Phishing attacks in healthcare are to be expected. Healthcare providers hold vast quantities of data on patients. Hospitals typically employ hundreds or thousands of members of staff, use many third-party vendors, and historically they have had relatively poor cybersecurity defenses compared to other industry sectors. That makes them an attractive target for phishers.
Phishing is a method of gaining access to sensitive information which typically involves a malicious actor sending an email to an employee in which they attempt to get that individual to reveal their login credentials. This is achieved using social engineering techniques to make the email recipient believe the email is a genuine. For instance, a security alert could inform the email recipient that an online account has been compromised and a password change is required. They are directed to a spoofed website where they are asked to login. The site is fake but looks genuine.
Credentials are entered and passed to the attacker who uses them to gain access to that individual’s account. Phishing can also involve malware. Emails attempt to convince the recipient to open a malware-infected attachment or download a malicious file from a compromised website.
Compliance with HIPAA Rules Helps to Prevent Phishing Attacks in Healthcare
HIPAA Rules require healthcare providers to implement administrative, technical, and physical safeguards to reduce the risk of cyberattacks and phishing. HIPAA only demands a minimum standard for data security be reached, although complying with HIPAA Rules can help to prevent phishing attacks in healthcare.
HIPAA is not technologically specific on the defenses that should be used to protect patient data. Healthcare providers can choose appropriate defenses based on the results of a risk analysis.
It is possible for healthcare organizations to be compliant with HIPAA Rules but still be vulnerable to phishing attacks. If healthcare providers are to block the majority of phishing attacks and truly secure patients’ data, they must go above and beyond the requirements of HIPAA.
HHS’ Office for Civil Rights Warns of Phishing Attacks in Healthcare
Recent phishing attacks in healthcare have prompted the HHS’ Office for Civil Rights to issue a warning about the risk from phishing.
Attacks are now highly sophisticated and can be hard to detect. The emails are often free from spelling mistakes, have near perfect grammar, include brand images and logos, and appear to have been sent from genuine domains. The reasons given for taking a specific course of action are perfectly plausible as is the need for urgent action.
OCR also highlights the rise in spear phishing attacks in healthcare. These attacks involve more targeted attempts to gain access to sensitive information and can be conducted on specific individuals or groups of individuals in an organization – The payroll or HR department for instance.
These attacks often see a CEO or superiors impersonated to add legitimacy to the attack. These attacks tend to require the opening of attachments or visiting links to download malware. Spear phishing emails are also used to request bank transfers or for sensitive information to be sent via email – W2-Forms of employees for instance. Many healthcare employees have been fooled by these scams.
Recent Phishing Attacks in Healthcare
Listed below are some of the recent examples of phishing attacks in healthcare. This is just a small selection of incidents that have resulted in healthcare records being exposed or stolen. The reality is that many data breaches start with a phishing email. Security awareness training company Cofense suggests that as many as 91% of data breaches have their root in a phishing campaign.
November 2017: 1,670 patients of Forrest General Hospital have their PHI exposed following a phishing attack on business associate HORNE.
October 2017: Henry Ford Health System discovers several email accounts were compromised as a result of employees responding to phishing emails. The PHI of 18,470 patients may have been stolen.
September 2017: Employees of UPMC Susquehanna responded to phishing emails with the attackers able to gain access to the PHI of 1,200 patients.
September 2017: A phishing attack on Wisconsin-based Network Health resulted in the PHI of approximately 51,000 patients being exposed.
August 2017: Chase Brexton Health Care in Maryland experienced a phishing attack that saw several email accounts compromised along with the PHI of 16,000 patients.
July 2017: The Medical College of Wisconsin experienced a phishing attack that allowed attackers to gain access to email accounts and the PHI of 9,500 patients.
July 2017: RiverMend Health employees responded to phishing emails and their accounts were accessed by the attackers. The PHI of 1,200 patients was potentially viewed or stolen.
June 2017: A phishing attack on Elderplan Inc., saw several email accounts compromised along with the PHI of 22,000 individuals.
June 2017: MJHS Home Care experienced a phishing attack that saw email access gained by an unauthorized individual. The compromised email accounts contained the PHI of 6,000 patients.
Staff Training and Anti-Phishing Technology
HIPAA does not specifically mention spam filters, but since phishing is used to target employees via email, spam filtering can be considered essential. By filtering out the majority of spam and malicious messages there is less potential for an employee to click on a malicious link or open a malware infected email attachment.
SpamTitan is a cloud-based anti-spam service that blocks more than 99.9% of spam emails from being delivered to inboxes and has a 0.03% false positive rate. Dual antivirus engines (Bitdefender/ClamAV) ensure malicious email attachments are blocked.
Healthcare employees are the last line of defense, so it is important for them to be able to recognize email threats and anti-phishing training is a requirement of HIPAA. In July 2017, OCR issued advice to healthcare organizations on anti-phishing training in its cybersecurity newsletter.
OCR also recommends using multi-factor authentication to ensure email accounts are not compromised when a password is guessed or stolen. Software and operating systems must be kept up to date and fully patched to prevent vulnerabilities from being exploited, and anti-virus and anti-malware solutions should be deployed to prevent infection. Regular backups can also prevent data loss in the event of a malware or ransomware infection.