Industry Voices—Why healthcare providers need to approach cybersecurity with a damage-control mindset

A key challenge facing healthcare organizations is meeting Health Insurance Portability and Accountability Act (HIPAA) compliance rules while reducing risk from an evolving threat landscape—all with limited resources.

Caring for patients takes priority.

As such, the industry often falls short in investments toward data security technologies and skilled personnel to manage them. Without a comprehensive approach to data privacy and security—and without the correct controls and resources in place—this can be a recipe for operation disruption and other cyberattacks that lead to reputational damage, financial losses and protracted regulatory investigations.

When healthcare organizations do start looking for security tools, they get hit with misguided approaches that overlook the real issue. Too many security solutions and recommended best practices focus on finding known malware or identified anomalies, as though your risk exposure is automatically remediated as soon as the vulnerability or exploit is discovered. But your work isn’t done just because you’ve found that proverbial needle in the haystack; in some ways, the real work is just beginning.

The next step after finding the needle

This is the common scenario: A suspicious event or activity has been discovered and requires immediate investigation and containment to keep it from causing further damage. This is where post-event forensics comes in.

Forensic analysis evaluates what led to the situation in the first place, with the goal of preventing it in the future. Much like a car accident or aviation event, crash investigators arrive on the scene to secure evidence and determine what caused the accident in hope of preventing a repeat incident.

However, a better goal is to catch this anomaly before it causes business-disrupting damage. This disruption includes not only a break in regular operations but temporary or permanent loss of patient data, reputational harm and even the risk of patient injury or death due to compromised medical devices, systems or technology. And then there are the potential financial losses: ransom payment, investigation, system remediation, lost billable hours and regulatory fines.

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Healthcare compliance penalties are a real concern. While many organizations struggle with risk analysis, cybersecurity controls and third-party management mandates from HIPAA and HITECH (the Health Information Technology for Economic and Clinical Health Act), the Office for Civil Rights (OCR) continues to impose record-setting fines. As breaches continue to evolve, the OCR has made it clear that much of its future focus will be enforcement through audits and breach investigation, including incidents under 500 or fewer individuals.

Compliance is often a complicated and subtle process, which is where automation can come in. Healthcare IT teams can use automation to find anomalies, which is when it comes to the attention of the security operations center (SOC) analyst.

Further investigation

From here, the SOC analyst can start digging to examine the anomaly and investigate. The analyst can triage and do what’s called a full packet capture. This process collects an identical copy of all the traffic streams that are going in and out of the network. This creates a DVR-like replay capability, where the analyst can see exactly what was going on in the network’s traffic: where it came from, where it went and what was contained in it.

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This is where it’s important to understand what kind of packet capture service you have. For example, a service may capture only the headers of HTML traffic, which provide only basic information. The analyst can see that the packet was an email and that it went to a certain location but cannot see the email itself. Full packet capture enables the analyst to open that packet and read that email. This is how inspection of every packet using full packet capture stops threats that would otherwise be missed. And it gives the analyst a way to replay the traffic before the incident occurred to determine what caused the problem in the first place.

When it's time to report a breach

Healthcare threats have become increasingly complex, and motives are evolving. Criminal attacks comprise only part of this threat landscape, though. Third-party error or breach, stolen devices, unintentional employee actions and malicious insiders also play a part.

When a breach occurs, it’s essential to get your general counsel involved quickly—because they’re responsible for protecting the business. Your legal and compliance departments can also evaluate the situation in light of the regulatory and privacy laws your organization must adhere to.

If you believe the attack involves an employee or another insider in an intentional capacity, law enforcement will definitely need to get involved.

Healthcare firms represent an opportunity to extract more value for cybercriminals’ efforts. With patient data and even physical well-being at stake, firms need to have systems, processes and controls in place to protect patients’ physical and data safety. Whether it’s mitigating risk from a third-party breach, preventing a ransomware infection from shutting down life-saving systems or detecting a malicious insider, healthcare providers need to approach the cybersecurity challenge with a damage-control mindset.

Focus on spotting network anomalies before they can cause damage, and make sure the tools you have enable you to make that process as fast and accurate as possible.

Mark Sangster is a vice president and industry security strategist at eSentire Inc.