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Brian Pennington

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The State of Cybersecurity in Healthcare Organizations in 2016

ESET and the Ponemon Institute have announced results of The State of Cybersecurity in Healthcare Organizations in 2016.

According to the study, healthcare organizations average about one cyber attack per month with 48% of respondents said their organizations have experienced an incident involving the loss or exposure of patient information during the last 12 months. Yet despite these incidents, only half indicated their organization has an incident response plan in place.

The concurrence of technology advances and delays in technology updates creates a perfect storm for healthcare IT security,” said Stephen Cobb, senior security researcher at ESET. “The healthcare sector needs to organize incident response processes at the same level as cyber criminals to properly protect health data relative to current and future threat levels. A good start would be for all organizations to put incident response processes in place, including comprehensive backup and disaster recovery mechanisms. Beyond that, there is clearly a need for effective DDoS and malware protection, strong authentication, encryption and patch management

Key findings of the survey:

78% of respondents, the most common security incident is the exploitation of existing software vulnerabilities greater than three months old.

63% said the primary consequences of APTs and zero-day attacks were IT downtime

46% of respondents experienced an inability to provide services which create serious risks for patient treatment.

Hackers are most interested in stealing patient information

  • The most attractive and lucrative target for unauthorized access and abuse can be found in patients’ medical records, according to 81% of respondents.

Healthcare organizations worry most about system failures

  • 79% of respondents said that system failures are one of the top three threats facing their organizations
  • 77% cyber attackers
  • 77% unsecure medical devices

Technology poses a greater risk to patient information than employee negligence

  • 52% of respondents said legacy systems and new technologies to support cloud and mobile implementations, big data and the Internet of Things increase security vulnerabilities for patient information
  • 46% of respondents also expressed concern about the impact of employee negligence
  • 45% cited the ineffectiveness of HIPAA mandated business associate agreements designed to ensure patient information security

DDoS attacks have cost organizations on average $1.32 million in the past 12 months

  • 37% of respondents say their organization experienced a DDoS attack that caused a disruption to operations and/or system downtime about every four months. These attacks cost an average of $1.32 million each, including lost productivity, reputation loss and brand damage.

Healthcare organizations need a healthy dose of investment in technologies

  • On average, healthcare organizations represented in this research spend $23 million annually on IT
  • 12% on average is allocated to information security
  • Since an average of $1.3 million is spent annually for DDoS attacks alone, a business case can be made to increase technology investments to reduce the frequency of successful attacks

Based on our field research, healthcare organizations are struggling to deal with a variety of threats, but they are pessimistic about their ability to mitigate risks, vulnerabilities and attacks,” said Larry Ponemon, chairman and founder of The Ponemon Institute. “As evidenced by the headline-grabbing data breaches over the past few years at large insurers and healthcare systems, hackers are finding the most lucrative information in patient medical records. As a result, there is more pressure than ever for healthcare organizations to refine their cybersecurity strategies

DataMotion_IG4_BriefHistoryofHCDataBreaches_092915

Shadow Cloud Services 20 Times More Prevalent than Sanctioned Cloud

Skyhigh Networks released its new “Cloud Adoption & Risk in the Government Report.” The Q1 2015 report reveals that shadow IT is prevalent in government agencies.

The average public sector organization uses 742 cloud services, which is about 10-20 times more than IT departments expect. Despite the security initiatives in place, such as FedRAMP, FISMA, and FITARA, many government employees are unaware of agency rules and regulations or simply ignore them and use cloud services that drive collaboration and productivity.

As agencies grapple with how to manage shadow IT and securely enable sanctioned IT, they need visibility into the real usage and risk of cloud services as well as the ability to detect threats and seamlessly enforce security, compliance, and governance policies,” said Rajiv Gupta, CEO of Skyhigh Networks. “Skyhigh manages shadow IT and securely enables sanctioned IT, allowing public sector organizations to use hundreds of cloud services while providing robust data protection services, thereby meeting data privacy requirements and conforming to regulations

Despite clear benefits of cloud services Federal agencies are slow to migrate to the cloud due to security concerns. As a result, employees adopt cloud services on their own, creating shadow IT. Under FITARA, Federal CIOs must oversee sanctioned cloud services as well as shadow IT. This new requirement underscores the uncertainty about how employees are using cloud services within their agencies.

