Transforming Healthcare Cybersecurity from Reactive to Proactive: Current Status and Future Recommendations

Cybersecurity breaches are becoming increasingly more common, particularly in the realm of healthcare. Systems to digitize patient information and facilitate the sharing of medical data, including the Electronic Health Records (EHR), bring benefits of reducing cost and increasing the efficiency of health care delivery, but come with vulnerabilities to cyberattack. Because health information is extremely high-value, they are a prime target for data breaches. In the five year period after 2009, 150 million patient health records were breached. Characterizing the major cybersecurity threats and explaining the players in cybersecurity lays the contextual scaffolding to inform healthcare providers and policymakers and equip society with the tools to ameliorate cybersecurity. Major healthcare attacks include Denial-of-Services (DoS), notable in a 2014 attack on Boston Children’s Hospital that shut down the hospital, Structured Query Language Injections Exploit, used to alter database information, and Phishing, a form of social engineering to trick healthcare employees into installing malware. These attacks occur in a dynamic ecosystem with many players, including the cyber-attackers themselves pushing forward with their malicious technology, end users that interact with the technology (i.e. healthcare employees), cyber defenders that actively work to preserve cybersecurity (e.g. security analysts, IT directors), and software developers that have the goal of making dependable, secure code. The coordinated efforts of the end users, cyber defenders, and software developers can resolve many cybersecurity issues. Importantly, Healthcare systems, must pursue a “comprehensive approach to cybersecurity rather than an ad hoc approach of dealing with threats on a case-by-case basis as they are discovered.”