TTA’s 4th of July Fireworks: sparklers and starbursts from Teladoc, King’s College London, ransomware, FCC, Samsung, Walgreens, more!

 

No fireworks near your Editor except illegal ones, but we have a few legal ones on hand. Ransomware is sending up mortars. COVID’s effect on telehealth is a flitter-glitter comet, but patient counts to date misfire. Samsung starbursts tele-genomics. We’re waving sparklers for the SURE Recovery app from King’s College London. And telehealth celebrated with some nifty Roman candles from the FCC, but Huawei and ZTE were sent the smoke bombs. 

Happy US Independence Day (a/k/a The Colonial Rebellion)–a day early!

News roundup: Teladoc closes InTouch, Samsung bets on tele-genomics, SURE Recovery app, Optimize.health’s seed round, Walgreens’ Microsoft boost
Hackermania runs wild, Required Reading Department: The Anatomy of a Ransomware Attack (Weekend reading for you and your IT department)
Do Huawei and ZTE present security threats to the US and global communications networks? The FCC says yes. (Recognizing geopolitical reality)
FCC approves 70 more COVID-19 telehealth funding applications for an additional $32 million (A major support for growth for small to large organizations)
Hackermania runs wild…all the way to the bank! Ransomware strikes Crozer-Keystone, UCSF med school, others (Hackers in their basements didn’t break for COVID)
COVID effect on US practices: in-person visits down 37%, telehealth peaks at 14%; ATA asks Congress to make expansion permanent (Patients still not visiting their doctors, virtual or not)
The TeleDentists now in 14 states with Anthem (Recognition of an oft-forgotten but key part of medicine)

On the First Day of Summer, there’s hot news with NHS finally giving up on its NHSX COVID tracing app and a few changes over at NHSX. Otherwise, we observe some semblance of a return to Business As Usual. A former unicorn goes bankrupt, a telecare company brings out a new product, the VA has more drama around its EHR. But still plenty of COVID related news, including its hopefully permanent telehealth stimulus, without any drugs!

Breaking: NHSX COVID contact tracing app exits stage left. Enter the Apple and Google dance team. (Not a surprise to anyone, and some changes made)

News Roundup (updated): Proteus files Ch. 11, VA’s EHR tests now fall–maybe, making US telehealth expansion permanent, Rennova’s rural telehealth bet, Oysta’s Lite, Fitbit’s Ready to Work jumps on the screening bandwagon
Where in the world is the NHS COVID contact tracing app? Apps rolling out globally, but will they roll out before it’s treatable?
(Apps have problems, but the protocols are getting better every day)

Despite other events, COVID still makes the news. Malcolm Fisk and his team studied how telehealth responded at the start of the pandemic in three countries. The ‘Thank And Praise’ virtual wall continues to accept thanks for healthcare workers. ATA’s now virtual conference may have been boosted by other cancellations. And finally, COVID struck the courts and held up the Cigna-Anthem breakup settlement–only three years in the making!

Another COVID casualty: a final decision on the Cigna-Anthem damages settlement (It’s only 3 years and billions at stake!)
ATA’s annual conference now 22-26 June–and fully virtual; announces three awards and Fellows (Plenty of names from US, UK, EU)
Thank and Praise’ to healthcare workers continues (UK) (A service that deserves notice for its graciousness)
Telehealth and the response to COVID-19 in Australia, UK, and US: the paper (Malcolm Fisk and team’s comparative study)

Gasping under our fabric masks, we are wheezing the Almost Summertime Blues. Is NHS a little blue with its unready contact tracing app and having to do things the Old Fashioned Way? Higi is not at all blue with a $30 million Series B infusion led by–Babylon Health–nor Propeller Health, 34 EU health tech startups, and Amazon. Google’s attorneys will roast in an Arizona summer. And finally, BMJ discovers that masks might make your breathing a lot more difficult–and concentrate whatever virus you’re exhaling.

Babylon Health leads a $30 million Series B for Higi health kiosks (An interesting series–of mutual interests in the US of A)
News roundup: LabCorp CRO boosts Medable, Propeller Health gains 510(k), EU’s 34 medtech startups, Amazon’s healthcare moves, Google’s Arizona privacy lawsuit
NHS’ COVID contact tracing service started today–but where’s the app? Australia?
(Looks like the old fashioned un-digital way)
Why ‘masking up’ isn’t such a great idea–more than a false sense of security (And 6 other reasons why)

Sloooowly emerging from our homes into the sunshine, and maybe back into our offices soon, we have a first-person participant view of TechForce19. Back in the office, there will be a whole lot of app tracking and separation going on, if we return. In other news, Optum continues its buying spree, Amwell raises a few dollars, and DHACA has a #WebinarWednesday coming up in June. 

