Healthcare institutions have become prime targets for cyberattacks in recent years, jeopardizing key systems and sensitive patient information. The allure of hospital systems for cybercriminals has grown so much that fictional data breaches, such as the one depicted in Grey's Anatomy, are now a stark reality for many institutions. In 2017, the year that episode aired, there were at least 477 healthcare data breaches that compromised more than 5.5 million records. By 2022, this number rose to 707 breaches, affecting nearly 50 million Americans. Despite compliance laws like HIPAA and security measures such as multifactor authentication, these numbers continue to climb.
Cybercriminals are drawn to healthcare systems for two main reasons: money and vulnerability. A person's medical records are significantly more valuable on the dark web, selling for as much as $1,000, compared to the few dollars fetched by credit card information or Social Security numbers. This potential for staggering profit makes healthcare data an extremely lucrative target. Furthermore, hacking into these systems is often easier than expected due to inherent vulnerabilities. The healthcare industry began integrating electronic health records (EHRs) even before the internet was born, leading to foundational weaknesses that cybercriminals exploit. This situation was exacerbated by the COVID-19 pandemic, which saw a rapid shift to digital care and increased remote device activity, alongside heightened global tensions in cyberspace. Therefore, ensuring EHR security has never been more critical to protect patient trust and institutional integrity.
Identifying Key EHR Security Vulnerabilities
Personal health information (PHI) is profoundly tied to individuals, containing medical histories, diagnoses, and sensitive identity details. If this information falls into the wrong hands, both care quality and trust suffer. Maintaining data integrity and compliance requires understanding common EHR security risks and cybersecurity threats:
• Phishing Attacks: These common threats involve fake emails and alerts designed to trick users into sharing sensitive details like passwords, allowing fraudsters to gain control of systems and accounts. They have become increasingly sophisticated, mimicking legitimate communications with spoofed sender addresses, fake links, virus-filled attachments, and even malicious password-protected documents. To prevent phishing, users must analyze email details before acting. Implementing multifactor authentication (MFA), which requires a combination of passwords and personal codes for system access, is a quick way to enhance protection. Other considerations include email filters, network access control, data backups, and security patches.
• Data Breaches and Vulnerabilities: While health data is confidential and restricted, breaches can occur due to innocent mistakes, such as an internal breach where a team member shares data without proper authorization. Much more serious are external breaches, where hackers penetrate EHR systems, disrupting healthcare delivery by affecting the EHR system, devices, or both. Many EHR security breaches also result from the loss of unencrypted devices containing PHI, such as employee laptops, highlighting security risks in electronic health devices.
• Malware and Ransomware Attacks: Malware can infiltrate EHRs alongside other attacks, like phishing, operating covertly to steal personal data, impair networks and devices, and monitor activity. Even if it doesn't directly penetrate the EHR, malware can spread through networked devices, deleting or compromising information and potentially shutting down the entire system. A particularly disruptive form is ransomware, which locks down systems until a monetary ransom is paid to the attackers. For instance, UnitedHealth was compelled to pay a $22 million ransom following a breach attributed to its lack of multifactor authentication. While off-the-shelf EHRs offer software patches and updates, these often take months to roll out and receive FDA approval, leaving organizations exposed. A personalized EHR that allows your team to deploy updates without relying on vendor support is a better solution for securing an EHR.
• Encryption Blind Spots: Encryption is designed to prevent unauthorized access and preserve confidentiality. However, attackers can exploit EHR encryption by encrypting their malicious traffic, impersonating legitimate team members to elude antivirus programs when accessing EHRs. System weaknesses also arise from poor password practices, such as passwords being changed only once a year, using simple details like a pet's name, or users failing to log out when leaving their computers. To address these security risks for an EHR, organizations should rotate passwords every few months, use password generators for strong, random passwords with special characters, and implement firewalls to filter traffic and improve network security. These practices help how to protect my data in an EHR.
The Five Pillars of Enhanced Healthcare Security: A Proactive Approach
Although the threat of healthcare data breaches can seem daunting, real-world organizations can significantly strengthen their security posture. To protect your organization and patient privacy, it is essential to focus on five pillars: electronic health records (EHR) systems, connected devices, payers, providers, and government regulators, as data breaches can originate from any of these areas. Cybersecurity threats demand unique responses depending on the attack, but implementing several best practices serves as a map to navigate any situation.
