CYBER SECURITY
Figure 2: Wireless mobile devices found using a common wireless location device.
way cross-referencing can be used to determine the location of the device if the switch port and patching information are available. Tracking down mobile equipment can be a challenging task, but standard network tools can be used to assist. The diagram in Figure 2 depicts wireless mobile devices found using a common wireless location device. Hackers don’t need complicated methods for obtaining access to hospital systems. For example, remote access systems are used routinely in hospitals to give vendors access for technical support. This method of entry into a hospital system is seen as a common target because – by nature – this point of entry is publicly accessible. Intended to meet legitimate business needs, such as allowing off-site clinicians to access clinical data, or vendors to troubleshoot systems installed at the facility, remote access systems can be exploited for illegitimate purposes. Attackers take advantage of unmaintained and vulnerable remote access systems to infiltrate an organisation’s network. Once they gain access – whether through medical or non-medical assets – attackers can move laterally to other connected devices or systems, installing ransomware or other malware, stealing data or rendering
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it unusable, or hijacking computing resources for other purposes, such as to generate cryptocurrency. Safeguarding assets requires identifying, protecting, and monitoring, all remote ingress points, as well as adhering to recommended cybersecurity practices, such as instituting a strong password policy, maintaining and patching systems, and logging system access.
Published cyber vulnerabilities Cyber vulnerabilities are published frequently by manufacturers and vendors of software, building control systems, and Internet of Things and medical devices that require corrective action – ranging from software patching through to replacement or hard firewalling. These vulnerabilities and their associated alerts and recalls do not always reach the hospital, and are not always communicated using the normal methods, meaning that they can slip past the usual risk management teams in the business. Having a clearly defined responsibility matrix is key to an effective and proactive preventative maintenance schedule for connected devices. There are many connected hospital
devices in plain sight that continue to operate on unsupported operating systems and remain unpatched, even as cyberattacks continue to grow in
Hackers don’t need complicated methods for obtaining access to hospital systems. For example, remote access systems are used routinely in hospitals to give vendors access for technical support
26 Health Estate Journal May 2024
the highly targeted healthcare sector. Take the example of nurse call systems. International experts report that 48% of nurse call systems have unpatched Common Vulnerabilities and Exposures (CVEs). This level of vulnerability makes such systems some of the higher risk Internet of Medical Things (IoMT) devices. Infusion pumps, which are used to provide fluids mechanically or electrically to patients, are the second riskiest IoMT devices, with almost a third (30%) operating with unpatched CVEs. In addition, 27% of these devices carry unpatched critical severity CVEs. When it comes to medication dispensing systems, 86% have unpatched CVEs. Just under a third (32%) of these devices operate on Microsoft Windows versions that are no longer supported. Over half (59%) of IP cameras in clinical environments have unpatched CVEs, of which 56% are critical severity. Protecting every type of connected device, medical, IoT, and even the building management system, with full visibility and continuous contextualised monitoring, is a key element to ensuring patient safety. Even though your data may be hosted locally by a global cloud services provider, staff who reside in different jurisdictions can access your data and configuration details from overseas. In circumstances where your data is hosted locally in your own data centre, or global cloud service provider, staff in various jurisdictions abroad can access your data, network and storage configuration details, and will have hypervisor access. The main issue is that it is often impossible to know who is accessing what data, even if legitimately. For example, at Cabrini we can see material amounts of data transfer across
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