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Why Penetration Testing in Healthcare Isn't Enough

Posted by Ben Ransford on Jun 26, 2017 7:01:00 AM

That thumping sound is the drumbeat of healthcare cybersecurity news stories. Ransomware, malware, spyware, records theft, covered entities, breaches. Suddenly hospital board members are asking questions about cybersecurity preparedness. That's healthy.

When the board starts knocking, well-meaning CISOs and security teams spring into action, ordering up assessments and other services from a growing cottage industry of third-party security consultants. That's healthy too — healthcare is one of many industries that needs an ecosystem of support around security activities.

The best assessments are sound, complete, and actionable. The worst ones ain't.

Given a statement of work from a third-party assessor, how can you tell whether it's sound, complete, and actionable? That's for a forthcoming post. This post is about one kind of unhelpful assessment: the kind that's only a penetration test.

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Topics: Clinical Cybersecurity, Connected Medical Devices, Medical Device Risk Assessments

Virta Labs at AAMI 2017: Bridging the Gap

Posted by Ben Ransford on Jun 12, 2017 10:53:10 PM

Clinical engineers (CE) and biomeds need to be in the loop if healthcare organizations can hope to address cybersecurity risks.

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Topics: Inventory Management, Clinical Cybersecurity, Healthcare IT

Cybersecurity and Medical Devices: A Practical Guide for Cardiac Electrophysiologists

Posted by Ben Ransford on May 18, 2017 8:32:45 AM

Clinicians now have a peer-reviewed guide from a medical journal on how to evaluate when a medical device security problem translates into a clinical risk. 

There's been a lot of confusion on risk management for pacemaker and defibrillator security because of the difficulty in explaining medical device security in the context of patient safety and risk management. We are pleased to announce our latest publication on the science and engineering to assess risks of medical device security. Led by Virta Labs, the peer-reviewed paper published in Pacing and Clinical Electrophysiology (PACE) is co-authored by researchers (including four PhDs and two MDs) with backgrounds in electrical engineering, computer science, IT security, and electrophysiology from Virta Laboratories, Beth Israel Deaconess Medical Center, the Mayo Clinic, Zhejiang University, the University of South Carolina, and the University of Michigan Health System.

 
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Topics: Clinical Cybersecurity

Not All Heroes Wear Suits: Finding Risks Before Attackers Do

Posted by Ben Ransford on May 16, 2017 6:35:00 AM

(This post is part 2 of 2.  Yesterday we wrote about the unfair fight between attackers and defenders.  Today: simple tools and techniques.)

 

If you WannaCry after this weekend's explosion of worm-ridden ransomware afflicting healthcare providers, go ahead; you're not alone.

The good news is that there are concrete steps you can take to assess your organization's level of exposure to WannaCry a

nd the vulnerability it exploits.  In this post, we'll share some free, basic tests you can perform using tried-and-true open-source tools.  We sell fancy tools to collect and assess networked clinical device inventory, but as technologists and IT administrators ourselves, we're always inclined toward whatever tools get the job done fastest.  In this post we'll cover a simple set of tests that you can start running in under a minute.

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Topics: Ransomware, Asset Management, Clinical Cybersecurity

Be the Hero of Your Weekly Ransomware Staff Meeting

Posted by Ben Ransford on May 15, 2017 6:25:00 AM

(This post is part 1 of 2.  Tomorrow we'll talk about how we coax identifiers out of clinical devices.)

This week's outbreak of click-less ransomware has not been kind to continuity of hospital operations. The bad guys on the outside know the cybersecurity risks of the clinical networks better than the good guys on the inside. That's not a fair fight. How do the bad guys write such infectious malware?  Thanks to easily used tools and public information sources, They know your inventory of software better than you do.

So here's a recommended script for your 7AM emergency cabinet meetings:

1. Offer 60 seconds for your staff to complain about ransomware.

Share a couple horror stories and anecdotes of dodged ransomware bullets. Then stop admiring the problem and focus on your own assets.

2. Biomedical engineering and the IT department need to be on the same page.

In our experience, the best prepared hospitals have a collaborative culture between biomedical engineering and IT. Maybe IT tipped over radiology a few times while trying to "help" biomedical engineering with vulnerability scanning. Don't blame people; you need to work together to continuously assess your population of devices because otherwise the bad guys are going to do it anyway, and not share the results with you. 

If your governance structure leads to in-fighting over responsibility and accountability for cybersecurity of networked medical devices, then your governance is broken. If your management does not provide a cybersecurity budget close to the industry standard for health systems, then maybe the Board needs a shake-up (4% of the IT budget is sad, 11% of the IT budget means you worry about nation state threats).

The CEO needs to empower an executive or manager who understands both IT and clinical risk to make cybersecurity decisions. Examples of potential candidates: a nurse with a degree in management of IT systems will likely understand the importance of safety and health outcomes in the context of cybersecurity. An IT manager who volunteers as an EMT will better understand that IT security is a means to an end, and that security must support safe delivery of healthcare.