Reflections of a TechForce19 Participant (What it’s like to be in the center of a tornado!)
Optum buys naviHealth for reported $1 billion; Amwell raises $194 million in Series C (More $ in analytics, telehealth)
DHACA home testing webinar 20th May 10am–next one 3 June (DHACA’s #WebinarWednesday)
Post-COVID back to work: for workplace screening, testing, contact tracing, there’s an app for that (You’ll be in a very different looking office with plenty of new rules–if you return there)

Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


Read Telehealth and Telecare Aware: http://telecareaware.com/  @telecareaware

Follow our pages on LinkedIn and on Facebook

We thank our present and past advertisers and supporters: Legrand/Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, DHACA, HIMSS, Health 2.0 NYC, MedStartr, Parks Associates, and HealthIMPACT.

Reach international leaders in health tech by advertising your company or event/conference in TTA–contact Donna for more information on how we help and who we reach. See our advert information here. 


Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine and health tech, worldwide–thoughtfully and from the view of fellow professionals

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

Hackermania runs wild…all the way to the bank! Ransomware strikes Crozer-Keystone, UCSF med school, others

News to make you livid. After surviving (to date) the COVID pandemic, health systems and medical schools are being attacked by ransomware criminals. Both the small Crozer-Keystone Health System and the globally known University of California San Francisco School of Medicine have been attacked by the ever-so cutely named Netwalker (a/k/a MailTo). Yes, this criminal hacker gang isn’t outside banging pots for first responders or donating money, or even sticking to a brief truce (Emsisoft), but figuring ways to spread malware into healthcare organizations for fun and profit. 

And profitable it’s been. UCSF paid Netwalker the princely sum of $1.14 million (£910,000) in 116.4 bitcoins after an attack starting 1 June that was also (to add insult to injury) published on Netwalker’s public blog. In the timeline presented by BBC News, it was negotiated down (professionally) from $3 million; BBC also obtained some key parts of the negotiation via an anonymous tipoff, and it’s fascinating reading. Netwalker leads the victim to a dark web ‘customer service’ site where there’s a countdown to double payment or deletion of your now-encrypted data. They are also able to live chat with the victim.

UCSF was able to limit the malware encryption damage to servers within the School of Medicine (according to the BBC, literally unplugging computers; according to UCSF, isolating servers) but decided to pay the ransom to unlock the encrypted data and return data they obtained, stating in its public release “The data that was encrypted is important to some of the academic work we pursue as a university serving the public good”. They will work with the FBI on the incident and have brought on board outside expert help.

According to FierceHealthcare, Netwalker was also behind the attack on the Champaign-Urbana Public Health District (Illinois) website in March and Michigan State University’s network in May.

Paying ransom is contrary to the advice of the major world security services such as the FBI, Europol, and the UK’s National Cyber Security Centre, on the simple basis that it encourages them. It’s a true damned-if-you-do, damned-if-you-don’t situation, as Brett Callow, a threat analyst at cyber-security company Emsisoft, said to the BBC: “But why would a ruthless criminal enterprise delete data that it may be able to further monetise at a later date?” 

Crozer-Keystone to date has refused to pay ransom. On 19 June, bitcoin publication Cointelegraph published a screenshot of Netwalker’s dark web auction page of the data. Apparently it is all financial and not medical records or PHI. Crozer also isolated the intrusion and took systems offline. Crozer is a small system of four hospitals in suburban Philadelphia (Delaware County) and serves parts of the state of Delaware and western New Jersey.

Neither Crozer nor UCSF have gone public with the source of the breach, but it is known that the main lure during the pandemic has been phishing emails with COVID-19 results or news, loaded with malware downloads.

As this Editor wrote back in May 2018 on the anniversary of WannaCry, it’s not a matter of if, but when, at highly vulnerable organizations like healthcare and academia with high-value information records. Right now, the Hakbit spear-phishing ransomware connected to an Excel spreadsheet macro is targeting mid-level individuals at pharma, healthcare, and other sectors in Austria, Germany, and Switzerland, according to tech research firm Proofpoint. TechGenix

More: Becker’s 22 June on Crozer-Keystone, 29 June on UCSF, 12 largest healthcare breaches to date, 10 healthcare system incidents for June, Kroger hacking incident exposing 11,000 health records. DataBreaches.net news page.

