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Medical Device Security At A Crossroads

Posted on April 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.

As anyone reading this knows, connected medical devices are vulnerable to attacks from outside malware. Security researchers have been warning healthcare IT leaders for years that network-connected medical devices had poor security in place, ranging from image repository backups with no passwords to CT scanners with easily-changed configuration files, but far too many problems haven’t been addressed.

So why haven’t providers addressed the security problems? It may be because neither medical device manufacturers nor hospitals are set up to address these issues. “The reality is both sides — providers and manufacturers — do not understand how much the other side does not know,” said John Gomez, CEO of cybersecurity firm Sensato. “When I talk with manufacturers, they understand the need to do something, but they have never had to deal with cyber security before. It’s not a part of their DNA. And on the hospital side, they’re realizing that they’ve never had to lock these things down. In fact, medical devices have not even been part of the IT group and hospitals.

Gomez, who spoke with Healthcare IT News, runs one of two companies backing a new initiative dedicated to securing medical devices and health organizations. (The other coordinating company is healthcare security firm Divurgent.)

Together, the two have launched the Medical Device Cybersecurity Task Force, which brings together a grab bag of industry players including hospitals, hospital technologists, medical device manufacturers, cyber security researchers and IT leaders. “We continually get asked by clients with the best practices for securing medical devices,” Gomez told Healthcare IT News. “There is little guidance and a lot of misinformation.“

The task force includes 15 health systems and hospitals, including Children’s Hospital of Atlanta, Lehigh Valley Health Network, Beebe Healthcare and Intermountain, along with tech vendors Renovo Solutions, VMware Inc. and AirWatch.

I mention this initiative not because I think it’s huge news, but rather, as a reminder that the time to act on medical device vulnerabilities is more than nigh. There’s a reason why the Federal Trade Commission, and the HHS Office of Inspector General, along with the IEEE, have launched their own initiatives to help medical device manufacturers boost cybersecurity. I believe we’re at a crossroads; on one side lies renewed faith in medical devices, and on the other nothing less than patient privacy violations, harm and even death.

It’s good to hear that the Task Force plans to create a set of best practices for both healthcare providers and medical device makers which will help get their cybersecurity practices up to snuff. Another interesting effort they have underway in the creation of an app which will help healthcare providers evaluate medical devices, while feeding a database that members can access to studying the market.

But reading about their efforts also hammered home to me how much ground we have to cover in securing medical devices. Well-intentioned, even relatively effective, grassroots efforts are good, but they’re only a drop in the bucket. What we need is nothing less than a continuous knowledge feed between medical device makers, hospitals, clinics and clinicians.

And why not start by taking the obvious step of integrating the medical device and IT departments to some degree? That seems like a no-brainer. But unfortunately, the rest of the work to be done will take a lot of thought.

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.

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.

Health IT Jobs Data Yields A Few Surprises

Posted on February 25, 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.

After taking a look at a pre-release copy of a new report chronicling trends in the healthcare IT staffing world (The full report will be released during HIMSS), I’ve realized that many of my assumptions about the health IT workforce are wrong.  The report, from specialist technology recruitment firm Greythorn, offers a useful look at just who makes up the healthcare IT workforce and how they prefer to work, but just as importantly, how health organizations are treating them.

To collect its data, the recruiting company surveyed 430 U.S. IT professionals over Q4 2015. Greythorn focused on factors that define the healthcare pro’s work experience, including the demographics of the HIT workforce, length of tenure, hours in a typical work week, career motivation and reward/bonus trends.

More than one item in the report surprised me. For example, despite last year’s ups and downs, 84% of respondents reported feeling optimistic or extremely optimistic about healthcare IT, up from 78% the previous year.

Also, some of the demographics data caught me off guard:

  • 59% of respondents were female, while only 41% were male. I couldn’t dig up a stat on the overall makeup of the US HIT workforce, but my best guess is that it’s still male-dominated. So this was of note.
  • Also, 52% of respondents were between 43 and 60 years old, though another 24% of respondents were 25 to 34 years old. On level it makes sense, as health IT work takes specialized expertise that doesn’t come overnight, but it bucks the general IT image as a haven for young hopefuls.
  • I was also surprised to learn that only 40% of respondents were employed full time,  On the other hand, given that consultants and contractors can earn 50% to 100% more than full-timers (Greythorn’s data), it’s actually a pretty logical development.
  • Greythorn found that 43% of respondents were working 41 to 45 per week, not bad for a demanding professional position. On the other hand, 21% report working 46 to 50 hours, and 10% more than 60 hours.

The report also served up some interesting data regarding HIT hiring and staff headcount:

  • 39% of respondents said that they expected to increase headcount, perhaps signalling a move away from implementing big projects largely with contractors. On the other hand, 24% reported that they expected to cut headcount, so I could be off base.
  • On the flip side, only 9% said that they expected to see significant headcount losses, with 33% asserting that headcount would probably remain the same.