These crucial measures for securing an EHR and mitigating the threats to electronic health records security are:
1. Analyze: Healthcare organizations must maintain vigilance, making security initiatives part of standard processes. Conducting an annual security assessment is vital to identify potential gaps and ensure HIPAA compliance. This involves addressing EHR security gaps, administrative processes, and safeguards to get ahead of vulnerabilities, misconfigurations, and firewall problems that could expose PHI.
2. Plan: Your team needs to know what to do if EHR security is compromised. HIPAA mandates that healthcare organizations establish comprehensive cybersecurity plans that support all departments, from IT to clinical to legal. A robust response plan should include clear processes for identifying, tracking, and containing security incidents. This complex process also involves proactively establishing methods for evaluating each type of incident, its threat level, and the necessary mitigation steps.
3. Educate: It is crucial to ensure that staff members understand the organization's cybersecurity policies and expectations for acceptable use. Basic requirements often include keeping devices updated with the latest EHR security patches or mobile phone encryption. As threats evolve, organizations may need to adjust their plans, making clear communication of any changes to staff members essential.
4. Protect: Confidential information must be kept on lockdown. Organizations should encrypt sensitive data not only within the EHR but also in transit and at rest across all devices, systems, and emails to render it useless to attackers. Maintaining network security involves limiting access via personal devices, restricting which staffers have access to PHI, and regularly updating systems. This is key to how to protect my data in an EHR.
5. Invest: Cybersecurity is an important investment that cannot be effective on a shoestring budget. Organizations must maintain an adequate budget for network security, including staff and the necessary tools and software. Remember, even the most effective EHR can be vulnerable if the people, policies, and systems surrounding them are inadequate.
Comparing EHR Systems for Robust Security
Choosing an EHR is a significant investment that organizations must consider from all angles, asking crucial questions about security measures, incident response plans, backups, recovery, and more. While the research process can be extensive, several key considerations can simplify it when aiming for securing an EHR:
• Standards and Certifications: The EHR you select should be certified compliant by the Office of the National Coordinator for Health Information Technology (ONC), which is part of the U.S. Department of Health and Human Services (HHS) and sets data-sharing expectations. Look for HIPAA and HITECH compliance, interoperability with key systems, and elevated information security.
• Encryption: EHR encryption acts as an invisible shield, granting information access only with the right credentials. Evaluate how EHRs manage and prevent access, paying close attention to password policies and MFA capabilities.
• Backup and Recovery: In the worst-case scenario of data loss, understanding your data backup strategy is critical. Before making a decision, assess how often different EHRs create system backups, where information is stored, and what recovery steps you can expect from unique solutions.
• User Support: Your team needs software they can navigate confidently in the face of any threat. Look for an EHR vendor that offers users help with understanding security procedures, as they may also be able to assist in resolving incidents.
Strengthening Your Organization's EHR Security for a Safer Future
Navigating EHR security is a substantial undertaking, but knowing the threats, such as phishing, data breaches, malware, and encryption missteps, makes it manageable. Regular monitoring and optimization can be the difference between minor disturbances and catastrophic disasters. Inadequate EHR security can lead to noncompliance and significant fines, with HIPAA violations alone ranging from $100 to $1.5 million, severely harming an organization.
To prevent these repercussions and mitigate the threat of electronic health record systems, evaluate your technology by asking the right questions about its design:
• Does your current EHR offer encryption, auditing, backup and recovery, and secure user access?
• Can you get training and support for EHR management, or is this vendor-controlled?
• Is backup and recovery easy to understand and manage?
• Does your EHR allow secure patient communications?
Answering "no" to any of these questions may indicate it's time for a change. Juno Health's EHR is designed by clinicians for clinicians, working the way you do, and is certified compliant with HIPAA, HITECH, and SOC 2 to ensure PHI safety and security. Juno EHR’s Build-a-Module further provides personalization, usability, and easy-to-use workflows, reducing reliance on vendor support.
Healthcare data breaches are a stark reality, but by focusing on the five pillars—EHR systems, connected devices, payers, providers, and government regulators—organizations can fortify their defenses and protect patient privacy. Analyzing vulnerabilities, creating robust response plans, educating staff on cybersecurity policies, implementing strong data encryption, and investing adequately in network security are vital steps toward mitigating EHR security risks. It's time for proactive measures to safeguard healthcare data, earn patients’ trust and confidence, and build a safer future where healthcare organizations remain resilient against evolving cyberthreats.