Hackermania ‘bigger than government itself’–and 25% of healthcare organizations report mobile breaches

To quote reporter Andy Rooney, ‘why is that?’ Everyone in healthcare (with our Readers well ahead of the curve) has known for years that our organizations are special targets, indeed–by hackers (activists or not), spammers, ransomwarers, criminals, bad guys in China, North Korea, and Eastern Europe, plus an assortment of malicious insiders and the simply klutzy. Why? Healthcare organizations, payers, and service companies have a treasure trove of PHI and PII with Big Value. 

So to read in Healthcare IT News that Christopher Wray, the new director of the FBI, is saying that today’s cyberthreats are bigger than any one agency, and in fact bigger than the government itself, it gives you the feeling that the steamroller has not only run over us, but is on the second pass.

According to one reporting company, Bitglass, breach incidents were year-over-year flat (290), but the number of records affected in 2018 nearly tripled from 4.7 million to 11.5 million. Hacking finally became the top cause (45.9 percent) versus unauthorized access and disclosure (35.9 percent). Loss and theft is down to about 15 percent.

And mobile feels like that second pass. Verizon’s Mobile Security Index 2019 reports that 25 percent of healthcare organizations have had a mobile-related compromise. Nearly all hospitals are investing in mobile. In the field, doctors and other clinicians are either using issued devices or BYOD, whether authorized or not. Whether or not their organizations are using app security systems like Blue Cedar [TTA 17 Feb 18] or work with companies like DataArt on securing proprietary systems is entirely another question. Apparently it’s not a priority. According to the Verizon study, nearly half of all organizations sacrificed mobile security in the past year to “get the job done.” Healthcare Dive.

Back to Director Wray, who is urging public-private cooperation especially with the FBI, which itself has not hesitated to break encryption (e.g. Apple’s) in going after criminals’ phones.

WannaCry’s anniversary: have we learned our malware and cybersecurity lessons?

Hard to believe that WannaCry, and the damage this malware wreaked worldwide, was but a year ago. Two months later, there was Petya/NotPetya. We’ve had hacking and ransomware eruptions regularly, the latest being the slo-mo malware devised by the Orangeworm hackers. What WannaCry and Petya/NotPetya had in common, besides cyberdamage, was they were developed by state actors or hackers with state support (North Korea and–suspected–Russia and/or Ukraine).

The NHS managed to evade Petya, which was fortunate as they were still repairing damage from WannaCry, which initially was reported to affect 20 percent of NHS England trusts. The final count was 34 percent of trusts–at least 80 out of 236 hospital trusts in England, as well as 603 primary care practices and affiliates. 

Has the NHS learned its lesson, or is it still vulnerable? A National Audit Office report concluded in late October that the Department of Health and the NHS were warned at least a year in advance of the risk.  “It was a relatively unsophisticated attack and could have been prevented by the NHS following basic IT security best practice.” There was no mechanism in place for ensuring migration of Windows XP systems and old software, requested by April 2015, actually happened. Another basic–firewalls facing the internet–weren’t actively managed. Worse, there was no test or rehearsal for a cyberdisruption. “As the NHS had not rehearsed for a national cyber attack it was not immediately clear who should lead the response and there were problems with communications.” NHS Digital was especially sluggish in response, receiving first reports around noon but not issuing an alert till 5pm. It was fortunate that WannaCry had a kill switch, and it was found as quickly as it was by a British security specialist with the handle Malware Tech. 

Tests run since WannaCry have proven uneven at best. While there has been reported improvement, even head of IT audit and security services at West Midlands Ambulance Service NHS Trust and a penetration tester for NHS trusts, said that they were “still finding some real shockers out there still.” NHS Digital deputy CEO Rob Shaw told a Public Accounts Committee (PAC) in February that 200 NHS trusts tested against cyber security standards had failed. MPs criticized the NHS and the Department of Health for not implementing 22 recommendations laid out by NHS England’s CIO, Will Smart. Digital Health News

Think ‘cyber-resilience’. It’s not a matter of ‘if’, but ‘when’. Healthcare organizations are never going to fix all the legacy systems that run their world. Medical devices and IoT add-ons will continue to run on outdated or never-updated platforms. Passwords are shared, initial passwords not changed in EHRs. Add to firewalls, prevention measures, emphasizing compliance and best practices, security cyber-resilience–more than a recovery plan, planning to keep operations running with warm backups ready to go, contingency plans, a way to make quick decisions on the main functions that keep the business going. Are healthcare organizations–and the NHS–capable of thinking and acting this way? WannaBet? CSO, Healthcare IT News. Hat tip to Joseph Tomaino of Grassi Healthcare Advisors via LinkedIn.

