privacy breach or violation as simple and fast as the action that may have caused it in the first place.  Understanding how to select and implement these next-generation tools will be a new and important challenge for the compliance officers of the future, but one that they can no longer afford to delay.

Protenus is a health data security platform that protects patient data in electronic medical records for some of the nation’s top-ranked hospitals. Using data science and machine learning, Protenus technology uniquely understands the clinical behavior and context of each user that is accessing patient data to determine the appropriateness of each action, elevating only true threats to patient privacy and health data security.

10 Health IT Security Questions Every Healthcare CIO Must Answer

Posted on April 19, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Logicalis recently sent out 10 Security Questions Every CIO Must Be Able to Answer. Here’s their list:

  1. If you knew that your company was going to be breached tomorrow, what would you do differently today?
  2. Has your company ever been breached? How do you know?
  3. What assets am I protecting, what am I protecting them from (i.e., theft, destruction, compromise), and who am I protecting them from (i.e. cybercriminals or even insiders)?
  4. What damage will we sustain if we are breached (i.e., financial loss, reputation, regulatory fines, loss of competitive advantage)?
  5. Have you moved beyond an “inside vs. outside” perimeter-based approach to information security?
  6. Does your IT security implementation match your business-centric security policies? Does it rely on written policies, technical controls or both?
  7. What is your security strategy for IoT (also known as “the Internet of threat”)?
  8. What is your security strategy for “anywhere, anytime, any device” mobility?
  9. Do you have an incident response plan in place?
  10. What is your remediation process? Can you recover lost data and prevent a similar attack from happening again?

Given the incredible rise in hospitals being breached or held ransom, it’s no surprise that this is one of the hottest topics in healthcare. No doubt many a hospital CIO has had sleepless nights thanks to these challenges. If you’re a CIO that has been sleeping well at night, I’m afraid for your organization.

The good news is that I think most healthcare organizations are taking these threats seriously. Many would now be able to answer the questions listed above. Although, I imagine some of them need some work. Maybe that’s the key lesson to all of this. There’s no silver bullet solution. Security is an ongoing process and has to be built into the culture of an organization. There’s always new threats and new software being implemented that needs to be protected.

With that said, health IT leaders need to sometimes shake things up in their organization too. A culture of security is an incredible starting point. However, there’s nothing that focuses an organization more than for a breach to occur. The hyper focus that occurs is incredible to watch. If I was a health IT leader, I’d consider staging a mock breach and see what happens. It will likely open your eyes to some poor processes and some vulnerabilities you’d missed.

Are Ransomware Attacks A HIPAA Issue, Or Just Our Fault?

Posted on April 18, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

With ransomware attacks hitting hospitals in growing numbers, it’s growing more urgent for healthcare organizations to have a routine and effective response to such attacks. While over the short term, providers are focused mostly on survival, eventually they’ll have to consider big-picture implications — and one of the biggest is whether a ransomware intrusion can be called a “breach” under federal law.

As readers know, providers must report any sizable breach to the HHS Office for Civil Rights. So far, though, it seems that the feds haven’t issued any guidance as to how they see this issue. However, people in the know have been talking about this, and here’s what they have to say.

David Holtzman, a former OCR official who now serves as vice president of compliance strategies at security firm CynergisTek, told Health Data Management that as long as the data was never compromised, a provider may be in the clear. If an organization can show OCR proof that no data was accessed, it may be able to avoid having the incident classed as a breach.

And some legal experts agree. Attorney David Harlow, who focuses on healthcare issues, told Forbes: “We need to remember that HIPAA is narrowly drawn and data breaches defined as the unauthorized ‘access, acquisition, use or disclosure’ of PHI. [And] in many cases, ransomware “wraps” PHI rather than breaches it.”

But as I see it, ransomware attacks should give health IT security pros pause even if they don’t have to report a breach to the federal government. After all, as Holtzman notes, the HIPAA security rule requires that providers put appropriate safeguards in place to ensure the confidentiality, the integrity and availability of ePHI. And fairly or not, any form of malware intrusion that succeeds raises questions about providers’ security policies and approaches.

What’s more, ransomware attacks may point to underlying weaknesses in the organization’s overall systems architecture. “Why is the operating system allowing this application to access this data?” asked one reader in comments on a related EMR and HIPAA post. “There should be no possible way for a database that is only read/write for specified applications to be modified by a foreign encryption application,” the reader noted. “The database should refuse the instruction, the OS should deny access, and the security system should lock the encryption application out.”

To be fair, not all intrusions are someone’s “fault.” Ransomware creators are innovating rapidly, and are arguably equipped to find new vectors of infection more quickly than security experts can track them. In fact, easy-to-deploy ransomware as a service is emerging, making it comparatively simple for less-skilled criminals to use. And they have a substantial incentive to do so. According to one report, one particularly sophisticated ransomware strain has brought $325 million in profits to groups deploying it.

Besides, downloading actual data is so five years ago. If you’re attacking a provider, extorting payment through ransomware is much easier than attempting to resell stolen healthcare data. Why go to all that trouble when you can get your cash up front?

