A few months ago, security leaders around the world faced an unprecedented challenge in addressing threats and challenges related to a global pandemic. In the healthcare space, CISOs juggled a spike in cyberattacks, newly remote employees, and securing healthcare institutions.
For Mike Gregory, CISO at Community Healthcare System, Northwest Indiana, the biggest problems were strategic.
"It was just triage after triage," he said during a virtual roundtable of healthcare CISOs hosted today by Proofpoint. The security team was working to protect remote employees, ensure hospital providers could do their jobs, monitor threat intelligence feeds, and keep up with essential operations.
The transition to remote work was significant. CISOs faced challenges related to endpoint protection, establishing virtual private networks, and training employees in security practices. Gregory's team was tasked with extending infrastructure out to the remote workforce and coping with remote filtering, he said. Without a large gateway, they couldn't monitor all of their activity, such as websites they visit or activities they're running that could distract from their work.
Roughly 40% of the workforce at Seattle Children's pivoted to remote work as a result of the pandemic, said CISO Gary Gooden. When they did, he said, the organization provided end-user training for certain types of roles depending on how that person interacted with their email.
The auditing department and executive leadership, for example, were trained in recognizing threats to improve awareness of malicious emails they might receive. Most of the attacks in the environment targeted accounts payable, specifically getting them to change payment data. In addition to raising awareness, Gooden implemented a system of checks and balances: If there is a request to change payment info, it's verified with phone calls and additional documentation.
Email-based threats like business email compromise (BEC) and phishing campaigns were most common during the pandemic. "We saw an exponential increase in that type of activity," said Gooden of BEC.
Panelists spoke to spikes in phishing attacks and COVID-19-themed attacks. At Community Health NW Indiana, remote employees were targeted in their personal email accounts and several were being attacked by ransomware, Gregory noted.
"We do this every day, but this was an escalation point," he said. "Who do you rely on when you have so much threat intelligence coming to you? Who do you really want to rely on? You can't possibly monitor all that traffic coming to you."
Prioritizing Projects: Telehealth, New Tech
Along with the transition to remote work, CISOs accelerated other projects to respond to the pandemic. Back in March, Gregory said, his team stopped nearly every project in mid-implementation to prioritize what the system needed. For example, because hospital patients were required to have their temperatures taken, the team quickly contacted vendors, began installing thermal scanners at critical entry points, and deployed nursing staff where needed.
Plans were in place to implement telemedicine at Community Health NW Indiana, said Gregory, but COVID-19 made it the top priority.
"We had some planning, but we did a whole lot of scrambling to get out telemedicine, strategize, get the equipment, get those cameras out there, install them, connect to EMR, synchronize the platforms … all of that was a pain point," he said. It was successful, he said, but they could have done more preplanning to prioritize it.
Gooden said the same of a heavy technology roadmap implementation, which was slated for Seattle Children's. While he wouldn't have done anything differently, he said, it could have been done faster.
"It's more about the speed we can accelerate to put things in place that need to be put in place," he added.
When the pandemic started, Community Health NW Indiana's security team created a twice-daily check-in with directors to report on system capacity, availability, and security, said Gregory. This led staff to be more attentive toward small issues that needed to be addressed quickly. The communications became a source of information to share with remote workers.
Two things became obvious as Seattle Children's started to adjust amid COVID-19, said Gooden. One of these was siloing within the IT organization, which they made efforts to change as they moved toward a security-defined set of processes. The more robust a security operation is, he said, the easier it is to provide services to users in an unfettered manner.
Another was a "huge uptick" in a need for robust third-party vendor risk management, which he noted they are focusing more on as a result of this experience.