Last month saw a significant rise in healthcare data breaches, clearly demonstrating that healthcare providers, health plans, and business associates are struggling to prevent healthcare data breaches.
The Health Insurance Portability and Accountability Act (HIPAA) Security Rule was introduced to ensure that healthcare organizations implement a range of safeguards to ensure the confidentiality, integrity, and availability of healthcare data. It has now been more than decade since the Security Rule was introduced, and data breaches still occurring with alarming frequency. In fact, more data breaches are occurring than ever before.
September Data Breaches in Numbers
The Protenus Breach Barometer Report for September, which tracks all reported healthcare data breaches, showed there were 46 breaches of protected health information (PHI) in September, with those breaches resulting in the exposure of 499,144 individuals’ PHI. Hacking and IT incidents were cited as the cause of 50% of those breaches, with insiders causing 32.6% of incidents. Loss and theft of devices was behind almost 11% of the month’s breaches. Previous monthly reports in 2017 have shown that insiders are often the biggest cause of healthcare data breaches.
HIPAA Compliance Will Not Prevent Healthcare Data Breaches
HIPAA compliance can go some way toward making healthcare organizations more resilient to cyberattacks, malware and ransomware infections, but simply complying with the HIPAA Security Rule does not necessarily mean organizations will be impervious to attack.
HIPAA compliance is about raising the bar for cybersecurity and ensuring a minimum standard is maintained. While many healthcare organizations see HIPAA compliance as a goal to achieve a good security posture, the reality is that it is only a baseline. To prevent data breaches, healthcare organizations must go above and beyond the requirements of HIPAA.
Detect Insider Breaches Promptly
Preventing insider data breaches can be difficult for healthcare organizations. Healthcare employees must be given access to patient records in order to provide medical care, and there will always be the occasional bad apple that snoops on the records of patients who they are not treating, and individuals who steal data to sell to identity thieves.
HIPAA Requires healthcare organizations to maintain access logs and check those logs regularly for any sign of unauthorized access. The term ‘regularly’ is open to interpretation. A check every six months or once a year could be viewed as regular and compliant with HIPAA regulations. However, during those 6 or 12 months, the records of thousands of patients could be accessed. Healthcare organizations should go above and beyond HIPAA requirements and should ideally implement a system that constantly monitors for unauthorized access or at least conduct access log reviews every quarter as a minimum. This will not prevent healthcare data breaches, but it will reduce their severity.
Close the Door to Hackers
50% of breaches in September were due to hacking and IT incidents. Hackers are opportunistic, and while targeted attacks on large healthcare organizations do occur, most of the time hackers take advantage of long-standing vulnerabilities that have not been addressed. In order to correct those vulnerabilities, they must first be identified, hence the need for regular risk analyses as required by the HIPAA Security Rule. An organization-wide risk analysis should take place at least every year to remain HIPAA compliant, but more frequently to ensure vulnerabilities have not crept in.
Additionally, a check should be performed at least every month to make sure all software is up to date and all patches have been applied. There have been numerous examples recently of cloud storage instances being left unprotected and accessible by the public. There are free tools that can be used to check for exposed AWS buckets for example. Scans should be regularly conducted. Cybercriminals will be doing the same.
Prevent Impermissible Disclosures of PHI
One of the leading causes of PHI disclosures occurs when laptop computers, zip drives, and other portable devices are lost or stolen. While employees can be trained to take care of their devices, thieves will seize any opportunity if devices are left unprotected. HIPAA does not demand the use of encryption, and alternative measures can be used to secure devices, but HIPAA covered entities and their business associates should use encryption on portable devices to ensure that in the event of loss or theft, data cannot be accessed. If an encrypted device is stolen or lost, it is not a HIPAA breach. Using encryption on portable devices is a good way to prevent healthcare data breaches.
Small portable storage devices such as pen drives are convenient, but they should never be used for transporting PHI – They are far too easy to lose or misplace. Use HIPAA-compliant cloud storage services such as Dropbox or Google Drive as they are more secure.
Block Malware and Ransomware Attacks
Malware and ransomware attacks are reportable breaches under HIPAA, and can result in major data breaches. Email is the primary vector for delivering malware, so it is essential for an effective spam filtering solution to be implemented. HIPAA requires training to be provided to employees regularly, but a once-a-year training session is no longer sufficient. Training sessions should take place at least every 6 months, with regular security alerts on the latest phishing threats communicated to employees as and when necessary. Ideally, training should be an ongoing process, involving phishing simulation exercises.
Malware and ransomware can also be downloaded in drive-by attacks when browsing the Internet. A web filtering solution should be used to prevent healthcare employees from visiting malicious sites, to block phishing websites, and prevent drive-by malware downloads. A web filter is not a requirement of HIPAA, but it is an important extra layer of security that can prevent healthcare data breaches.