Lancaster Physician Fall 2020 - 15

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Compromised health information is the root
cause of a large majority of ID theft.

financial information, the consequences
would be devastating.

One Pennsylvania health system recently
began notifying over 700 patients after it
discovered a former employee inappropriately
accessed their medical records.

Our citizens' cyber habits are the very thing
that could render such an attack successful.

The Wanna Cry ransomware attacks struck
worldwide in over 150 countries. According
to a June 2019 report from cybersecurity firm
Armis, more than 40 percent of health care
organizations were victims of the Wanna Cry
attacks. Organizations of all kinds paid over
$325 million in ransom, and the total cost in
terms of financial losses was over $4 billion.
Ransomware attacks increased 25 percent
from Q4 2019 through Q1 2020 and show
no signs of slowing down.
On February 9th, Forbes reported that
the country of Iran sustained a nationwide
cyberattack on its internet infrastructure. The
NetBlocks Internet Observatory, which maps
internet freedom, reported extensive internet
disruption. NetBlocks also reported that
another disruption was confirmed on March
3, 2020. Forbes reported that the nature of the
February attack was a Distributed Denial of
Service Attack (DDOS). There are two reasons
this attack was so dangerous. The first reason
is that Iran is in a battle against coronavirus.
When their infrastructure is compromised, the
flow of information stops. The infrastructure is
critical. Without it, people will die. The second
reason is the history that Iran has with cyberattacks. In 2010, Iran was hit with a virus that
damaged its uranium enrichment capabilities.
The name of the virus was Stuxnet. This attack
is widely considered the first cyberattack that
affected a physical machine, otherwise known
as "ground zero."
It can be argued that this attack is Iran's
problem. As Americans, we could say that
Iran is our enemy and what is bad for
them is good for us. I would argue that
this view is shortsighted and dangerous. If
the entire country of Iran can be affected
by a cyberattack, our county, state, and
country is also at risk. Just as in the case
of Iran, we are in a war where information
is mission critical. If an attack stops the
flow of clinical, scientific, logistical, and

A DDOS attack sends millions of requests
to a network, overwhelming it and denying
service to legitimate users. The only way an
attack like this can be successful is for those
requests to come from hundreds, if not thousands, of computers. One of those computers
could easily be yours. There are multiple ways
a cyber-criminal can get software onto an
unsuspecting personal computer or remote or
wireless device without the owner's knowledge.
Just as in the case of the coronavirus, protection from vulnerability is straightforward yet
inconvenient for many people. To complicate
matters, the growth of telehealth presents a
new vulnerability. A recent MedPage Today
article stated that "Telehealth increases cyber
liability, especially when providers are seeing
patients from a variety of devices in a variety
of locations."
One tactic to help stem the spread of
COVID-19 is the use of contact tracing apps.
An article in Healthcare Innovation (July/August
2020) reported that a mobile app security
company assessed 17 Android mobile contact
tracing apps built by government entities in
17 different countries and found that the "vast
majority are not sufficiently secured."
Only by creating a culture of cybersecurity
can we hope to avoid disaster and optimally
manage our risks.
A good initial tactic is a solid password
policy. Passwords can be unruly and inconvenient. Being forced to come up with complex
passwords with many requirements seems like
overkill. Information technology professionals
I know assure me that it is not overkill. There
are ways to manage passwords and make this
part of your cyber life optimally secure. Using
a password manager and allowing a program
to generate a random password for you is an
effective tactic.
A second effective tactic is to understand
what phishing is and how to combat it. A 2019
article in Health IT Security stated that "25%

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of phishing emails get past Office 365 Default
Security." Generally, phishing attacks are emails
prompting a user to click on an embedded,
malicious link with attachments to a main
vector. When clicked, the malicious software
is downloaded onto the user's computer. The
user has no idea it is there until the person that
controls the program remotely activates it. At
the same time, this attacker activates thousands
of other machines that have also been affected.
Through this method, our networks can be
taken down and information access stopped.
There are talented cybersecurity professionals
guarding our networks and the information
stored within them.  Our job as users is to
perform inconvenient tasks to decrease the
risks. In so doing, we do not make the security professionals' jobs harder. Education is
extremely important. Read, watch videos,
and learn all you can about proper computer
and network security behavior. Another way
to get your cyber "house in order" is to ask for
help from a cyber coach. A cyber coach can
help you set up proper password policies and
educate you on best practices to keep you, and
our country, safe. Train, educate, reinforce the
training, and never stop. During my time in
the Marine Corps, training was explained with
the statement, "The more we train in peace,
the less we bleed in war." Make no mistake; we
are in more than one war right now.
The line between our online and offline lives
is indistinguishable. These technology-fueled
times place our lives, our homes, our society's
safety, our economic prosperity, and, indeed our
country's security at constant risk. During this
time of pandemic, uncertainty, and vulnerability, it is essential that we take every precaution
to protect ourselves. This comes with many
rules and some common sense behaviors that
are not at all convenient. Washing and disinfecting our hands incessantly is needed. Mask
wearing and social distancing are examples of
effective behaviors we should follow to ensure
safety. However, there are threats that can
derail our efforts beyond hygiene. We must be
"right" constantly with our efforts to thwart
cyberattacks. The cybercriminals only have to
be right once.



Lancaster Physician Fall 2020

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