"While blackmailing patients and hacking pacemakers are common hand-waving examples used by some to stress the importance of protecting medical records, the actual threat landscape is much more in line with run-of-the-mill cybercrime seen in other industries. The vast majority of attackers seek information from which they can directly or indirectly profit," reads the 2012 Verizon Data Breach Investigations Report, released Wednesday morning.
Additionally, criminals tend to target smaller organizations--think physician and dental practices with fewer than 100 employees rather than hospitals--and look for the easiest electronic defenses to exploit. In many cases, they go after credit/debit card readers, otherwise known as point-of-sale (POS) terminals, the Verizon RISK (Research Investigations Solutions Knowledge) Team, which has been collecting data on breaches since 2004, reported.
"POS systems and desktops were at the forefront of breaches in the healthcare sector. At first glance, this may seem counterintuitive, since electronic health records would almost certainly be stored in a file or database server, and surely this is what the criminals are after. But this likely represents an incorrect assumption; most cybercriminals are more interested in accessing your bank account and applying for loans in your name than they are the details of your last medical exam," the report said.
[ Practice management software keeps the medical office running smoothly. For a closer look at KLAS' top-ranked systems, see 10 Top Medical Practice Management Software Systems. ]
"Their MO is to scan large areas of the Internet to see if there are portals left open," Mark Spitler, one of the report's authors, told InformationWeek Healthcare. The card terminal is the "weakest link," according to Spitler, and once a thief is in, it is easy to move laterally among systems if the server is part of a "flat" network.
POS servers might list the name of the hardware vendor, and more than a few end users just go with the manufacturer's default password, making the system easy to crack, Spitler explained. "In the majority of cases, the attacker gained initial access by exploiting default or guessable credentials, usually via Internet-facing remote access services," the report said.
The Verizon healthcare report focused on about 60 confirmed breaches over the past two years in healthcare and social services. Almost all the attacks involved both hacking and the introduction of malware into the host system, and 95% of security threats against healthcare entities came from external sources, Verizon reported.
Spitler explained that the typical lost laptop or USB drive responsible for so many compromised healthcare records does not fall into Verizon's definition of a data breach investigation because victims in such cases rarely call in forensic investigators.
Since late 2009, healthcare organizations have been required to report any breaches affecting at least 500 people to the U.S. Department of Health and Human Services (HHS), the affected individuals, and, in some cases, news media.
Health data is not usually the primary target in the kinds of breaches involving forensic investigators, Spitler said, but it can be involved. "[Criminals] don't know if it's a physician office or a retail location," Spitler explained. "They're looking for one that's open to the Internet and with weak security credentials."
Although thieves might not know if they have hit a medical practice, protected health information--the kind of data covered by Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations--often is not segmented from other databases, according to the Verizon security analyst. "We do get cases where PHI is at risk," he said.
To protect against such threats, Spitler first recommended putting a firewall in front of the POS server so nobody can access the system from an outside IP address. "No. 2, just change the password," he added.
The healthcare security analysis is part of a series of industry-specific "snapshots" Verizon released Wednesday. In addition to healthcare, the telecommunications giant examined data breaches in retail, hospitality, and financial services, and issued a report on theft of intellectual property.
Intellectual property does not seem to be what criminals are targeting in healthcare. "That was one of the most interesting things we found when we pulled out healthcare data," Spitler said.
InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)