Understanding Shadow IT
The average public sector organization now uses 742 cloud services, which is about 10-20 times more than IT departments report. What agencies don’t know can hurt them. When asked about insider threats, just 7% of IT and IT security professionals at public sector organizations indicated their agency had experienced an insider threat. However, looking at actual anomaly data, Skyhigh Networks found that 82% of public sector organizations had behavior indicative of an insider threat.

Agencies cannot rely on the security controls offered by cloud providers alone. Analyzing more than 12,000 cloud services across more than 50 attributes of enterprise readiness developed with the Cloud Security Alliance, the report found that just 9.3% achieved the highest CloudTrust Rating of Enterprise Ready. Only 10% of cloud services encrypt data stored at rest, 15% support multi-factor authentication, and 6% have ISO 27001 certification. Skyhigh Networks helps Federal agencies address these security gaps and gain control over shadow IT by providing unparalleled visibility, comprehensive risk assessment, advanced usage and threat analytics, and seamless policy enforcement.

Password Insecurity
Compromised credentials can also mean disaster for Federal agencies. According to a study by Joseph Bonneau at the University of Cambridge, 31% of passwords are used in multiple places. This means that for 31% of compromised credentials, attackers can potentially gain access not only to all the data in that cloud service, but all the data in other cloud services as well. The average public sector employee uses more than 16 cloud services, and 37% of users upload sensitive data to cloud file sharing services. As a result, the impact of one compromised account can be immense.

The Skyhigh “Cloud Adoption & Risk in the Government Report” reveals that 96.2% of public sector organizations have users with compromised credentials and, at the average agency, 6.4% of employees have at least one compromised credential.

Cloud Services in the Public Sector
Most cloud services deployed in the public sector are collaboration tools. The average organization uses 120 distinct collaboration services, such as Microsoft Office 365, Gmail, and Cisco Webex. Other top cloud services are software development services, file sharing services, and content sharing services. The average employee uses 16.8 cloud services including 2.9 content sharing services, 2.8 collaboration service, 2.6 social media services, and 1.3 file sharing services. Shockingly, the average public sector employee’s online movements are monitored by 2.7 advertising and web analytics tracking services, the same services used by cyber criminals to inform watering hole attacks.

The report also reveals the top cloud services used in the public sector.

Top ten enterprise cloud services are:-
1. Microsoft Office 365
2. Yammer
3. Cisco WebEx
4. ServiceNow
5. SAP ERP
6. Salesforce
7. DocuSign
8. NetSuite
9. Oracle Taleo
10. SharePoint Online

Top ten consumer cloud services are:-
1. Twitter
2. Facebook
3. YouTube
4. Pinterest
5. LinkedIn
6. Reddit
7. Flickr
8. Instagram
9. StumbleUpon
10. Vimeo

The “Cloud Adoption & Risk in the Government Report” is based on data from 200,000 public sector employees in the United States and Canada.

Most Healthcare Organisations Have Experienced A Data Breach

The Fifth Annual Benchmark Study on Privacy & Security of Healthcare Data reveals that the majority of healthcare organizations represented in this study have experienced multiple security incidents and nearly all have faced a data breach. Despite the universal risk for data breach, the study found that many organizations lack the funds and resources to protect patient data and are unprepared to meet the changing cyber threat environment.

The 2015 study was expanded beyond healthcare organizations to include Business Associates.

Represented in this study are 90 covered entities (hereafter referred to as healthcare organizations) and 88 business associates (hereafter may be referred to as either business associates or BAs). A BA is a person or entity that performs services for a covered entity that involves the use or disclosure of protected health information (PHI), according to the U.S.

