A Proactive Approach to Healthcare IT Security

Andrew Froehlich, Network Engineer & IT Consultant | 2/7/2013 | 14 comments

Andrew Froehlich
The promise of profits to be made in healthcare IT, coupled with new HIPAA regulations, has put a renewed focus on software security.

It used to be that software security was an afterthought in the healthcare industry. But HIPAA regulations have helped to bring the security topic to the forefront, and many healthcare IT managers are now placing security on an even plane with functionality.

For example, the University of Michigan recently announced that it is offering a new graduate-level course that specifically focuses on medical device security.

While this is a positive step in the right direction, it's hard to patch an already broken system. The real challenge occurs in assuring security across the full lifecycle of the software. Although software security may, indeed, be improved when an application is first deployed on a medical center infrastructure, it doesn't remain secure for long.

The real reason software security eventually fails is the outdated method for regulating medical software over the long haul. The process to recertify software after adding new security updates is tedious at best. Software companies find that it requires an inordinate amount of time and money to keep software security patches up to current standards.

What ends up happening is that software is developed, certified, and deployed, never to be updated again. There's not a great deal of profit involved in maintaining security, so it's often ignored. I've personally seen this occur on numerous occasions -- even with well-respected medical device companies. It's this combination of antiquated regulations and lack of interest by the software companies that creates an environment of lax security practices.

Security pressures mount in healthcare IT
The responsibility falls on the healthcare provider to properly secure devices and applications. A large number of healthcare systems are deployed by vendors using common desktop and server operating systems such as Microsoft Windows or Linux. Even though these operating systems receive regular security patches from the OS vendor, they cannot be deployed onto medical systems until they are certified and approved by the vendor. This process happens slowly, if at all.

Additionally, it's common for healthcare device and application vendors to disallow third-party applications from being installed on these systems. This significantly limits what can be done to secure systems on an OS level, such as third-party anti-virus or software firewalls.

If you want to protect your organization from the latest vulnerabilities, the best defense is to physically or logically separate weak systems, providing an added layer of security. Fortunately, there are a couple different methods that can be used to proactively protect insecure health systems.

One way around this is to deploy small hardware-based firewalls between these systems and the rest of the network. Many enterprise-class networking companies offer low-cost firewalls that can be deployed in a bridged, or transparent mode. This means that the firewall can be deployed without any reconfiguration or re-addressing being needed. This is especially useful if a medical device regularly moves from one location to another.

An alternative to providing hardware point-based solutions for vulnerable health systems is to create separate, secure DMZ areas. By leveraging today's modern, virtualized firewall solutions, it's fairly easy to create multiple, logical DMZs. These effectively quarantine unpatched systems so they can't affect the rest of the network if they become compromised. While this may create a complex infrastructure, it often is necessary in order to quarantine specific systems that don't meet a minimum level of security.

A renewed interest in medical device security is a positive step toward safe healthcare software in the future. But securing software for deployment on day one is only part of the challenge. The real issue is continuing security measures throughout the lifecycle of the system. Because of problems within the industry, IT managers must take a proactive approach to securing software themselves.

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Syerita Turner   A Proactive Approach to Healthcare IT Security   2/21/2013 9:06:05 AM
Re: InfoSec the enemy.
When it comes to security and healthcare there are some things that can be done to protect information and then some things will fall through the cracks. I think that allowing people in the healthcare industry very little play when it comes to downloading on a healthcare or company computer because this is where your problems begin. Keeping people off of sites that are not for business and providing strict guidelines about plugging up personal devices will have to be set before issuing these machiines out to the masses.
singlemud   A Proactive Approach to Healthcare IT Security   2/18/2013 9:47:03 PM
Re: IT Security in Health care
I really do not think the security concerns will be addressed. It is always the second thing and forgotten easily. Thinking about banking industries, with so many credit card breaches, it still keeps leaking
soozyg   A Proactive Approach to Healthcare IT Security   2/13/2013 11:39:34 AM
Re: A Proactive Approach to Healthcare IT Security

A great selling point? Yes, actually would I agree that security could be a good selling point. But the statement here is There's not a great deal of profit involved in maintaining security, so it's often ignored. Which seems accurate...BUT if a company is talking about the money-making departments, security is up there with the non-money makers like marketing, publicity and accounting. I would say if we're categorizing like that, sales would be the only direct money making department.
Susan Nunziata   A Proactive Approach to Healthcare IT Security   2/12/2013 11:42:01 PM
Re: InfoSec the enemy.
@Damian: I think that's a fair assessment. There is $$ at stake in penalties and unfortunately that is often what is needed to drive appropriate behavior. I'd like to think ethics come first, but that has not been proven out in much of corporate history.
tekedge   A Proactive Approach to Healthcare IT Security   2/12/2013 7:09:50 PM
IT Security in Health care
It will soon become important to the healthcare industry to invest in IT security to guard the  confidentiality of the patient history. But at present the slew of changes in the industry is keeping them fighting to keep the costs down. I am really skeptical when they will actually address the security concerns!
Sara Peters   A Proactive Approach to Healthcare IT Security   2/11/2013 5:47:14 PM
Re: A Proactive Approach to Healthcare IT Security
@soozyg   Over recent years, some IT security professionals have tried to say that good security practices will eventually become a great selling point for a lot of organizations. I'm not sure that it's true, though. If it's true at all, then I think it only applies to the financial services industry. When it comes to healthcare services, people are going to make their choices based upon what healthcare organization they can trust with their body, not which they can trust with their data.
Sara Peters   A Proactive Approach to Healthcare IT Security   2/11/2013 5:44:13 PM
Re: InfoSec the enemy.
@Damian  Agreed:  "I'm amazed at how little security is considered amongst many IT professionals I meet."  On the flip side, I'm often amazed at how little the business is considered by many security professionals I meet. I think that CIOs, CISOs, and CFOs should overcome their differences and become friends. Like the fox and the hound.
Sara Peters   A Proactive Approach to Healthcare IT Security   2/11/2013 5:37:42 PM
third parties factor in too
Thanks for the post Andrew. Another thing that comes to mind when thinking about healthcare device security is that the devices aren't entirely run by the healthcare organization. For example, the EEG equipment used at my hospital is maintained by a third party vendor -- the hospital's IT department apparently has nothing to do with it.
soozyg   A Proactive Approach to Healthcare IT Security   2/10/2013 7:43:01 PM
Re: A Proactive Approach to Healthcare IT Security
There's not a great deal of profit involved in maintaining security, so it's often ignored.

Interesting take--so because an area doesn't make any money, health care companies don't talk about it even though patient confidentiality is crucial and avoids lawsuits.
batye   A Proactive Approach to Healthcare IT Security   2/8/2013 2:16:29 PM
Re: InfoSec the enemy.
Susan you are right... as with Healthcare and IT security is more like cat and dog fighting... no one wants to give priority to IT security until breach happens... and everyone started thinking... why? as with out proper balance is bad... 
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