Vital Infrastructure

Legacy protocols within the healthcare trade current risks that may make hospitals extraordinarily weak to cyberattacks.

08 Dec 2023
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3 min. learn

The healthcare trade will, I’m certain, stay a vital goal for cybercriminals because of the large potential it offers them to monetize their efforts by way of ransomware calls for or by abusing the exfiltrated information of sufferers. Operational disruption and delicate information, corresponding to medical information, mixed with monetary and insurance coverage information supply a possible payday that merely doesn’t exist in lots of different environments.

At Black Hat Europe 2023, the difficulty of legacy protocols being utilized by many healthcare organizations was introduced by a staff from Aplite GmbH. The problem of legacy protocols is nothing new; there have been quite a few situations the place gear or techniques stay in use because of the vital value related to alternative regardless of them using protocols not appropriate for right now’s linked atmosphere. For instance, changing an MRI scanner can value as a lot as 500,000 USD and if the necessity to exchange the system is because of an end-of-life discover on the software program working the system, then the chance could appear acceptable given budgetary necessities.

The troubles with DICOM

The Aplite staff highlighted points with the DICOM (digital imaging and communications in medication) protocol, which is used for the administration and transmission of medical photographs and associated information.

The protocol has been broadly used within the medical imagery sector for greater than 30 years and has been topic to many revisions and updates. When a medical picture scan is performed, it sometimes accommodates a number of photographs; the pictures are grouped as a sequence, and related affected person information is then saved with the picture, together with any notes from the affected person’s medical staff, together with diagnoses. The info is then accessible utilizing the DICOM protocol by way of software program options that permit entry, addition, and modification.

Legacy variations of DICOM didn’t pressure the usage of authorization to entry the info, permitting anybody who may set up a connection to the DICOM server to probably entry or modify the info. The Aplite presentation detailed that 3,806 servers working DICOM are publicly accessible over the web and include information regarding 59 million sufferers, with simply over 16 million of those together with identifiable info corresponding to title, date of start, handle, or social safety quantity.

The examine discovered that simply 1% of the servers accessible by way of the web had applied the authorization and authentication mechanisms accessible within the present variations of the protocol. It’s vital to notice that organizations that perceive the chance related and have taken prior motion might have eliminated the servers from public entry by segmentation onto networks which have the suitable authentication and safety measures in place to guard the affected person and medical information.

Healthcare is a sector that has strict laws and laws, corresponding to HIPPA (US), GDPR (EU), PIPEDA (Canada), and so on. This then makes it stunning that 18.2 million of the information accessible on these publicly-facing servers are situated within the US.

Associated studying: 5 explanation why GDPR was a milestone for information safety

Defending crucial techniques

The misuse of the info accessible from these accessible servers offers cybercriminals with large alternative. Extorting the sufferers because of the risk of publicly disclosing their diagnoses, modifying information to create false diagnoses, holding the accountable hospitals or different healthcare suppliers to ransom over what information had been modified, abusing sufferers’ social safety numbers and private info, or utilizing that info in spearphishing campaigns are just some potential methods such information may very well be used to monetize the cybercrime.  

Problems with securing legacy techniques, which have recognized potential safety points, corresponding to DICOM, ought to be on the radar of regulators and legislators. If regulatory our bodies which have the ability to impose monetary or different penalties particularly request affirmation from organizations that these weak techniques have the suitable safety measures in place to safe medical and private information, it could be the motivator for these in procession of such techniques to safe them.

Many industries undergo from the burden of pricey alternative of legacy techniques, together with the likes of utility, medical, and maritime to call however a couple of. It’s vital that these techniques are both changed, or in conditions the place it could be too advanced or financially tough to exchange the techniques, then applicable motion should be taken to keep away from these previous protocols from haunting you.

Earlier than you go: RSA – Digital healthcare meets safety, however does it actually need to?