Department of Health & Human Services. The inclusion of BAs provides a broader perspective of the healthcare industry as a whole and demonstrates the impact third parties have on the privacy and security of patient data. Respondents were surveyed about their privacy and security practices and experiences with data breaches, as well as their experiences with both electronic and paper security incidents.

Data breaches in healthcare continue to put patient data at risk and are costly. Based on the results of this study, they estimate that data breaches could be costing the industry $6 billion.

  • 90% of healthcare organizations represented in this study had a data breach
  • 40% had more than five data breaches over the past two years

According to the findings of this research, the average cost of a data breach for healthcare organizations is estimated to be more than $2.1 million. No healthcare organization, regardless of size, is immune from data breach. The average cost of a data breach to BAs represented in this research is more than $1 million. Despite this, half of all organizations have little or no confidence in their ability to detect all patient data loss or theft.

For the first time, criminal attacks are the number one cause of data breaches in healthcare. Criminal attacks on healthcare organizations are up 125% compared to five years ago. In fact, 45% of healthcare organizations say the root cause of the data breach was a criminal attack and 12 % say it was due to a malicious insider. In the case of BAs, 39% say a criminal attacker caused the breach and 10% say it was due to a malicious insider.

The percentage of criminal-based security incidents is even higher; for instance, web-borne malware attacks caused security incidents for 78% of healthcare organizations and 82% for BAs. Despite the changing threat environment, however, organizations are not changing their behaviour, only 40% of healthcare organizations and 35% of BAs are concerned about cyber attackers.

Security incidents are part of everyday business. 65% of healthcare organizations and 87% of BAs report their organizations experienced electronic information-based security incidents over the past two years.

  • 54% of healthcare organizations suffered paper-based security incidents
  • 41% of BAs had such an incident

However, many organizations do not have the budget and resources to protect both electronic and paper-based patient information. For instance, 56 % of healthcare organizations and 59% of BAs don’t believe their incident response process has adequate funding and resources. In addition, the majority of both types of organizations fail to perform a risk assessment for security incidents, despite the federal mandate to do so.

Even though medical identity theft nearly doubled in five years, from 1.4 million adult victims to over 2.3 million in 2014, the harms to individuals affected by a breach are not being addressed. Many medical identity theft victims report they have spent an average of $13,500 to restore their credit, reimburse their healthcare provider for fraudulent claims and correct inaccuracies in their health records.

Nearly two-thirds of both healthcare organizations and BAs do not offer any protection services for patients whose information has been breached.

Since 2010, this study has tracked privacy and security trends of patient data at healthcare organizations. Although the annual economic impact of a data breach has remained consistent over the past five years, the most-often reported root cause of a data breach is shifting from lost or stolen computing devices to criminal attacks. At the same time, employee negligence remains a top concern when it comes to exposing patient data. Even though organizations are slowly increasing their budgets and resources to protect healthcare data, they continue to believe not enough investment is being made to meet the changing threat landscape.

Key Findings

In this section, they provide a deeper analysis of the findings. They have organized this report according to the two following topics:

  • Privacy and security of patient data in healthcare organizations and business associates
  • Five-year trends in privacy and security practices in healthcare organizations

To respond quickly to data breaches, organizations need to invest more in technologies.

  • 58 % of healthcare organizations agree that policies and procedures are in place to effectively prevent or quickly detect unauthorized patient data access, loss or theft.
  • 49% agree they have sufficient technologies
  • 33% agree they have sufficient resources to prevent or quickly detect a data breach.
  • 53% of organizations have personnel with the necessary technical expertise to be able to identify and resolve data breaches involving the unauthorized access, loss or theft of patient data.

