Enhance Cybersecurity in Your ASC Try these low-cost strategies to stay ahead of the game BY TOM HUI

ASC owners and adminis- trators sometimes hesitate to fund the expensive tech- nologies they assume are required to improve cyber-

security at their center. In reality, some of the most effective preventive cyber- security measures an ASC can put in place also are affordable. By addressing the “low-hanging fruit” of cybersecu- rity risk, ASCs can reduce vulnerability without breaking the bank. Here are three low- and no-cost

steps ASCs can take to improve their cybersecurity posture:

1 Educate staff—and then edu- hear “cybersecurity

cate them again. When people measures,” they

think expensive and technical solutions to thwart hackers. Most hacks or vulner- abilities, however, are caused by human behavior. A classic example of this is phishing. Phishing is when fraudulent emails disguised as legitimate messages are sent to staff or clinicians but con- tain malware such as a computer virus or ransomware. Staff members are in a hurry or get fooled and open an email that looks like it came from the bank or UPS. A careless user clicks on the link, and the door is opened to a hacker. It is important for ASCs to develop comprehensive educational programs reviewing common hacking strategies because of the frequency of this type of threat. In-service sessions about cyberattack techniques and strategies should be held at least quarterly for support staff and clinicians.

Frequent educational sessions on

cybersecurity result in multiple ben- efits. First, they help keep staff cur- rent on the latest hacking approaches. As with everything else in technology,

policy or operational procedures man- ual should explicitly spell out how often user roles need to be reviewed. Subse- quent actions taken to comply with the policy should be documented. User role assignments should be

hacking strategies are in a constant state of evolution and frequent educational programs keep staff abreast of changes. Second, frequent in-services keep cyber risk issues top-of-mind for staff and clinicians. Otherwise, cybersecurity risk tends to recede in importance as other daily priorities take precedence. Finally, frequent cybersecurity sessions communicate to staff that cybersecurity is an important issue at your facility and something they should pay attention to.

2 Review administrative user assignments/roles quarterly or

whenever there are personnel changes. A key aspect of security during the imple- mentation of a new software system is to assign who will have access to what data based on the role the user plays in the organization. This initial assignment of user roles is typically the respon- sibility of the facility administrator. As time passes, however, it is easy to lose track of user role assignments. Staff turns over, nurses are promoted or leave and, over time, no one knows why someone has access to what data. Review of administrative user roles

is an example of where policy and pro- cedures meet technology. ASCs need policy and procedures and technology to combat cyberattacks. One cannot replace the other. In this case, the ASC’s


reviewed quarterly at a minimum in addition to as needed when person- nel changes occur. Even when lateral moves occur, such as a nurse moving from preop to postop or intra-op, user roles need to be updated.

ating systems, server operating system and database management software are up-to-date. Comput- ers using outdated operating systems are more vulnerable and increase the chance of being exploited by hackers. For example, if the desktop computers in your facility are still running on older versions of Windows or lacking the lat- est security patches, you are exposing your network and servers to a higher risk of a successful cyberattack. Server operating systems and database manage- ment systems also need to be updated. If you are using cloud-hosted software, it is your vendor’s responsibility to main- tain current versions of the server oper- ating system and the database man- agement software. If your systems are locally hosted, it is your responsibility to make sure that all the server operat- ing systems and database management software is current in addition to your facility’s desktop computers. Together, implementing these three

3 Ensure that your desktop oper-

low-cost to no-cost strategies can help enhance an ASC’s security posture.

Tom Hui is the founder and chief executive officer of HSTpathways in Lafayette, California. Write him at

The advice and opinions expressed in this column are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion.

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