Breached healthcare records down 72% but incident numbers steady. Then there’s MyFitnessPal’s 150 million…

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]Hackermania in healthcare may be running less wild…but what about consumer health devices? Year-end and top-of-year analyses indicate that the flood of breached records may be starting to drain. A Bitglass analysis of 2017 US Department of Health and Human Services (HHS) data from its infamous ‘Wall of Shame’ is encouraging. They found that the number of breached records decreased over the 2015-2017 period by 72 percent between 2015 and 2017 and by 95 percent from 2016. The calculation excludes the huge spike in breaches due to two 2015 incidents at Anthem and Premera Blue Cross [TTA 9 Sep 15]. Numerically, the breach incident numbers decreased but are relatively steady: 2017 at 294, 2016 at 328. Data security company Protenus in its tracking found more incidents in 2017 versus 2016 (477 in 2017 v. 450 in 2016) but the same reduction in records affected, with five times fewer records in 2017 versus 2016’s 27.3 million records.

What’s been successful has been reducing mega-breaches and containment of healthcare device loss and theft through education and enforcement of employee practices. What continues is the major cause of breaches continue to be insider-related via error and wrongdoing; this includes the major annual Verizon report. Healthcare Informatics

Protenus’ February report, while continuing the reduction trend, had its share of hacking and insider incidents. Of the 39 incidents in their report affecting over 348,000 records, insider actions such as the misuse of system credentials accounted for 51 percent of breached records while hacks were 46 percent, with the majority involving ransomware or malware. Hacking as a cause hasn’t disappeared but perhaps has shifted to easier targets.

UnderArmour’s MyFitnessPal delivers another breach blow. Late last month, the company revealed that 150 million user records were hacked in February. The MyFitnessPal mobile app (more…)

Petya/NotPetya compared to an armed attack by a ‘state actor’ by NATO, Ukraine

Aux armes, citoyens? Hold that Article 5. This US holiday weekend has been light on Petya news, but it seems that NATO has roused itself into the cyberdefense arena as a military arena for them, based on NATO Secretary General Jens Stoltenberg’s statement on Article 5’s collective defense, and a Friday brief that declared:

The global outbreak of NotPetya malware on 27 June 2017 hitting multiple organisations in Ukraine, Europe, US and possibly Russia can most likely be attributed to a state actor, concluded a group of NATO CCD COE researchers Bernhards Blumbergs, Tomáš Minárik, LTC Kris van der Meij and Lauri Lindström. Analysis of both recent large-scale campaigns WannaCry and NotPetya raises questions about possible response options of affected states and the international community.

and

Nevertheless, NotPetya was probably launched by a state actor or a non-state actor with support or approval from a state. Other options are unlikely. The operation was not too complex, but still complex and expensive enough to have been prepared and executed by unaffiliated hackers for the sake of practice. Cyber criminals are not behind this either, as the method for collecting the ransom was so poorly designed that the ransom would probably not even cover the cost of the operation.

NATO’s Secretary General reaffirmed on 28 June that a cyber operation with consequences comparable to an armed attack can trigger Article 5 of the North Atlantic Treaty and responses might be with military means. However, there are no reports of such effects, so according to Tallinn Manual 2.0 on the International Law Applicable to Cyber Operations, self-defence or collective defence of victim states are not available options.

Well, the cyber-tanks are not rolling as of yet. The brief notes three interesting factors: low estimated deployment cost ($100,000) means that a non-state or criminal actor could have developed it, but the lack of ransom counterbalances that; the kill switch was a simple one that could be used to limit spread; and it was targeted to spread via internal networks versus the wide spread of the internet.

The brief’s options for international response seem contradictory and incomplete to this Editor. 

The number of affected countries shows that attackers are not intimidated by a possible global level investigation in response to their attacks. This might be an opportunity for victim nations to demonstrate the contrary by launching a special joint investigation.