Background

  • Covered entities are defined in the HIPAA rules as (1) health plans, (2) health care clearinghouses, and (3) health care providers who electronically transmit any health information in connection with transactions for which HHS has adopted standards.
  • A security incident is defined as a violation of an organization’s security or privacy policies involving protected information such as social security numbers or confidential medical information. A data breach is an incident that meets specific legal definitions per applicable breach law(s). Data breaches require notification to the victims and may result in regulatory investigation, corrective actions, and fines.
  • This is based on multiplying $1,067,400 (50% of the average two year cost of a data breach experienced by the 90 healthcare organizations in this research) x 5,686 (the total number of registered US hospitals per the AHA).

Cloud usage is extending the perimeter of most organisations

CloudLock have produced an interesting report on how the use of the cloud and apps has extending the perimeter of most organisations.

CloudLock Executive Summary

The adoption of public cloud applications continues to accelerate for both organizations and individuals at an exponential rate, evidenced across the massive growth in the volume of accounts, files, collaboration, and connected third-party cloud applications.

The rapid surge of accounts, files, and applications presents increased risk in the form of an extended data perimeter. The adoption of cloud applications has significantly increased the threat surface for cyber attacks. Faced with this massive growth and the elevated risk, security professionals are looking to enable their organizations to embrace and leverage the benefits of cloud technologies while remaining secure and compliant.

Sensitive data is moving to the cloud, beyond the protection of your perimeter controls. As this occurs ,the amount of data, and, most importantly, the amount of sensitive or ‘toxic’ data the enterprise stores in these Software-as-a-Service (SaaS) and Infrastructure-as-a-Service (laaS) platforms is increasing by the day – and regardless of its locations, S&R pros still need to protect it effectively.” Forrester Research (2015, March) Market Overview: Cloud Data Protection Solutions

Cloudlock key findingsOther findings

  • 100,000 files per organization that represent risk. Number of files per organization stored in public cloud applications that violate corporate data security policy, amplifying the danger of exposing sensitive information.
  • 4,000 files per organization contain passwords. Number of files per organization stored in public cloud applications containing credentials to corporate systems, inviting cybercriminals to hijack corporate SaaS environments.
  • 1 in 4 employees violating security policies. Number of employees that violate corporate data security policy in public cloud applications, opening organizations to risk of data breach and compliance concerns.
  • 45,000 third-party apps installs conducted by privileged users. Third-party cloud applications with access to privileged users accounts significantly elevates organizational risk.
  • 12% of an organizations files are sensitive/Violate a policy
  • 65% of Security Teams Care about what type of sensitive data is exposes
  • 35% care about how/where it is exposed
  • 70% of corporate cloud based external collaboration occurs with non-corporate entities
  • 77,000 Third Party cloud Apps that touch corporate systems
  • 4x increase in the number of third-party applications enabled per organization, from 130 to 475. The total number of unique third-party cloud apps ballooned to 77,000, amounting to 2.5 million installs
  • 2% growth in third-party SaaS application installations performed by privileged users (administrators and super admins)

Information that organizations worry about most includes:

  • 59% Intellectual Property and Confidential Information
  • 19% PCI DSS data
  • 13% PII data e.g. social security numbers
  • 5% Objectionable content for CIPA compliance- e.g. curse words, harassment
  • 4% PHI/healthcare related data such as medical conditions, prescription drug terminology, patient identification numbers or Compliance

CloudLock Methodology

Cloudlock bases findings on anonymized usage data over 2014 and 2015

  • 77,500+ Apps
  • 750Million Files
  • 6 Million Users

The full report can be found here.

Cyber Attacks on U.S. Companies in 2014

The spate of recent data breaches at big-name companies such as JPMorgan Chase, Home Depot, and Target raises questions about the effectiveness of the private sector’s information security.

According to FBI Director James Comey

There are two kinds of big companies in the United States. There are those who’ve been hacked…and those who don’t know they’ve been hacked

A recent survey by the Ponemon Institute showed the average cost of cyber crime for U.S. retail stores more than doubled from 2013 to an annual average of $8.6 million per company in 2014. The annual average cost per company of successful cyber attacks increased to $20.8 million in financial services, $14.5 million in the technology sector, and $12.7 million in communications industries.

