Researchers have discovered a new version of medical device hijack (MEDJACK), which is leaving medical devices like x-ray machines and MRI scanners vulnerable to cybercriminals. MEDJACK.3 is a sophisticated zero-day attack through which hackers steal patient data.
MEDJACK was discovered in 2015 as an organized initiative targeting medical devices in three disparate hospital attacks. TrapX Labs found medical devices provided backdoors for hackers to infiltrate healthcare networks because they're the hardest devices to secure and remediate after an attack.
MEDJACK.2, discovered in 2016, is a more advanced version of the original. Cybercriminals used backdoors and botnets to exploit devices and enter networks. Because they used old malware to exploit older versions of Windows, they went undetected by endpoint security software.
At RSAC 2017, TrapX vice president of marketing Anthony James will discuss a new variation of the threat in the session MEDJACK.3: New Research on Attacks on Hospital Medical Devices. The company was conducting a proof-of-value investigation on the medical infrastructure of ten UK member hospitals when it noticed sophisticated advancements in how hackers entered networks.
James explains how experts created fake medical devices like MRI scanners and CT scanners on the hospital networks. When the devices started to get probed, the researchers learned how vulnerable the fake devices were. Devices were deployed on both older operating systems (Windows XP, Windows Server 2003) and newer ones (Windows 2008, 2012).
"What was really interesting and different was this [attack] was a little more targeted," he says. "The others were indiscriminate - they would take anything that would accept malware."
As the attack progressed, interesting data came to light. Researchers learned hackers were using an old malware spreader to redirect the attack towards older operating systems. An OS without specific security patches would be left vulnerable and accept the hacker's tool.
The attack had been architected in a way that new operating systems would ignore it because they had been patched against those spreading capabilities. Newer systems wouldn't even be alerted to such a low-level vulnerability.
A Dangerous Combination
Further, James continues, there were interesting characteristics in the malware, which is equipped with anti-detection capabilities. "It didn't want to be detected by sandboxing systems and newer advanced protection threat systems," he says. If a victim had a sandbox, it would lay dormant.
"The combination is concerning," he notes. "Attackers are leveraging legacy malware-spreading tools that bypass a lot of today's operating systems and target older systems."
This is a major problem for the healthcare industry because most medical devices run old software. A high percentage of healthcare infrastructure already has these types of attacks resident in their medical devices; they just don't know it.
"Of all the [healthcare] breaches in the last 1-2 years, there hadn't been a drastic change in how to protect the infrastructure," James notes.
It takes years for healthcare devices to get certified, and technology continues to change in the meantime. Once a device is certified on the Windows XP operating system, they won't go back through the multi-year process to get re-certified on an upgraded system.
The healthcare space is a hotspot for cybercriminals seeking easy access to sensitive patient data. Major cyberattacks on the healthcare industry grew 63% in 2016, TrapX found. Sophisticated hackers were responsible for 31% of all major HIPAA data breaches in 2016, marking a 300% jump over the past three years.
It's a tough problem to tackle, and lack of both funding and awareness is putting institutions at risk. There are best practices healthcare organizations can adopt to protect themselves. Segregating the networks is an important step, James notes.
"It's one of the glaringly obvious things," he says. For example, make devices separate in design so the x-ray doesn't connect to the nurses' station; this could prevent the spread of an attack.
He also recommends healthcare organizations regularly update devices with new software and patches as often as they can. This isn't very different from standard IT infrastructure, but healthcare institutions often don't have the mentality that devices are all on the same network. These devices are viewed as industrial machines, but they can be breach points.
TrapX will discuss the details of MEDJACK.3 and strategies healthcare institutions can implement to protect themselves from this threat and future MEDJACK attacks.