Ukraine’s speculation (of course) is that it’s Russia, though Russian organizations were also hacked. This is of a piece with earlier Russian attempts to disrupt, and Ukrainian spokesmen pointed out, as did NATO, that Petya was easy to limit if you knew how. ZDNet

And now Australia is going on the offensive. The Australian Signals Directorate (ASD) has been authorized to “disrupt, degrade, deny, and deter” bad cyber actors, placing a national emphasis on cybersecurity for “the mums and dads, the small businesses, large businesses, government departments and agencies” according to Dan Tehan, Australian Minister Assisting the Prime Minister for Cyber Security (whew!). Can we include healthcare? Leading the way! ZDNet

Petya no pet as it spreads: is it ransomware or a vicious design for data destruction? (updated)

Breaking–The ‘more and worse’ experts predicted after WannaCry is here.  In two days, the Petya or PetyaWrap (or NotPetya) ransomware has spread from Ukraine to affect organizations in 64 countries with 2,000+ attacks involving 12,000+ machines. On the hit list are mostly Eastern European and trans-national companies: Maersk shipping, Merck, Nuance cloud services, WPP advertising, Mars and Mondelez foods, Rosneft (Russia’s largest oil producer), Chernobyl, unnamed Norwegian firms, Beiersdorf and Reckitt Benckiser in India, Cadbury and law firm DLA Piper in Australia. One local US healthcare provider affected in a near-total shutdown of their computer systems, and resorting to backups, is Heritage Valley Health System in western Pennsylvania. There are no reports to this hour that the NHS, major US, Asia-Pacific, or European health systems being affected. Update: Trading in FedEx shares were halted 29 June due to the Petya attack on its TNT Express international division. Update 30 June: The Princeton Community Hospital in rural West Virginia is running on paper records as Petya forced a complete replacement of its EHR and computer hardware. Fox Business

Like WannaCry, the ransomware exploited the EternalBlue backdoor; a report from ArsTechnica UK adds an exploit touchingly dubbed EternalRomance. But unlike WannaCry, according to ZDNet, both “Symantec and Bitdefender have confirmed that it’s a Petya ransomware strain dubbed GoldenEye, which doesn’t just encrypt files — it also encrypts hard drives, rendering entire computers useless.” ArsTechnica goes deeper into methodology. Petya uses a hacking tool called MimiKatz to extract passwords and then uses legitimate Microsoft utilities and components to spread it. (Ed. note: if you have time for only one technical article, read ArsTechnica’s as the latest and most detailed.)

The Microsoft patch–and Microsoft has just issued an update for Win10, which this Editor heartily recommends you download and install–while defending against WannaCry, still isn’t preventing the spread. It’s speedier than WannaCry, and that says a great deal. Its aim appears not to be ransom, but data destruction. Updated: this POV is confirmed in today’s ZDNet article confirming that Comae Technologies and Kaspersky Lab strongly believe that Petya is a ‘wiper’ designed to destroy data by forever blocking it on your hard drive.

Another article in ZDNet (Danny Palmer) attempts to isolate why hackers remain one step ahead of us:

Law enforcement agencies and cybersecurity firms across the world are investigating the attack – and researchers have offered a temporary method of ‘vaccinating’ against it** – but how has this happened again, just six weeks on from a previous global ransomware outbreak?

One reason this new form of Petya is proving so effective is due to improved worm capabilities, allowing it to spread across infected networks, meaning that only one unpatched machine on a whole network needs to become infected in order for the whole operation to come crashing down.

Not only that, but cybersecurity researchers at Microsoft say the ransomware has multiple ‘lateral movement’ techniques, using file-shares to transfer the malware across the network, using legitimate functions to execute the payload and it even has trojan-like abilities to steal credentials.

**  The inclusion of this link in the quote does not imply any recommendation by TTA, this Editor, or testing of said fix.

What you can do right now is to ensure every computer, every system, you own or are responsible for is fully updated with Microsoft and security patches. If you’re in an enterprise, consult your security provider. Run backups. Remind employees to not click on links in suspicious messages or odd links even from known senders–and report them immediately. Based on reports, phishing emails and watering hole attacks are the main vectors of spread, like WannaCry. (A suggestion from this Editor–limit web search to reputable sites, and don’t click on those advert links which are buggy anyway!) Be judicious on updates for your software except by Microsoft and your security provider; there is growing but still being debated evidence that the initial Ukrainian spread was through a hacked update on a popular tax accounting software, MeDoc. More on this in ZDNet’s 6 Quick Facts. Another suggestion from Wired: run two anti-virus programs on every computer you have, one free and one paid.

