A Cybersecurity review of Healthcare Industry

Antecedentes La ciberseguridad no es un concepto nuevo de nuestros días. Desde los años 60 la ciberseguridad ha sido un ámbito de discusión e investigación. Aunque los mecanismos de defensa en materia de seguridad han evolucionado, las capacidades del atacante también se han incrementado de igual o mayor manera. Prueba de este hecho es la precaria situación en materia de ciberseguridad de muchas empresas, que ha llevado a un incremento de ataques de ransomware y el establecimiento de grandes organizaciones criminales dedicadas al cibercrimen. Esta situación, evidencia la necesidad de avances e inversión en ciberseguridad en multitud de sectores, siendo especialmente relevante en la protección de infraestructuras críticas. Se conoce como infraestructuras críticas aquellas infraestructuras estratégicas cuyo funcionamiento es indispensable y no permite soluciones alternativas, por lo que su perturbación o destrucción tendría un grave impacto sobre los servicios esenciales. Dentro de esta categorización se encuentran los servicios e infraestructuras sanitarias. Estas infraestructuras ofrecen un servicio, cuya interrupción conlleva graves consecuencias, como la pérdida de vidas humanas. Un ciberataque puede afectar a estos servicios sanitarios, llevando a su paralización total o parcial, como se ha visto en recientes incidentes, llevando incluso a la pérdida de vidas humanas. Además, este tipo de servicios contienen multitud de información personal de carácter altamente sensible. Los datos médicos son un tipo de datos con alto valor en mercados ilegales, y por tanto objetivos de ataques centrados en su robo. Por otra parte, se debe mencionar, que al igual que otros sectores, actualmente los servicios sanitarios se encuentran en un proceso de digitalización. Esta evolución, ha obviado la ciberseguridad en la mayoría de sus desarrollos, contribuyendo al crecimiento y gravedad de los ataques previamente mencionados. - Metodología e investigación El trabajo presentado en esta tesis sigue claramente un método experimental y deductivo. Está investigación se ha centrado en evaluar el estado de la ciberseguridad en infraestructuras sanitarias y proponer mejoras y mecanismos de detección de ciberataques. Las tres publicaciones científicas incluidas en esta tesis buscan dar soluciones y evaluar problemas actuales en el ámbito de las infraestructuras y sistemas sanitarios. La primera publicación, 'Mobile malware detection using machine learning techniques', se centró en desarrollar nuevas técnicas de detección de amenazas basadas en el uso de tecnologías de inteligencia artificial y ‘machine learning’. Esta investigación fue capaz de desarrollar un método de detección de aplicaciones potencialmente no deseadas y maliciosas en entornos móviles de tipo Android. Además, tanto en el diseño y creación se tuvo en cuenta las necesidades específicas de los entornos sanitarios. Buscando ofrecer una implantación sencilla y viable de acorde las necesidades de estos centros, obteniéndose resultados satisfactorios. La segunda publicación, 'Interconnection Between Darknets', buscaba identificar y detectar robos y venta de datos médicos en darknets. El desarrollo de esta investigación conllevó el descubrimiento y prueba de la interconexión entre distintas darknets. La búsqueda y el análisis de información en este tipo de redes permitió demostrar como distintas redes comparten información y referencias entre ellas. El análisis de una darknet implica la necesidad de analizar otras, para obtener una información más completa de la primera. Finalmente, la última publicación, 'Security and privacy issues of data-over-sound technologies used in IoT healthcare devices' buscó investigar y evaluar la seguridad de dispositivos médicos IoT ('Internet of Things'). Para desarrollar esta investigación se adquirió un dispositivo médico, un electrocardiógrafo portable, actualmente en uso por diversos hospitales. Las pruebas realizadas sobre este dispositivo fueron capaces de descubrir múltiples fallos de ciberseguridad. Estos descubrimientos evidenciaron la carencia de certificaciones y revisiones obligatorias en materia ciberseguridad en productos sanitarios, comercializados actualmente. Desgraciadamente la falta de presupuesto dedicado a investigación no permitió la adquisición de varios dispositivos médicos, para su posterior evaluación en ciberseguridad. - Conclusiones La realización de los trabajos e investigaciones previamente mencionadas permitió obtener las siguientes conclusiones. Partiendo de la necesidad en mecanismos de ciberseguridad de las infraestructuras sanitarias, se debe tener en cuenta su particularidad diseño y funcionamiento. Las pruebas y mecanismos de ciberseguridad diseñados han de ser aplicables en entornos reales. Desgraciadamente actualmente en las infraestructuras sanitarias hay sistemas tecnológicos imposibles de actualizar o modificar. Multitud de máquinas de tratamiento y diagnostico cuentan con software y sistemas operativos propietarios a los cuales los administradores y empleados no tienen acceso. Teniendo en cuenta esta situación, se deben desarrollar medidas que permitan su aplicación en este ecosistema y que en la medida de los posible puedan reducir y paliar el riesgo ofrecido por estos sistemas. Esta conclusión viene ligada a la falta de seguridad en dispositivos médicos. La mayoría de los dispositivos médicos no han seguido un proceso de diseño seguro y no han sido sometidos a pruebas de seguridad por parte de los fabricantes, al suponer esto un coste directo en el desarrollo del producto. La única solución en este aspecto es la aplicación de una legislación que fuerce a los fabricantes a cumplir estándares de seguridad. Y aunque actualmente se ha avanzado en este aspecto regulatorio, se tardaran años o décadas en sustituir los dispositivos inseguros. La imposibilidad de actualizar, o fallos relacionados con el hardware de los productos, hacen imposible la solución de todos los fallos de seguridad que se descubran. Abocando al reemplazo del dispositivo, cuando exista una alternativa satisfactoria en materia de ciberseguridad. Por esta razón es necesario diseñar nuevos mecanismos de ciberseguridad que puedan ser aplicados actualmente y puedan mitigar estos riesgos en este periodo de transición. Finalmente, en materia de robo de datos. Aunque las investigaciones preliminares realizadas en esta tesis no consiguieron realizar ningún descubrimiento significativo en el robo y venta de datos. Actualmente las darknets, en concreto la red Tor, se han convertido un punto clave en el modelo de Ransomware as a Business (RaaB), al ofrecer sitios webs de extorsión y contacto con estos grupos

