Nearly a decade ago, researchers made international news by demonstrating that an implantable medical device — an insulin pump — could be hacked via radio and controlled to the detriment of its user. Even earlier research indicated that heart monitors could be hacked to provide incomplete or erroneous data from their sensors. These two cases shared a trait also shared by most of the implantable medical device security research that has followed.
Most of the research has been focused on how the devices could be manipulated to harm the user. Alan Michaels tries to answer a very different question with his research: Could an implantable medical device be hacked to harm a third party?
Michaels, director of the Electronic Systems Lab at the Virginia Tech Hume Center, has a very specific third party in mind. He's interested in the threat a "rogue" implantable device might pose to a Sensitive Compartmented Information Facility (SCIF) — a special facility where sensitive and classified information can be worked on and discussed.
The issue, Michaels says, is that insulin pumps, continuous glucose monitors, heart monitors, and more are electronic devices that have radio communications capabilities. From the viewpoint of the SCIF, the fact that they're involved with human health is almost irrelevant.
"We're all paranoid, you know. I mean, we can pick up what could happen," Michaels explains, "but we also have to be practical about the true risk." And calculating that true risk is the focus of his research.
Part of that risk begins when the devices are manufactured. "We're most interested in the fact that devices are mostly not manufactured in the United States," Michaels says. For the reason location matters, he turns to the example of the popular DJI drones, which were found to have encrypted tunnels back to the manufacturer in China, through which the drones' telemetry data was communicated. "Why would I not believe that the same thing is occurring [in implantable devices]?" he asks.
Michaels is most interested in the possibility that a third party might hack into a user's device and use it as a point of entry for the SCIF — a point of entry that would then allow the third party to pivot to other, much more sensitive systems.
Attack pivots become more of a concern as devices become more capable. Michaels points to fitness trackers and similar devices as wearable systems that some SCIFs now allow because of the health benefits. And yet, "Basically it is a smartwatch that starts to look a lot like a personal computer. It really is very capable," he says.
And some of these wearables are more than just step counters that can easily be removed at the SCIF's door. "We found one called 'Adam' that's an asthma monitor," Michaels says. "And it basically gives you a predictive warning that you're about to have a major asthma attack." He points out, "That's harder to take off because you're not worried about your 10,000 steps — you may actually have an asthma attack while in the facility."
So far, SCIF administrators have dealt with implantable devices through one-off waivers for the wearers. That may be fine for a single employee in a single facility, but Michaels says his team has calculated that there could easily be more than 100,000 individuals with implantable devices who have a regular need to access a SCIF. That's a lot of waivers, he believes.
So far, Michaels says, there has been relatively little recognition of this as an issue in secure facilities, with existing rules driven by HR as much as cybersecurity. "We want to protect the information and support the individual. Yet there comes a point which you probably deny entry," he adds, and that point may be coming sooner than many people think.
The reason for the rapid arrival rests on medical devices in the research pipeline. Michaels mentions a "bionic eyeball" that might provide sight but also have sufficient intelligence to pose a threat.
Michaels' research points him to a broad conclusion: "Make sure you give the support to the individual to do their work, but we think there needs to be a balance with mitigations."
Michaels will be presenting results of his research at Black Hat, in a session titled "Carrying Our Insecurities with Us: The Risks of Implanted Medical Devices in Secure Spaces" at 10:00 a.m. on Wednesday, August 5.