Still, the reality is that healthcare organizations must be particularly careful when it comes to protecting patient privacy, both for ethical and regulatory reasons. Perhaps ransomware will be the jolt that pushes lagging players to step up and invest in security, as it creates a unique form of havoc that could easily put patient care at risk. I certainly hope so.

You Might Have a Culture of Healthcare IT Security if…

Posted on April 6, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve often written that the key to really ensuring the security and privacy of data in healthcare, we need healthcare organizations to build a culture of security and privacy. It’s not just going to happen with a short term sprint.

So, I thought I’d have some fun and turn it into a list of ways for you to know if your organization has an organization of healthcare IT security or not.

You might have a culture of healthcare IT security if…your chief security officer has power to influence change.

You might have a culture of healthcare IT security if…you’ve spent time doing risk mitigation after your HIPAA risk assessment.

You might have a culture of healthcare IT security if…you’ve found breaches in your system (Note that you found them as opposed to them finding you).

You might have a culture of healthcare IT security if…you’ve turned down a company because of their inability to show you security best practices.

You might have a culture of healthcare IT security if…you’ve spent as much time on people as technology.

You might have a culture of healthcare IT security if…someone other than your chief security officer or HIPAA committee has brought a security issue to your attention.

You might have a culture of healthcare IT security if…you’ve spent a sleepless night worrying about security at your organization.

I’m sure I’m missing some obvious things. Please add to the list in the comments.

Breach Affecting 2.2M Patients Highlights New Health Data Threats

Posted on April 4, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A Fort Myers, FL-based cancer care organization is paying a massive price for a health data breach that exposed personal information on 2.2 million patients late last year. This incident is also shedding light on the growing vulnerability of non-hospital healthcare data, as you’ll see below.

Recently, 21st Century Oncology was forced to warn patients that an “unauthorized third party” had broken into one of its databases. Officials said that they had no evidence that medical records were accessed, but conceded that breached information may have included patient names Social Security numbers, insurance information and diagnosis and treatment data.

Notably, the cancer care chain — which operates on hundred and 45 centers in 17 states — didn’t learn about the breach until the FBI informed the company that it had happened.

Since that time, 21st Century has been faced with a broad range of legal consequences. Three lawsuits related to the breach have been filed against the company. All are alleging that the breach exposed them to a great possibility of harm.  Patient indignation seems to have been stoked, in part, because they did not learn about the breach until five months after it happened, allegedly at the request of investigating FBI officials.

“While more than 2.2 million 21st Century Oncology victims have sought out and/or pay for medical care from the company, thieves have been hard at work, stealing and using their hard-to-change Social Security numbers and highly sensitive medical information,” said plaintiff Rona Polovoy in her lawsuit.

Polovoy’s suit also contends that the company should have been better prepared for such breaches, given that it suffered a similar security lapse between October 2011 and August 2012, when an employee used patient names Social Security numbers and dates of birth to file fraudulent tax refund claims. She claims that the current lapse demonstrates that the company did little to clean up its cybersecurity act.

Another plaintiff, John Dickman, says that the breach has filled his life with needless anxiety. In his legal filings he says that he “now must engage in stringent monitoring of, among other things, his financial accounts, tax filings, and health insurance claims.”

All of this may be grimly entertaining if you aren’t the one whose data was exposed, but there’s more to this case than meets the eye. According to a cybersecurity specialist quoted in Infosecurity Magazine, the 21st Century network intrusion highlights how exposed healthcare organizations outside the hospital world are to data breaches.

I can’t help but agree with TrapX Security executive vice president Carl Wright, who told the magazine that skilled nursing facilities, dialysis centers, imaging centers, diagnostic labs, surgical centers and cancer treatment facilities like 21st are all in network intruders’ crosshairs. Not only that, he notes that large extended healthcare networks such as accountable care organizations are vulnerable.

And that’s a really scary thought. While he doesn’t say so specifically, it’s logical to assume that the more unrelated partners you weld together across disparate networks, it multiplies the number of security-related points of failure. Isn’t it lovely how security threats emerge to meet every advance in healthcare?

This Time, It’s Personal: Virus Hits My Local Hospital

Posted on March 30, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

In about two weeks, I am scheduled to have a cardiac ablation to address a long-standing arrhythmia. I was feeling pretty good about this — after all, the procedure is safe at my age and is known to have a very high success rate — until I scanned my Twitter feed yesterday.

It was then that I found out that what was probably a ransomware virus had forced a medical data shutdown at Washington, D.C.-based MedStar Health. And while the community hospital where my procedure will be done is not part of the MedStar network, the cardiac electrophysiologist who will perform the ablation is affiliated with the chain.

During my pre-procedure visit with the doctor, a very pleasant guy who made me feel very safe, we devolved to talking shop about EMR issues after the clinical discussion was over. At the time he shared that his practice ran on GE Centricity which, he understandably complained, was not interoperable with the Epic system at one community chain, MedStar’s enterprise system or even the imaging platforms he uses. Under those circumstances, it’s hard to imagine that my data was affected by this breach. But as you can imagine, I still wonder what’s up.