When it came to technical specializations, the results were fairly predictable. When asked which EMR system they knew best:

  • 55% of respondents named Epic
  • 19% named Cerner
  • 5% named Meditech
  • 3% named Allscripts and McKesson
  • 14% cited “other”

Finally, given that many of the survey respondents seem to cluster at the high end of experience levels, I was intrigued to note the wide spread in salaries, which ranged from less than $50K per year to to more than $160K. Some of the most interesting numbers, included the following:

  • 20% reported earning $50K to $69,999
  • 21% were earning $100K to $119,999
  • 6% reported earning more than $160K

To my way of thinking, it doesn’t make sense that 53% of  health IT pros  — many of whom reported being fairly senior, were making less than $100K per year.

Sure, health organizations’ budgets are stretched thin. But skimping on IT pay is likely to have a negative impact on recruitment and retention. As we cruise into 2016, let’s keep an eye on this problem. I doubt junior- to mid-level salaries will attract the hard-core HIT veterans needed to transform health IT over the coming years.

Note: Healthcare Scene helped promote this survey and Greythorn pays to post its healthcare IT jobs to our healthcare IT job board.

Patient Engagement Will Be Key to Personalized Medicine and Healthcare Analytics

Posted on February 16, 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.

When I wrote about personalized medicine solutions that are available today, I mostly covered the data aspects of personalized medicine. It’s a logical place to start since the basis of personalized medicine is data. In that post I highlighted the SAP Foundation for Health and the SAP Hana platform along with the work of ASCO and their CancerLinQ project. No doubt there are hundreds of other examples around health care where data is being used to personalize the care that’s provided.

It makes a lot of sense for a company like SAP to take on the data aspects of personalized medicine. SAP is known for doing massive data from complex data sets. They’re great at sorting through a wide variety of data from multiple sources and they’re even working on new innovations where they can analyze your data quickly and effectively without having to export every single piece of data to some massive (Translation: Expensive) enterprise data warehouse. Plus, in many cases they’re doing all of this health data analytics in the cloud so you can be sure that your healthcare analytics solution can scale. While this is a huge step forward, it is just the start.

As I look at the discussion around personalized medicine, what seems to be missing is a focus on creating a connection with the patient. Far too often, analytics vendors in healthcare just want to worry about the data analysis and don’t build out the tools required to engage with the patient directly. This leads to poor patient engagement in two ways: improving patient communication and collecting patient data.

Improving Patient Communication
As we look into the future of reimbursement in healthcare, it’s easy to see how crucial it will be to leverage the right data to identify the right patients. However, you can’t stop there. Once you’ve identified the right patients, you have to have a seamless and effective way to regularly communicate with that patient. As value based reimbursement becomes a reality, no healthcare analytics solution will be complete without the functionality to truly engage with the patient and improve their health.

Patient engagement platforms will require the following three fundamentals to start improving care: interaction between patient and caregiver, privacy, and security. No doubt we’re already starting to see a wide variety of approaches to how you’ll communicate with and engage the patient. However, if you don’t get these three fundamentals down then all of the rest doesn’t really matter. The basis of improved patient communication is going to be efficient communication between patient and caregiver in a secure and private manner.

Collecting Patient Data
Too many analytics platforms only focus on the data that comes from the healthcare providers like the EHR. As the health sensor market matures, more and more clinically relevant data is going to be generated by the patient and the devices they use at home. In fact, in some areas like diabetes this is already happening. Over the next 5 years we’re going to start seeing this type of patient generated data spread across every disease state.

Health analytics platforms of the future are going to have to be able to handle all of this patient generated health data. The key first step is to make it easy for the patient to connect their health devices to your platform. The second step is to convert this wave of patient generated health data into something that can easily be consumed by the healthcare provider. Both steps will be necessary for personalized medicine to become a reality in health care.

As we head into HIMSS 2016 in a couple weeks, I’ll be looking at which vendors are taking analytics to the next level by including patient engagement. While there’s a lot of value in processing healthcare provider data, the future of personalized medicine will have to include the patient in both how we communicate with them and how we incorporate the data they collect the 99% of their lives spent outside of the hospital.

SAP is uniquely positioned to help advance personalized medicine. The SAP Foundation for Health is built on the SAP Hana platform which provides scalable cloud analytics solutions across the spectrum of healthcare. SAP is a sponsor of Influential Networks of which Healthcare Scene is a member. You can learn more about SAP’s healthcare solutions during #HIMSS16 at Booth #5828.

NIST Goes After Infusion Pump Security Vulnerabilities

Posted on January 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.