And no matter what you do–don’t pay the ransom! The email provider within hours blocked the email so that the payment cannot go through. Updates to come. More reading from Bleeping ComputerHealthcare IT News, CNBC, HIStalk, US-CERT, Fortune, Guardian,

Updated 15 May: 20% of NHS organizations hit by WannaCry, spread halted, hackers hunted

Updated 15 May: According to the Independent, 1 of 5 or 20 percent of NHS trusts, or ‘dozens’, have been hit by the WannaCry malware, with six still down 24 hours later. NHS is not referring to numbers, but here is their updated bulletin and if you are an NHS organization, yesterday’s guidance is a mandatory read. If you have been following this, over the weekend a British specialist known by his/her handle MalwareTech, tweeting as @malwaretechblog, registered a nonsensical domain name which he found was the stop button for the malware as designed into the program, with the help of Proofpoint’s Darien Huss.

It looks as if the Pac-Man march is over. Over the weekend, a British specialist known as MalwareTech, tweeting as @malwaretechblog, registered a nonsensical domain name which he found was the stop button for the malware, with the help of Proofpoint’s Darien Huss. It was a kill switch designed into the program. The Guardian tagged as MalwareTech a “22-year-old from southwest England who works for Kryptos logic, an LA-based threat intelligence company.”

Political fallout: The Home Secretary Amber Rudd is being scored for an apparent cluelessness and ‘wild complacency’ over cybersecurity. There are no reported statements from Health Secretary Jeremy Hunt. From the Independent: “Patrick French, a consultant physician and chairman of the Holborn and St Pancras Constituency Labour Party in London, tweeted: “Amber Rudd is wildly complacent and there’s silence from Jeremy Hunt. Perhaps an NHS with no money can’t prioritise cyber security!” Pass the Panadol!

Previously: NHS Digital on its website reported (12 May) that 16 NHS organizations have been hacked and attacked by ransomware. Preliminary investigation indicates that it is Wanna Decryptor a/k/a WannaCry. In its statement, ‘NHS Digital is working closely with the National Cyber Security Centre, the Department of Health and NHS England to support affected organisations and ensure patient safety is protected.’ Healthcare IT News

According to cybersecurity site Krebs on Security, (more…)

Hackermania meets The Dark Overlord with 2.3 million 2017 health data breaches

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]It’s a cage match! Reports are soaring, with a proliferation of data breaches year to date, after a relatively quiet period in 2016.

The Dark Overlord (TDO), in the mainstream news with dumping unseen Netflix program episodes on illegal file-sharing sites and demanding ransom (Guardian), also has been hard at work dumping PHI hacked from various clinics. DataBreaches.net tallied it at 180,000 records from at least nine medical clinics.

Health data security developer/provider Protenus, whose Breach Barometer tracks the numbers, counted 2.1 million breaches in 1st Quarter. March spiked with 700,000 coming from Commonwealth Health Corporation of Kentucky.

Our standby Privacy Rights Clearinghouse counted over 175,000 to date, but 160,000 came from MedCenter Health in Protenus’ total, so their net addition was 15,000. But PRC’s detail illustrates that ransomware is alive, well, and invading smaller healthcare organizations. Other reasons are unauthorized data server access, third-party vendors, email error, and theft.

16 or 27 million 2016 breaches, 1 in 4 Americans? Data, IoT insecurity runs wild (US/UK)

What’s better than a chilly early spring dive into the North Sea of Health Data Insecurity?

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/03/Accenture-Health-2017-Consumer-Survey.jpg” thumb_width=”150″ /]Accenture’s report released in February calculated that 26 percent of Americans had experienced a health care-related data breach. 50 percent of those were victims of medical identity theft and had to pay out an average of $2,500 in additional cost. One-third (36 percent) believed the breach took place in hospitals, followed by urgent care and pharmacies (both 22 percent). How did they find out? Credit card and insurer statements were usual, with only one-third being notified by their provider. Interestingly, a scant 12 percent of data breach victims reported the breach to the organization holding their data. (You’d think they’d be screaming?) The samples were taken between November 2016 and January 2017. Accenture has similar surveys for UK, Australia, Singapore, Brazil, Norway, and Saudi Arabia. Release  PDF of the US Digital Trust Report

So what’s 16 million breaches between friends? Or 4 million? Or 27 million?

