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2/12/2016
10:30 AM
Jay Trinckes
Jay Trinckes
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Cybersecurity & Healthcare: Does Cybersecurity Act Help or Hurt?

Without adequate resources, the new Cybersecurity Act of 2015 Act is merely a snapshot in time that does little to safeguard sensitive medical information.

There’s been a lot of talk about the new Cybersecurity Act of 2015, but does Section 405: Improving Cybersecurity in the Healthcare Industry really do enough?  While the bill is a welcome start to help lower cybersecurity risks, the improvements do not do enough to protect us from the compromise of sensitive information.

Within 90 days of the bill’s passage, a healthcare industry task force will be established by the Secretary of the Department of Health and Human Services (HHS) in consultation with the Director of the National Institute of Science and Technology (NIST) and the Secretary of the Department of Homeland Security.  This task force of healthcare industry stakeholders, cybersecurity experts, and related federal agencies has six responsibilities:

  1. Analyze how other industries have implemented safeguards for protecting data. This is nothing new. There is a lot of information already available such as the safeguards found in the financial services industry (FFIEC/GLBA) and government (FedRAMP/FISMA).
  2. Analyze the challenges and barriers private healthcare organizations facewhen securing data.Rather than focusing only on the private sector, the Cybersecurity Act of 2015 should require that all entities within the healthcare industry are secured, especially government entities.  Two challenges/barriers that the task force can start with are the financial resources allocated to security and the lack of security experts within healthcare.
  3. Review challenges involvedwith securing networked medical devices and other software or systems that connect to an electronic health record. This should be expanded to include government oversight agencies such as the Food and Drug Administration (FDA), which is charged with overseeing voluntary – not mandatory – compliance to medical device security standards.
  4. Disseminate information to healthcare-industry stakeholders of all sizes about improving preparedness for, and response to, cybersecurity threats.
  5. Establish a plan for government and healthcare-industry stakeholders to share actionable cyber-threat indicators and defensive measures in real time.
  6. Report findings and recommendations to Congress.

What Congress will do with this information once it’s compiled is an open question, particularly without ongoing resources for the effort. As it is written, the Cybersecurity Act of 2015 is basically a snapshot in time that creates even greater risk since cybersecurity threats change so rapidly and the task force is only in operation for one year.

Worse, the law aligns healthcare-industry security approaches to a common set of voluntary, consensus-based, and industry-led guidelines, best practices, methodologies, procedures and processes.  This common-set approach is intended to serve as a cost-effective resource to reduce cybersecurity risks for a wide range of healthcare organizations.  However, in healthcare, few organizations do things exactly the same way – a circumstance that sometimes creates too much flexibility and allows for the misinterpretation of the intention of security requirements.

There are already several guidelines, best practices, methodologies, procedures, and processes available for the healthcare industry such as those developed by HITRUST, NIST, ISO and others, and/or those that can be adapted from other industries (for example, the financial services industry) to serve healthcare organizations’ needs.  While interest in these approaches has increased in the wake of numerous, highly publicized major breaches, adoption has been slow. 

Worse, a voluntary approach doesn’t emphasize the importance of security within the healthcare industry itself; healthcare organizations will most likely ignore the guidance due to an overload of similar requirements. And unless Congress legislates specific sets of approved security-control frameworks, it’s my expectation that few organizations will actually “volunteer.”  What we may see is the industry ‘policing’ itself by requiring business associates and service providers to obtain approved validation such as HITRUST and/or SOC 2 certifications. 

Aside from the disappointment in making these approaches voluntary, it’s written within the law that HHS has no authority to provide for audits to ensure that healthcare organizations are in compliance.  Without enforcement, there is no compliance.  The agency can’t even mandate, direct, or condition the award of any federal grant, contract, or purchase pertaining to compliance with this common set of security approaches.  On top of this, there are no consequences for non-participation, not even an incentive through safe-harbor exceptions for organizations that voluntarily comply with the security approaches under development.

Let’s face it, the healthcare industry as a whole hasn’t taken security seriously and the lack of any formal enforcement of compliance has led to huge breaches and major concerns over the privacy and security of protected health information.  Why can’t the healthcare industry be more like the financial services industry in requiring that independent assessments be performed to validate/verify security compliance activities?  When it comes to protecting and safeguarding sensitive medical information, the health of the healthcare industry will be hard-pressed to improve until Congress and the regulators get tougher on healthcare organizations.

Jay has over 15 years of experience in information security and other related disciplines. With multiple certifications and specialized training, Jay is a subject matter expert and thought leader in healthcare privacy and security matters. The author of "The Definitive Guide ... View Full Bio
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ChloeMica
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ChloeMica,
User Rank: Apprentice
2/17/2016 | 3:18:41 AM
Re: Bankers and financiers have a direct understanding of risk, healthcare pros see risk differently
Improving operational efficiency and reducing cost, while also improving the quality of care is a global healthcare challenge.

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royhugginsms
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royhugginsms,
User Rank: Apprentice
2/13/2016 | 4:01:36 PM
Bankers and financiers have a direct understanding of risk, healthcare pros see risk differently
Firtly, thank you for this essay. It hits a lot of my frustration points, most especially the fact that committees trying to develop best practices could never keep up with security needs.

As a health care guy (mental health) who spends a lot of time consulting and training other health care pros on security in their small practices, I can say that we don't have a solid idea of risk management as a paradigm for protecting information. We work with risk all the time in clinical contexts, e.g. risk of self-harm or risk that certain activities or treatments could result in harm to a client/patient.

The idea of information security, however, is entirely grounded in "best practices" for us. Clinicians look to professional organizations for these best practices, and those orgs have little-to-no idea how to manage them.

When administrators try to advise and guide clinicians according to regs like HIPAA, we often chafe against it because those administrators are usually focused on the concept of "compliance," which feels antithetical to the concept of "care."

My point is: I think healthcare will continue to have significant security issues until healthcare professionals and security professionals learn to understand each other, much like healthcare pros and attorneys have managed to do over the years. 

 
RetiredUser
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RetiredUser,
User Rank: Ninja
2/12/2016 | 3:01:40 PM
Red Tape, Red Coffers
I pretty much agree with you here.  And, oh God - I actually read the whole subsection on Healthcare, including a good portion of the Cybersecurity Information Sharing Act of 2015.  What is it about formal Government process that just screams bleeding coffers from the outset?  Not to mention the muddled standards that are hard-to-read and inspire reactions of "yeah, obvious" and "in what world are you living".  

In the time it took to draft the Act, the game changed.  In the time it takes to pass the Act, the game will have changed again.  In the time it takes to form committees, auditing teams, processes, checks and balances...  

You called it: Healthcare needs to treat security the way Financial institutions (finally) are starting to.  Don't look to Government standards or regulations; get on the ball and hire the right InfoSec resources who are current, relevant and part of the hacking landscape.

As always, the distance between the Red Tape lovers and the tech community is light-years apart.

  
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