While there’s been no official public statement saying this virus was part of a ransomware attack, some form of virus has definitely wreaked havoc at MedStar, according to a report by the Washington Post. (As a side note, it’s worth pointing out that if this is a ransomware attack, health system officials have done an admirable job of keeping the amount demanded for data return out of the press. However, some users have commented about ransomware on their individual computers.)

As the news report notes, MedStar has soldiered on in the face of the attack, keeping all of its clinical facilities open. However, a hospital spokesperson told the newspaper that the chain has decided to take down all system interfaces to prevent the spread of the virus. And as has happened with other hospital ransomware incursions, staffers have had to revert to using paper-based records.

And here’s where it might affect me personally. Even though my procedure is being done at a non-MedStar hospital, it’s possible that the virus driven delay in appointments and surgeries will affect my doctor, which could of course affect me.

Meanwhile, imagine how the employees at MedStar facilities feel: “Even the lowest-level staff can’t communicate with anyone. You can’t schedule patients, you can’t access records, you can’t do anything,” an anonymous staffer told the Post. Even if such a breach had little impact on patients, it’s obviously bad for employee morale. And that can’t be good for me either.

Again, it’s possible I’m in the clear, but the fact that the FUD surrounding this episode affects even a trained observer like myself plays right into the virus makers’ hands. Now, so far I haven’t dignified the attack by calling the doctor’s office to ask how it will affect me, but if I keep reading about problems with MedStar systems I’ll have to follow up soon.

Worse, when I’m being anesthetized for the procedure next month, I know I’ll be wondering when the next virus will hit.

Cyber Breach Insurance May Be Useless If You’re Negligent

Posted on March 28, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Ideally, your healthcare organization will never see a major data breach. But realistically, given how valuable healthcare data is these days — and the extent to which many healthcare firms neglect data security — it’s safer to assume that you will have to cope with a breach at some point.

In fact, it might be wise to assume that some form of costly breach is inevitable. After all, as one infographic points out, 55 healthcare organizations reported network attacks resulting in data breaches last year, which resulted in 111,809,322 individuals’ health record information being compromised. (If you haven’t done the math in your head, that’s a staggering 35% of the US population.)

The capper: if things don’t get better, the US healthcare industry stands to lose $305 billion in cumulative lifetime patient revenue due to cyberattacks likely to take place over the next five years.

So, by all means, protect yourself by any means available. However, as a recent legal battle suggests, simply buying cyber security insurance isn’t a one-step solution. In fact, your policy may not be worth much if you don’t do your due diligence when it comes to network and Internet security.

The lawsuit, Columbia Casualty Company v. Cottage Health System, shows what happens when a healthcare organization (allegedly) relies on its cyber insurance policy to protect it against breach costs rather than working hard to prevent such slips.

Back in December 2013, the three-hospital Cottage Health System notified 32,755 of its patients that their PHI had been compromised. The breach occurred when the health system and one of its vendors, InSync, stored unencrypted medical records on an Internet accessible system.

It later came out that the breach was probably caused by careless FTP settings on both systems servers which permitted anonymous user access, essentially opening up access to patient health records to anyone who could use Google. (Wow. If true that’s really embarrassing. I doubt a sharp 13-year-old script kiddie would make that mistake.)

Anyway, a group of presumably ticked off patients filed a class action suit against Cottage asking for $4.125 million. At first, cyber breach insurer Columbia Casualty paid out the $4.125 million and settled the case. Now, however, the insurer is suing Cottage, asking the health system to pay it back for the money it paid out to the class action members. It argues that Cottage was negligent due to:

  • a failure to continuously implement the procedures and risk controls identified in the application, including, but not limited to, its failure to replace factory default settings and its failure to ensure that its information security systems were securely configured; and
  • a failure to regularly check and maintain security patches on its systems, its failure to regularly re-assess its information security exposure and enhance risk controls, its failure to have a system in place to detect unauthorized access or attempts to access sensitive information stored on its servers and its failure to control and track all changes to its network to ensure it remains secure.

Not only that, Columbia Casualty asserts, Cottage lied about following a minimum set of security practices known as a “Risk Control Self Assessment” required as part of the cyber insurance application.

Now, if the cyber insurer’s allegations are true, Cottage’s behavior may have been particularly egregious. And no one has proven anything yet, as the case is still in the early stages, but this dispute should still stand as a warning to all healthcare organizations. If you neglect security, then try to get an insurance company to cover your behind when breaches occur, you might be out of luck.

The Sick State of Healthcare Data Breaches Infographic

Posted on March 9, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the topics discussed at HIMSS 2016 last week is the number of healthcare data breaches that have happened recently. Most people predicted that it was likely to get worse. I agree with them. It’s amazing how many healthcare organizations are playing the “ignorance is bliss” card when it comes to these breaches.

This infographic from LightCyber should put a little perspective on the quantity and impact of all these health care data breaches. If I were the leader of a healthcare organization, I’d be making this one of my top priorities.

The Sick State of Healthcare Data Breaches Infographic