"As little as two years ago, we checked some hospitals and found that there was less than one networked clinical device per bed," said Earl Reber, executive director, eProtex, an Indianapolis-based company that provides security for networked medical devices. Now, it's about three per bed, according to Reber, who spoke Tuesday at the second Mobile Health Expo in New York.
About 40% of networked devices are Windows-based, about 30% run on Linux, and the rest are on various other operating systems, according to Reber. Windows, of course, is a favorite target of hackers who spread malware. Reber also said he's seen an increasing number of attacks against Apple operating systems, an important concern because the iPad and other Apple mobile devices have become so popular in healthcare.
Reber reported seeing a rapid increase in the number of devices infected with viruses, and it's difficult if not impossible to install antivirus software on medical devices. He said he's seen people in hospitals surf the Web on a $100,000 medical device because the screen looks the same as that of a $300 consumer PC, and such devices are not well protected against external threats.
Some healthcare organizations are not in a good position to respond to or prevent malware infections because of ingrained cultural differences. "There's a known gap between IT and clinical engineering," Reber said. IT people don't like to handle medical devices and clinical engineering professionals often get scared away when they see a computer hooked to a device.
They'd best overcome their differences and start collaborating because the stakes have never been higher. In the worst-case scenario, a virus could throw off calibration on radiological devices and subject patients to dangerous doses of radiation, Reber said. But the more realistic concern may be the stronger HIPAA rules and increased penalties for data breaches brought on by the 2009 American Recovery and Reinvestment Act.
According to eProtex chief security officer Derek Brost, healthcare facilities may be focusing on the wrong assets when deciding what they need to protect. "It's not the actual medical device in most cases [that is at risk]. It's the individual patient's health information." Brost said.
Brost said that healthcare organizations need to align policies and procedures between IT and clinical engineering. Take a comprehensive inventory of networked medical devices, record the network information for those devices, and conduct a risk assessment for any system or device that stores protected health information (PHI) as defined by HIPAA.
Reber said that it may be time to replace some aging, expensive devices that still run DOS, because they were developed in an era when data protection was not as critical and probably cannot be made HIPAA-compliant.
For the purpose of assessing risk, Brost recommended referring to the "Manufacturer Disclosure Statement for Medical Device Security"--commonly called MDS2--for various devices. This standardized form, created by the HIMSS Medical Device Security Work Group in conjunction with the National Electrical Manufacturers Association, is intended to help device users assess vulnerabilities and the risks related to PHI passing through medical devices.
The Healthcare IT Leadership Forum is a day-long venue where senior IT leaders in healthcare come together to discuss how they're using technology to improve clinical care. It happens in New York City on July 12. Find out more.