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Health devices, data ripe for hacks

Gaps leave patients’ records vulnerable

Rubin

As the health care industry rushed onto the Internet in search of efficiencies and improved care in recent years, it has exposed a wide array of vulnerable hospital computers and medical devices to hacking, according to documents and interviews.

Security researchers warn that intruders could exploit known gaps to steal patients’ records for use in identity theft schemes and even launch disruptive attacks that could shut down critical hospital systems.

A yearlong examination of cybersecurity by the Washington Post has found that health care is among the most vulnerable industries in the country, in part because it lags behind in addressing known problems.

“I have never seen an industry with more gaping security holes,” said Avi Rubin, a computer scientist and technical director of the Information Security Institute at Johns Hopkins University. “If our financial industry regarded security the way the health care sector does, I would stuff my cash in a mattress under my bed.”

Compared with financial, corporate and military networks, relatively few hacks have been directed at hospitals and other medical facilities. But in recent months, officials with the Department of Homeland Security have expressed growing fear that health care presents an inviting target to activist hackers, cyberwarriors, criminals and terrorists.

“These vulnerabilities may result in possible risks to patient safety and theft or loss of medical information,” a DHS intelligence bulletin said in May.

Security researchers are starting to turn up the same kinds of trivial-seeming flaws that earlier opened the way for hackers to penetrate financial services networks, Pentagon systems and computers at firms such as Google.

Rubin has documented the routine failure to fix known software flaws in aging technology and a culture in which physicians, nurses and other health care workers sidestep basic security measures, such as passwords, in favor of convenience.

Another researcher found that a system used to operate an electronic medicine cabinet for hospital prescriptions in Oklahoma could be easily taken over by unauthorized users because of weaknesses in the software interface.

OpenEMR, an open-source electronic medical records management system that is about to be adopted worldwide by the Peace Corps, has scores of security flaws that make it easy prey for hackers.

The University of Chicago medical center operated an unsecure Dropbox site for new residents managing patient care through their iPads, using a single user name and password published in a manual online.

After a Post reporter called about the vulnerabilities, officials at the cabinet manufacturer and the medical center took steps to close the gaps. The Peace Corps said it was considering changes.

Government oversight and industry practices have not kept pace with changing technology. The Food and Drug Administration, responsible for overseeing medical devices, most recently published guidance on cybersecurity in 2005.

The agency has urged hospitals to allow vendors to guide them on security of sophisticated devices. But the vendors sometimes tell hospitals that they cannot update FDA-approved systems, leaving those systems open to potential attacks. In fact, the agency encourages such updates.

“A lot of people are very confused about FDA’s position on this,” said John Murray Jr., a software compliance expert at the agency.

A Government Accountability Office report in August noted that defibrillators and insulin pumps are vulnerable to hacks. In July, one researcher-hacker was able for the first time to use a specialized search engine called Shodan to discover a wireless patient-glucose monitor in Wisconsin linked to the Internet and open to hacking.

The Department of Health and Human Services is overseeing the move to electronic health records systems, some of which have documented security vulnerabilities.

John Halamka, a physician and co-chairman of the HHS health information technology standards committee, said security in the health care industry is “not as good” as in other industries. But he added that the industry is aware of the problems and is scrambling to make improvements.

“It’s completely headed in the right direction,” he said.

But Laurie Williams, a computer scientist at North Carolina State University, said health care remains widely vulnerable.

“There are basic, basic, Security 101 vulnerabilities we identified,” said Williams, who was among a team of researchers that identified numerous security flaws in several electronic heath records systems two years ago. “I’m concerned that at some point the hackers are really going to begin exploiting them. And that’s going to be a scary day.”

HHS officials said health care providers must combine cultural, practical and technological solutions to defend against theft and hacking. The officials also said that they have ramped up enforcement efforts against organizations that failed to protect patient information.

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