The massive Allscripts EHR breach in January 2018 resulted in massive disruption for the company and its clients. Clients were locked out of their electronic health records for several days while the company battled to recover from the attack. Around 1,500 of the company’s clients were affected.
The cost of mitigating the ransomware attack was considerable, and in addition to those costs, the Allscripts EHR breach prompted many clients to take legal action. The costs continue to mount.
The Allscripts EHR breach involved SamSam ransomware, which has plagued the healthcare industry over the past couple of years. The threat actors behind the attacks typically gain access to healthcare networks through RDP vulnerabilities and deploy the ransomware manually after scouting the network. This way, maximum damage can be inflicted, which increases the probability of the ransom being paid.
The Allscripts EHR breach certain stands out as one of the most damaging ransomware attacks of 2018, although it was just one of many healthcare ransomware attacks in 2018 involving many ransomware variants.
According to Beazley Breach Response Services, ransomware attacks more than doubled in September. Many cybercriminals have switched to cryptocurrency mining malware, but the ransomware attacks on healthcare organizations are continuing and show no sign of slowing.
In recent months, there has been a growing trend of combining malware variants to maximize the profitability of attacks. Ransomware is a quick and easy way for cybercriminals to earn money but combining ransomware with other malware variants is much more profitable. Further, if files are recovered from backups and no ransom is paid, cybercriminals can still profit from the attacks.
Several campaigns have been detected recently that combine Trojans such as AZORult, Emotet and Trickbot with ransomware. Attacks with these Trojans have increased by 132% since 2017 according to Malwarebytes. The Trojans steal sensitive information through keylogging, are capable lateral movement within a network, and also serve as downloaders for other malware such as Ryuk and GandCrab ransomware. Once information has been stolen, the ransomware payload is deployed.
The Allscripts EHR breach was somewhat atypical. It is far more common for ransomware to be delivered via email than brute force attacks on RDP. The campaigns combining Emotet, Trickbot, and AZORult with ransomware are primarily delivered by email.
In addition to ransomware attacks, phishing attacks are rife in healthcare. Email was the most common location of exposed protected health information in 2018. Email security is a weak point in healthcare defenses.
The number of successful ransomware and phishing attacks in healthcare make it clear that email security needs to improve. An advanced spam filter to block malicious emails, improved end user training is required to teach employees how to recognize email threats, intrusion detection systems need to be deployed, along with powerful anti-virus solutions. Only by implementing layered defenses to block email attacks and other attack vectors will healthcare organizations be able to reduce the risk of ransomware attacks.