  • That is the number (well, 15.9 million and change) of healthcare/medical records breached in 2016 in 376 breaches reported by the Identity Theft Resource Center (ITRC), a Federally/privately supported non-profit. Healthcare, no surprise, is far in the lead with 34 percent and 44 percent respectively. The 272 pages of the 2016 End of Year Report will take more than a casual read, but much of its data is outside of healthcare.
  • For a cross-reference, we look to the non-profit Privacy Rights Clearinghouse which for many years has been a go-to resource for researchers. PRC’s 2016 numbers are lower, substantially so in the number of records: 301 breaches and 4 million records.
  • HIMSS and Healthcare IT News insist that ransomware is under-reported, (more…)

The malware siege of Northern Lincolnshire and Goole NHS: a preview of more? (UK)

By now our UK readers are well aware of the shutdown due to malware starting Sunday 30 Oct, only resolved today, of the Northern Lincolnshire and Goole NHS Trust hospitals: Diana, Princess of Wales; Goole and District; Scunthorpe General.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/11/nhsalert-940×445.png” thumb_width=”300″ /] (NHS website via Krebsonsecurity.com, click to enlarge)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/11/nhsalert2.png” thumb_width=”300″ /] (NHS website, click to enlarge)

It is estimated that it affected approximately 1,000 patients over the three shutdown days. Most patients were diverted to neighboring hospitals, according to The Guardian.

The Health Services Journal (paywalled) broke as an exclusive the NHS‘ high priority warning to providers around the country. Yet it seemed equivocal. According to The Sun, while NHS Digital marked the message as ‘severity: high’ and warned that “… we would like to remind all users of the need for proactive measures to reduce the likelihood of infection and minimise the impacts of any compromise.”, it was tempered with “We have no evidence that this is anything other than a local isolated incident but we will continue to keep health and care organisations informed.” Also according to The Sun, the Department of Health has noted that this has not been the first incident.

As our Readers know, US and Canadian hospitals and healthcare organizations have been subject of late to malware and its latest iteration, ransomware, with a large outbreak this summer. (more…)

Friday’s cyberattack is a shot-over-bow for healthcare (updated)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/03/26ED4A2300000578-3011302-_Computers_are_going_to_take_over_from_humans_no_question_he_add-a-28_1427302222202.jpg” thumb_width=”150″ /]Friday’s multiple distributed denial-of-service (DDoS) attacks on Dyn, the domain name system provider for hundreds of major websites, also hit close to home. Both Athenahealth and Allscripts went down briefly during the attack period. Athenahealth reported that only their patient-facing website was affected, not their EHRs, according to Modern Healthcare. However, a security expert from CynergisTek, CEO Mac McMillan, said that Athenahealth EHRs were affected, albeit only a few–all small hospitals.

A researcher/spokesman from Dyn had hours before the attack presented a talk on DDoS attacks at a meeting of the North American Network Operators Group (NANOG)

The culprit is a bit of malware called Mirai that targets IoT–Internet of Things–devices. It also took down the (Brian)KrebsOnSecurity.com blog which had been working with Dyn on information around DDoS attacks and some of those promoting ‘cures’. According to Krebs, the malware first looks through millions of poorly secured internet-connected devices (those innocent looking DVRs, smart home devices and even security devices that look out on your front door) and servers, then pounces via using botnets to convert a huge number of them to send tsunamis of traffic to the target to crash it. According to the Krebs website, it’s also entwined with extortion–read, ransomware demands. (Click ‘read more’ for additional analysis on the attack)

Here we have another warning for healthcare, if ransomware wasn’t enough. According to MH, “even for those hospitals with so-called “legacy” EHRs that run on the hospital’s own computers, an average of about 30 percent of their information technology infrastructure is hosted (more…)

Summertime, and the ransomware is running wild (updated)

Mashing up our summer ‘tune’ list are the latest reports on ransomware attacks and data breaches:

  • Banner Health’s odd breach of 3.7 million records, first testing their café credit cards then entering their patient information systems, is leading to at least one class-action lawsuit. HealthITOutcomes, Becker’s Hospital Review
  • Bon Secours Health System of Maryland had a exposure of 655,000 records when a business associate of Bon Secours left patient information exposed online for four days while it adjusted its network settings. Healthcare Dive
  • The Locky ransomware has been battering hospitals since the beginning of August, with phishing emails spiking on August 11. Most of this global strike is attacking healthcare, with transportation and telecom running second; countries with the highest frequency of attacks are US, Japan, and South Korea, FireEye reports. ZDNet
  • Solutionary, now NTT Security, which specializes in cybersecurity services, reported last month that 88 percent of all ransomware detections in second quarter 2016 targeted healthcare. However, Cryptowall, not Locky, was the killer ransomware they spotted, accounting for nearly 94 percent of detections. Release
  • Can you anticipate cyber crimes like these? ID Experts has an intriguing blog post on how you can think like a cyber thief. Part One of a promised three-part series. Updated: ID Experts disclosed earlier this week that it spun off RADAR, its two-year-old IT security and compliance company, effective 2 Aug, with a $6.2 million Series A funding. It appears that the CEO wrote the check (CrunchBase).  There’s gold in dem dere cyber varmints! MedCityNews  Release
  • Scared enough? The Federal Trade Commission comes to the rescue with a half-day seminar on ransomware detection and prevention in Washington DC on September 7. The session is free and will be webcast (details to come). FTC release, event page