As useful as networked medical devices are, it’s become increasingly apparent that they pose major security risks.  Not only could intruders manipulate networked devices in ways that could harm patients, they could use them as a gateway to sensitive patient health information and financial data.

To make a start at taming this issue, the National Institute of Standards and Technology has kicked off a project focused on boosting the security of wireless infusion pumps (Side Note: I wonder if this is in response to Blackberry’s live hack of an infusion pump). In an effort to be sure researchers understand the hospital environment and how the pumps are deployed, NIST’s National Cybersecurity Center of Excellence (NCCoE) plans to work with vendors in this space. The NCCoE will also collaborate on the effort with the Technological Leadership Institute at the University of Minnesota.

NCCoE researchers will examine the full lifecycle of wireless infusion pumps in hospitals, including purchase, onboarding of the asset, training for use, configuration, use, maintenance, decontamination and decommissioning of the pumps. This makes a great deal of sense. After all, points of network connection are becoming so decentralized that every touchpoint is suspect.

The team will also look at what types of infrastructure interconnect with the pumps, including the pump server, alarm manager, electronic medication administration record system, point of care medication, pharmacy system, CPOE system, drug library, wireless networks and even the hospital’s biomedical engineering department. (It’s sobering to consider the length of this list, but necessary. After all, more or less any of them could conceivably be vulnerable if a pump is compromised.)

Wisely, the researchers also plan to look at the way a wide range of people engage with the pumps, including patients, healthcare professionals, pharmacists, pump vendor engineers, biomedical engineers, IT network risk managers, IT security engineers, IT network engineers, central supply workers and patient visitors — as well as hackers. This data should provide useful workflow information that can be used even beyond cybersecurity fixes.

While the NCCoE and University of Minnesota teams may expand the list of security challenges as they go forward, they’re starting with looking at access codes, wireless access point/wireless network configuration, alarms, asset management and monitoring, authentication and credentialing, maintenance and updates, pump variability, use and emergency use.

Over time, NIST and the U of M will work with vendors to create a lab environment where collaborators can identify, evaluate and test security tools and controls for the pumps. Ultimately, the project’s goal is to create a multi-part practice guide which will help providers evaluate how secure their own wireless infusion pumps are. The guide should be available late this year.

In the mean time, if you want to take a broader look at how secure your facility’s networked medical devices are, you might want to take a look at the FDA’s guidance on the subject, “Cybersecurity for Networked Medical Devices Containing Off-the-Shelf Software.” The guidance doc, which was issued last summer, is aimed at device vendors, but the agency also offers a companion document offering information on the topic for healthcare organizations.

If this topic interests you, you may also want to watch this video interview talking about medical device security with Tony Giandomenico, a security expert at Fortinet.

Mobile Health Security Issues To Ponder In 2016

Posted on January 11, 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 some ways, mobile health security safeguards haven’t changed much for quite some time. Making sure that tablets and phones are protected against becoming easy network intrusion points is a given. Also seeing to it that such devices use strong passwords and encrypted data exchange whenever possible is a must.

But increasingly, as mobile apps become more tightly knit with enterprise infrastructure, there’s more security issues to consider. After all, we’re increasingly talking about mission-critical apps which rely on ongoing access to sensitive enterprise networks. Now more than ever, enterprises must come up with strategies which control how data flows into the enterprise network. In other words, we’re not just talking about locking down the end points, but also seeing to it that powerful edge devices are treated like the vulnerable hackable gateways they are.

To date, however, there’s still not a lot of well-accepted guidance out there spelling out what steps health organizations should take to ramp up their mobile security. For example, NIST has issued its “Securing Electronic Health Records On Mobile Devices” guideline, but it’s only a few months old and remains in draft form to date.

The truth is, the healthcare industry isn’t as aware of, or prepared for, the need for mobile healthcare data security as it should be. While healthcare organizations are gradually deploying, testing and rolling out new mobile platforms, securing them isn’t being given enough attention. What’s more, clinicians aren’t being given enough training to protect their mobile devices from hacks, which leaves some extremely valuable data open to the world.

Nonetheless, there are a few core approaches which can be torqued up help protect mobile health data this year:

  • Encryption: Encrypting data in transit wasn’t invented yesterday, but it’s still worth a check in to make sure your organization is doing so. Gregory Cave notes that data should be encrypted when communicated between the (mobile) application and the server. And he recommends that Web traffic be transmitted through a secure connection using only strong security protocols like Secure Sockets Layer or Transport Layer Security. This also should include encrypting data at rest.
  • Application hardening:  Before your organization rolls out mobile applications, it’s best to see to it that security defects are detected before and addressed before deployment. Application hardening tools — which protect code from hackers — can help protect mobile deployments, an especially important step for software placed on machines and locations your organization doesn’t control. They employ techniques such as obfuscation, which hides code structure and flow within an application, making it hard for intruders to reverse engineer or tamper with the source code.
  • Training staff: Regardless of how sophisticated your security systems are, they’re not going to do much good if your staff leaves the proverbial barn door open. As one security expert points out,  healthcare organizations need to make staffers responsible for understanding what activities lead to breaches, or security hackers will still find a toehold.”It’s like installing the most sophisticated security system in the world for your house, but not teaching the family how to use it,” said Grant Elliott, founder and CEO of risk management and compliance firm Ostendio.