This paper lists known cyber attacks on private U.S. companies since the beginning of 2014. (A companion paper discussed cyber breaches in the federal government.) By its very nature, a list of this sort is incomplete. The scope of many attacks is not fully known. For example, in July, the U.S. Computer Emergency Readiness Team issued an advisory that more than 1,000 U.S. businesses have been affected by the Backoff malware, which targets point-of-sale (POS) systems used by most retail industries. These attacks targeted administrative and customer data and, in some cases, financial data.

This list includes only cyber attacks that have been made known to the public. Most companies encounter multiple cyber attacks every day, many unknown to the public and many unknown to the companies themselves.

The data breaches below are listed chronologically by month of public notice.

January

  • Target (retail). In January, Target announced an additional 70 million individuals’ contact information was taken during the December 2013 breach, in which 40 million customer’s credit and debit card information was stolen.
  • Neiman Marcus (retail). Between July and October 2013, the credit card information of 350,000 individuals was stolen, and more than 9,000 of the credit cards have been used fraudulently since the attack. Sophisticated code written by the hackers allowed them to move through company computers, undetected by company employees for months.
  • Michaels (retail). Between May 2013 and January 2014, the payment cards of 2.6 million Michaels customers were affected. Attackers targeted the Michaels POS system to gain access to their systems.
  • Yahoo! Mail (communications). The e-mail service for 273 million users was reportedly hacked in January, although the specific number of accounts affected was not released.

April

  • Aaron Brothers (retail). The credit and debit card information for roughly 400,000 customers of Aaron Brothers, a subsidiary of Michaels, was compromised by the same POS system malware.
  • AT&T (communications). For two weeks AT&T was hacked from the inside by personnel who accessed user information, including social security information.

May

  • eBay (retail). Cyber attacks in late February and early March led to the compromise of eBay employee log-ins, allowing access to the contact and log-in information for 233 million eBay customers. eBay issued a statement asking all users to change their passwords.
  • Five Chinese hackers indicted. Five Chinese nationals were indicted for computer hacking and economic espionage of U.S. companies between 2006 and 2014. The targeted companies included Westinghouse Electric (energy and utilities), U.S. subsidiaries of SolarWorld AG (industrial), United States Steel (industrial), Allegheny Technologies (technology), United Steel Workers Union (services), and Alcoa (industrial).
  • Unnamed public works (energy and utilities). According to the Department of Homeland Security, an unnamed public utility’s control systems were accessed by hackers through a brute-force attack on employee’s log-in passwords.

June

  • Feedly (communications). Feedly’s 15 million users were temporarily affected by three distributed denial-of-service attacks.
  • Evernote (technology). In the same week as the Feedly cyber attack, Evernote and its 100 million users faced a similar denial-of-service attack.
  • P.F. Chang’s China Bistro (restaurant). Between September 2013 and June 2014, credit and debit card information from 33 P.F. Chang’s restaurants was compromised and reportedly sold online.

August

  • U.S. Investigations Services (services). U.S. Investigations Services, a subcontractor for federal employee background checks, suffered a data breach in August, which led to the theft of employee personnel information. Although no specific origin of attack was reported, the company believes the attack was state-sponsored.
  • Community Health Services (health care). At Community Health Service (CHS), the personal data for 4.5 million patients were compromised between April and June. CHS warns that any patient who visited any of its 206 hospital locations over the past five years may have had his or her data compromised. The sophisticated malware used in the attack reportedly originated in China. The FBI warns that other health care firms may also have been attacked.
  • UPS (services). Between January and August, customer information from more than 60 UPS stores was compromised, including financial data, reportedly as a result of the Backoff malware attacks.
  • Defense Industries (defense). Su Bin, a 49-year-old Chinese national, was indicted for hacking defense companies such as Boeing. Between 2009 and 2013, Bin reportedly worked with two other hackers in an attempt to steal manufacturing plans for defense programs, such as the F-35 and F-22 fighter jets.

