CYBER RISKS
Simple hygiene to prevent unauthorised network access Hackers do not need complicated methods for obtaining access to hospital systems. For example, remote access systems are used routinely in hospitals to provide 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 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, IoMT 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 and 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.
Unsupported operating systems 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 the highly targeted healthcare sector. Take the example of nurse call systems, which allow patients to communicate with nurses should they require assistance. International experts report that 48 per cent of nurse call systems have unpatched Common Vulnerabilities and Exposures (CVEs). This level of vulnerability makes nurse call systems one of the higher risk
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Figure 2. Gandel Wing, Emergency Dept, showing connected wireless devices.
IoMT. Infusion pumps, which are used to provide fluids mechanically or electrically to patients, are the second riskiest IoMT, with almost a third (30 per cent) operating with unpatched CVEs. In addition, 27 per cent of these devices carry unpatched critical severity CVEs. When it comes to medication dispensing systems, 86 per cent have unpatched CVEs. Just under a third (32 per cent) of these devices operate on Microsoft Windows versions that are no longer supported. Over half (59 per cent) of IP cameras in
clinical environments have unpatched CVEs, of which 56 per cent are critical severity.
Data sovereignty – data privacy 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 dozens of different countries. Figure 3 shows over 2,000 devices communicating to China and Russia, some of these being medical.
Our approach Using one of the better known IoMT network monitoring tools, we have taken a proactive approach on a journey toward best practice. To date we have achieved: l Visibility of 24,716 networked devices of all types.
l Accurate detection and association with specific asset.
l Identification of 51 risk alerts and 13 threat alerts.
Figure 3. Devices communicating to China and Russia. IFHE DIGEST 2024
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