Why hackers feel the $$ love for healthcare: Brookings study

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]It’s the information, silly! A recent study by the Center for Technology Innovation at the Brookings Institution tells us what we already know: healthcare organizations hold high-value information electronically, and because they haven’t invested equally in cybersecurity, it’s all vulnerable. When those nifty EHRs hold names, dates of birth, addresses, Social Security numbers and health histories, they are eminently salable. What’s new here is that the vulnerability increases due to factors not based on security, but on legal and data exchange requirements:

  • Data sharing and accessing
  • Length of storage to comply with regulations
  • The size of the records–the more information they hold, the more vulnerable

Lay on top of this ransomware.

The worst threat is not the hacker in a Bulgarian basement, but what is termed ‘state actors’ who want health information for a variety of reasons. They may be compiling a big database:”…a dossier of individuals that they could use for social engineering for future attacks”–such as sending phishing emails to government employees with specific, accurate information that when opened, infect their computers with malware for another purpose. Some solutions presented are using an outside cloud storage provider; using blockchain, which requires both public and private encryption keys; intrusion-detection systems (IDS) and security information and event management (SIEM) software. CSO, Brookings report (28 pages)

‘Protecting Patient Information’–a ‘worst case scenario’ book for HIT

A much-needed book in the age of Hacker/RansomwareMania. A new book published, ‘Protecting Patient Information’ by Paul Cerrato, is subtitled ‘A Decision-Maker’s Guide to Risk, Prevention, and Damage Control.” It’s not a tome at 162 pages, since it’s written not for academics or IT Gearheads, but for physicians (including doctors running small practices), nurses, healthcare executives and business associates. It takes a practical, three-part approach to IT security in healthcare organizations which can be applied internationally:

  1. How to do an in-depth analysis of the organization’s risk level
  2. How to lower the risk of a data breach within the myriad of Federal and state rules regarding protected PHI
  3. How to deal with a data breach, even if you’ve followed 1) and 2) (This may be the ‘worst case scenario’ part of the book)

The preface to the book is written by John Halamka, MD, himself a CIO of Beth Israel Deaconess Medical Center in Boston and a professor at Harvard Medical School. It will set you back about $42, but worth it. Hat tip to our friends at HITECH Answers via Twitter. If you’ve read the book or will read it soon, this Editor and your fellow Readers would be interested in your thoughts or even a review.

Ransomware alert up in US, Canada: more details

Ransomware threats are now the subject of a joint alert in both the US and Canada, with at least 14 hospitals under attack on both sides of the border. Ten of the hospitals are part of MedStar in Maryland [TTA 26 March, updated], and as your Editors have noted, it’s not just hospitals but also Mac iOS under attack and now, reportedly, even police and cafes (Telegraph.ukNPR). $24 million was lost to ransomware in 2015 in the US alone, according to the FBI. Healthcare IT News reports a new variation called PowerWare which is delivered through MS Word documents, but goes further than Locky in mimicking legitimate files and activities without writing new files on the system, which makes it hard to detect. It invades PowerShell which is used by system admins for task automation and configuration management.

If you are catching up and want a useful overview, see Wired. The headline states the obvious, at least to this Editor. Hospitals and their often-flawed IT managed by overworked staffs are the perfect target for ransomware and multiple viruses as lives are at stake, not widget production. Like most malware and internet Bad Things, ransomware originated in Eastern Europe (where else?) back in 2005. Most attacks include instructions on how to access bitcoin, the untraceable payment method demanded by the hospital hostage-takers.

How to prevent or mitigate? NPR cites Peter Van Valkenburgh, director of research at Coin Center, a digital currency advocacy non-profit, that hospitals can take safeguards including HTTPS encryption, two-factor authentication and implementing file backups on a separate server.