September

  • Home Depot (retail). Cyber criminals reportedly used malware to compromise the credit card information for roughly 56 million shoppers in Home Depot’s 2,000 U.S. and Canadian outlets.
  • Google (communications). Reportedly, 5 million Gmail usernames and passwords were compromised. About 100,000 were released on a Russian forum site.
  • Apple iCloud (technology). Hackers reportedly used passwords hacked with brute-force tactics and third-party applications to access Apple user’s online data storage, leading to the subsequent posting of celebrities’ private photos online. It is uncertain whether users or Apple were at fault for the attack.
  • Goodwill Industries International (retail). Between February 2013 and August 2014, information for roughly 868,000 credit and debit cards was reportedly stolen from 330 Goodwill stores. Malware infected the chain store through infected third-party vendors.
  • SuperValu (retail). SuperValu was attacked between June and July, and suffered another malware attack between late August and September. The first theft included customer and payment card information from some of its Cub Foods, Farm Fresh, Shop ‘n Save, and Shoppers stores. The second attack reportedly involved only payment card data.
  • Bartell Hotels (hotel). The information for up to 55,000 customers was reportedly stolen between February and May.
  • U.S. Transportation Command contractors (transportation). A Senate report revealed that networks of the U.S. Transportation Command’s contractors were successfully breached 50 times between June 2012 and May 2013. At least 20 of the breaches were attributed to attacks originating from China.

October

  • J.P. Morgan Chase (financial). An attack in June was not noticed until August. The contact information for 76 million households and 7 million small businesses was compromised. The hackers may have originated in Russia and may have ties to the Russian government.
  • Dairy Queen International (restaurant). Credit and debit card information from 395 Dairy Queen and Orange Julius stores was compromised by the Backoff malware.
  • Snapsave (communications). Reportedly, the photos of 200,000 users were hacked from Snapsave, a third-party app for saving photos from Snapchat, an instant photo-sharing app.

Securing Information

As cyber attacks on retail, technology, and industrial companies increase so does the importance of cybersecurity. From brute-force attacks on networks to malware compromising credit card information to disgruntled employees sabotaging their companies’ networks from the inside, companies and their customers need to secure their data. To improve the private sector’s ability to defend itself, Congress should:

  • Create a safe legal environment for sharing information. As the leaders of technological growth, private companies are in most ways at the forefront of cyber security. Much like government agencies, companies must share information that concerns cyber threats and attack among themselves and with appropriate private-public organizations. Congress needs to create a safe environment in which companies can voluntarily share information without fear of legal or regulatory backlash.
  • Work with international partners. As with the Backoff malware attacks, attacks can affect hundreds if not thousands of individual networks. These infected networks can then infect companies outside the U.S. and vice versa. U.S. and foreign companies and governments need to work together to increase overall cybersecurity and to enable action against individual cyber criminals and known state-sponsored cyber aggressors.
  • Encourage cyber insurance. Successful cyber attacks are inevitable because no security is perfect. With the number of breaches growing daily, a cybersecurity insurance market is developing to mitigate the cost of breaches. Congress and the Administration should encourage the proper allocation of liability and the establishment of a cyber insurance system to mitigate faulty cyber practices and human error.

Conclusion

The recent increases in the rate and the severity of cyber attacks on U.S. companies indicate a clear threat to businesses and customers. As businesses come to terms with the increasing threat of hackers, instituting the right policies is critical to harnessing the power of the private sector. In a cyber environment with ever-changing risks and threats, the government needs to do more to support the private sector in establishing sound cybersecurity while not creating regulations that hinder businesses more than help them.

Riley Walters is a Research Assistant in the Asian Studies Center, of the Kathryn and Shelby Cullom Davis Institute for National Security and Foreign Policy, at The Heritage Foundation.

The original research article can be found here.

Cyber Data Breach – Is Your Business Ready?

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