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NHS attack latest example of healthcare sector’s vulnerability to Ransomware

Last week’s crippling of the National Healthcare System in the UK by "WannaCry" aka. WanaCrypt0r was just the latest instance of healthcare facilities falling victim to ransomware attacks.

Ransomware’s defining characteristic is that it attempts to deny access to a user’s data, usually by encrypting the data with a key known only to the hacker who deployed the malware, until a ransom is paid, usually in a cryptocurrency, such as Bitcoin) in order to receive a decryption key. Hackers may deploy ransomware that also destroys or exfiltrates data, or ransomware in conjunction with other malware that does so.

WannaCry locks users' files and demands a $300 payment to allow access, along with a warning that the payment will be doubled after 3 days and the files will be unrecoverable after 7 days. After initial infection, WannaCry uses EternalBlue exploit and DoublePulsar backdoor originally developed by the U.S. National Security Agency (NSA) and later leaked by hacker group Shadow Brokers in April 2016, to spread through a network which has not installed recent security updates to directly infect any exposed systems (A patch was issued by Microsoft on 14 March 2017 to remove the underlying vulnerability for supported systems). 

Starting on May 12, it infected hundreds of thousands of computers in 150 countries around the world, affecting several large companies such Telefónica (Spain), FedEx (USA), Deutsche Bahn (Germany), LATAM Airlines (Chile), as well as the Russian Interior Ministry.

The BBC reported that 47 NHS trusts in England and 13 NHS organisations in Scotland reported problems. The volume of planned services was reduced at some hospitals, and routine surgeries and GP appointments were cancelled. Hospitals were diverting patients from Accidents & Emergency (A&E). Though on a reduced scale, the disruptions were continuing as of May 15.  

Dick Bussiere, Tenable Network Security’s APAC technical director said, “Whilst this isn’t the first time the NHS has been hit with Ransomware, it seems like this particular attack has affected more trusts than before. Until the NHS speak publicly about how the ransomware entered their systems and started encrypting crucial files, we can only guess that it was successful due to lax security practices like insufficient patching, poor configuration, and effective filtering of internet communications.”

According to a report in Channel News Asia that two major Indonesian hospitals, Dharmais Hospital and Harapan Kita Hospital in Jakarta were affected by the ransomware. Abdul Kadir, president-director of Dharmais Hospital, said that nearly all computers across the hospital were locking up its IT system and with it patient medication records and billing. The hospital was re-installing its system on back- up computers and servers.

This article lists 14 hospitals attacked by ransomware in North America alone during the first eight months of 2016.

The healthcare sector provides a perfect target for ransomware. Getting locked out of hospital systems and equipment and being unable to access including patient records and surgery directives, could potentially mean a life or death situation, as patient care is obstructed or even halted. More often than not, the hospitals are left with no choice but to pay the ransom.

The reasons for the high level of vulnerability range from legacy infrastructure, inadequate cybersecurity spend as a proportion of budget, lack of employee awareness and training and in general an absence of focus on cybersecurity.

A 2016 HIMSS (Healthcare Information and Management Systems Society) Analytics Healthcare IT Security and Risk Management Study found that medical device manufacturers are not mandated to incorporate cybersecurity features in their design and development and healthcare organizations are not filling the gaps in security for medical devices. The growth of Internet-of-things with increasing number of hospital equipment, wearables and implanted devices being connected to the Internet means an expanded attack surface for hackers to exploit.  

A December 2016 report from Experian predicted that healthcare organizations will be the most targeted sector during 2017, with ransomware and and theft of valuable personal medical information (The FBI’s cyber division warned a few years ago that the going rate for electronic healthcare records was $50 per chart on the black market, compared to a measly $1 for a stolen social security number or credit card number).

Another April 2017 report from CyberSecurity Ventures predicted that ransomware attacks on healthcare organizations are expected to quadruple by 2020. It recommended training employees on security awareness and doing regular back-ups, so as to reduce the instances of ransoms paid out and minimise disruption to critical business and patient care.

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