In addition to these efforts, I’d argue that staffers need to really get it as to what happens when security goes awry. Knowing that mistakes will upset some IT guy they’ve never met is one thing; understanding that a breach could cost millions and expose the whole organization to disrepute is a bit more memorable. Don’t just teach the security protocols, teach the costs of violating them. A little drama — such as the little old lady who lost her home due to PHI theft — speaks far more powerfully than facts and figures, don’t you agree?

Tiny Budgets Undercut Healthcare’s Cyber Security Efforts

Posted on January 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.

This has been a lousy year for healthcare data security — so bad a year that IBM has dubbed 2015 “The Year of The Healthcare Security Breach.” In a recent report, Big Blue noted that nearly 100 million records were compromised during the first 10 months of this year.

Part of the reason for the growth in healthcare data breaches seems to be due to the growing value of Protected Health Information. PHI is worth 10x as much as credit card information these days, according to some estimates. It’s hardly surprising that cyber criminals are eager to rob PHI databases.

But another reason for the hacks may be — to my way of looking at things — an indefensible refusal to spend enough on cybersecurity. While the average healthcare organization spends about 3% of their IT budget on cybersecurity, they should really allocate 10% , according to HIMSS cybersecurity expert Lisa Gallagher.

If a healthcare organization has an anemic security budget, they may find it difficult to attract a senior healthcare security pro to join their team. Such professionals are costly to recruit, and command salaries in the $200K to $225K range. And unless you’re a high-profile institution, the competition for such seasoned pros can be fierce. In fact, even high-profile institutions have a challenge recruiting security professionals.

Still, that doesn’t let healthcare organizations off the hook. In fact, the need to tighten healthcare data security is likely to grow more urgent over time, not less. Not only are data thieves after existing PHI stores, and prepared to exploit traditional network vulnerabilities, current trends are giving them new ways to crash the gates.

After all, mobile devices are increasingly being granted access to critical data assets, including PHI. Securing the mix of corporate and personal devices that might access the data, as well as any apps an organization rolls out, is not a job for the inexperienced or the unsophisticated. It takes a well-rounded infosec pro to address not only mobile vulnerabilities, but vulnerabilities in the systems that dish data to these devices.

Not only that, hospitals need to take care to secure their networks as devices such as insulin pumps and heart rate monitors become new gateways data thieves can use to attack their networks. In fact, virtually any node on the emerging Internet of Things can easily serve as a point of compromise.

No one is suggesting that healthcare organizations don’t care about security. But as many wiser heads than mine have pointed out, too many seem to base their security budget on the hope-and-pray model — as in hoping and praying that their luck will hold.

But as a professional observer and a patient, I find such an attitude to be extremely reckless. Personally, I would be quite inclined to drop any provider that allowed my information to be compromised, regardless of excuses. And spending far less on security than is appropriate leaves the barn door wide open.

I don’t know about you, readers, but I say “Not with my horses!”

Hospital CFO Insights from Craneware Summit

Posted on October 22, 2015 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.

Today I had a chance to attend the Craneware Summit in Las Vegas. The Craneware Summit gives me a nice view into what’s happening in the financial world of healthcare. The Summit kicked off today with Todd Nelson speaking about the hospital CFO. Here’s a look at some of the insights he offered:


Todd Nelson is a former hospital CFO that is now a VP at HFMA.


Is this equation too simple?


I don’t think that meaningful use money will go away, but it’s worth considering. Would your organization survive if the rest of the meaningful use money were pulled out from underneath you?


This is often forgotten. It’s “easy” to get the billion dollar EHR implementation budget, but many forget to include the ongoing EHR support and optimization budget. In my experience this is often just bad planning, but in a few cases it’s done deliberately in order to allow the EHR project to go forward. They figure they can always ask for the support and optimization budget later.


This was an interesting comment coming from an accountant and former hospital CFO. He was willing to admit that he doesn’t have the skill or at least the desire to be the actuary for the hospital. However, as we shift to value based reimbursement, hospitals are going to have to become good at actuarial analysis.


Todd Nelson also extended this comment by saying that you can survive a long time even with losses as long as you have the cash. If you’ve worked with a hospital CFO, you’ve probably seen the cash focus first hand. That hasn’t and probably won’t change.


This is great advice as hospital executives evaluate how to approach the changing healthcare reimbursement environment. Hope is not a strategy.