3. Fix your networked medical device inventory by fixing the process.

Within a hospital, biomedical engineering often owns the database of medical devices for the Joint Commission certification of 99% accuracy of inventory of life-sustaining devices, but IT owns the databases of network inventory. The days of separately managed data ended when your medical devices joined the network. You have to do both at the same time to understand what networked medical device assets are at risk. We find the most mature healthcare systems follow the NIST cybersecurity framework to first enumerate the risks of assets (both tracked assets and shadow IT). Only after getting solid coverage of the asset population can one make risk-based and business-based decisions on how to compensate for security deficiencies in medical devices. Hire an expensive consulting team or buy a product from any healthcare cybersecurity vendor to get a grip on your inventory and prioritized remediations and compensating controls. The third step is most forgotten: continuously measure the effectiveness of your compensating controls because the bad guys certainly do. No security solution will last in perpetuity, so you must constantly verify controls and adapt to shifting threats and new vulnerabilities. But do so in a risk-based manner focused on essential clinical performance. Do not fetishize cybersecurity, for it is merely a means to and end for safe and highly available delivery of healthcare.

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Topics: Ransomware, Asset Discovery

EMU CTF and the Power of Thinking Outside the Box

Posted by Ben Ransford on Mar 8, 2017 4:00:00 PM

We've written before about our sharp and industrious intern Jessica Wilson, who hacks medical devices to learn then better and who has contributed to many parts of BlueFlow, most recently our Active Directory integration.

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Topics: RECRUITING, Healthcare Cybersecurity, Penetration Testing

American Hospital Association Advice on cybersecurity

Posted by Ben Ransford on Mar 7, 2017 3:23:09 PM

Medical Device Security is an Inventory Problem

Last week, the American Hospital Association (AHA) interviewed us on how to improve medical device security for its podcast to member hospitals. The AHA represents and serves all types of hospitals, health care networks, and their patients and communities in the United States. Nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members come together to form the AHA.

Our colleagues at the AHA get a lot of questions from their members on medical device security. How can a healthcare delivery organization assess the cybersecurity of its inventory of medical devices without resorting to manual entry? How much security is enough? What are the roles of ISAOs? 

Visit the AHA website to listen to their podcast interview of Dr. Kevin Fu of Virta Labs.  

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Topics: Asset Discovery

Safety first: cybersecurity of assets on clinical networks

Posted by Kevin Fu on Mar 4, 2017 3:39:54 PM

It's been an amazingly busy year for medical device security. In 2015, the average hospital had not heard of ransomware. (We warned of the hospital malware onslaught in 2012!) In 2016, the hospital C-suites began asking us, "Could that happen here??" after neighboring health systems were taken offline for days by malware. Duh, yes. The important question is how will you ensure that hospital operations continue to remain available to deliver patient care despite legacy capital equipment, cybersecurity risks, and the shifting threat landscape.

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Topics: Healthcare Cybersecurity, Ransomware, Medical Device Security, Legacy Medical Devices, Asset Management, Enterprise Risk Management, Inventory Management, Clinical Security, CMMS

Pacemaker Programmers (Rogue Ones): Detecting MICS Band Intruders with Software Radio

Posted by Denis Foo Kune on Dec 16, 2016 12:17:07 AM

The healthcare world is abuzz about potential vulnerabilities in cardiac implants. It seems that every few months, hackers publish yet another attack paper. We know the hospital C-suites are concerned about it, because protecting health delivery organizations is our business. The good news is that there are cost-effective ways for healthcare delivery organizations to manage many of the cybersecurity risks against implantable medical devices.

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Topics: Healthcare Cybersecurity, Medical Device Security, Internet of Things / IoT

How health systems recognize cybersecurity awareness month: medical device security webinars

Posted by Kevin Fu on Oct 13, 2016 10:30:48 PM

How is your health system recognizing October as National Cybersecurity Awareness Month? Last year, we were invited to speak in an exclusive webinar for clinical engineers and IT staff at the 12 hospitals within the University of California Health System. This year, we help hospitals recognize National Cybersecurity Awareness Month in two ways. First, we co-authored a commentary in Modern Healthcare with our colleagues from AAMI, UMHS, and BIDMC on why hospitals need better cybersecurity, not more fear. Second, we decided to make a live webinar available to any health system! To learn more, sign up for our Halloween Medical Device Security webinar. 
Register for Free Webinar

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Topics: Medical Device Security, Healthcare IoT, Healthcare IT, Clinical Information Security, Connected Medical Devices

SECURITY IS CONTINUITY OF OPERATIONS

Virta Labs builds security tools tailored to healthcare. With a decade of experience in healthcare security, we understand the importance of respecting safety and clinical workflow. We help healthcare IT focus on the risks that matter.

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