A Test Environment for Wireless Hacking in Domestic IoT Scenarios

Security is gaining importance in the daily life of every citizen. The advent of Internet of Things devices in our lives is changing our conception of being connected through a single device to a multiple connection in which the centre of connection is becoming the devices themselves. This conveys the attack vector for a potential attacker is exponentially increased. This paper presents how the concatenation of several attacks on communication protocols (WiFi, Bluetooth LE, GPS, 433 Mhz and NFC) can lead to undesired situations in a domestic environment. A comprehensive analysis of the protocols with the identification of their weaknesses is provided. Some relevant aspects of the whole attacking procedure have been presented to provide some relevant tips and countermeasures.This work has been partially supported by the Spanish Ministry of Science and Innovation through the SecureEDGE project (PID2019-110565RB-I00), and by the by the Andalusian FEDER 2014-2020 Program through the SAVE project (PY18-3724). // Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. // Funding for open access charge: Universidad de Málaga / CBU

Privacy and information security risks in a technology platform for home-based chronic disease rehabilitation and education

Background Privacy and information security are important for all healthcare services, including home-based services. We have designed and implemented a prototype technology platform for providing home-based healthcare services. It supports a personal electronic health diary and enables secure and reliable communication and interaction with peers and healthcare personnel. The platform runs on a small computer with a dedicated remote control. It is connected to the patient’s TV and to a broadband Internet. The platform has been tested with home-based rehabilitation and education programs for chronic obstructive pulmonary disease and diabetes. As part of our work, a risk assessment of privacy and security aspects has been performed, to reveal actual risks and to ensure adequate information security in this technical platform. Methods Risk assessment was performed in an iterative manner during the development process. Thus, security solutions have been incorporated into the design from an early stage instead of being included as an add-on to a nearly completed system. We have adapted existing risk management methods to our own environment, thus creating our own method. Our method conforms to ISO’s standard for information security risk management. Results A total of approximately 50 threats and possible unwanted incidents were identified and analysed. Among the threats to the four information security aspects: confidentiality, integrity, availability, and quality; confidentiality threats were identified as most serious, with one threat given an unacceptable level of High risk. This is because health-related personal information is regarded as sensitive. Availability threats were analysed as low risk, as the aim of the home programmes is to provide education and rehabilitation services; not for use in acute situations or for continuous health monitoring. Conclusions Most of the identified threats are applicable for healthcare services intended for patients or citizens in their own homes. Confidentiality risks in home are different from in a more controlled environment such as a hospital; and electronic equipment located in private homes and communicating via Internet, is more exposed to unauthorised access. By implementing the proposed measures, it has been possible to design a home-based service which ensures the necessary level of information security and privacy.publishedVersio

Analyzing the attack surface and threats of industrial Internet of Things devices

The growing connectivity of industrial devices as a result of the Internet of Things is increasing the risks to Industrial Control Systems. Since attacks on such devices can also cause damage to people and machines, they must be properly secured. Therefore, a threat analysis is required in order to identify weaknesses and thus mitigate the risk. In this paper, we present a systematic and holistic procedure for analyzing the attack surface and threats of Industrial Internet of Things devices. Our approach is to consider all components including hardware, software and data, assets, threats and attacks throughout the entire product life cycle

Identity Management and Authorization Infrastructure in Secure Mobile Access to Electronic Health Records

We live in an age of the mobile paradigm of anytime/anywhere access, as the mobile device is the most ubiquitous device that people now hold. Due to their portability, availability, easy of use, communication, access and sharing of information within various domains and areas of our daily lives, the acceptance and adoption of these devices is still growing. However, due to their potential and raising numbers, mobile devices are a growing target for attackers and, like other technologies, mobile applications are still vulnerable. Health information systems are composed with tools and software to collect, manage, analyze and process medical information (such as electronic health records and personal health records). Therefore, such systems can empower the performance and maintenance of health services, promoting availability, readability, accessibility and data sharing of vital information about a patients overall medical history, between geographic fragmented health services. Quick access to information presents a great importance in the health sector, as it accelerates work processes, resulting in better time utilization. Additionally, it may increase the quality of care. However health information systems store and manage highly sensitive data, which raises serious concerns regarding patients privacy and safety, and may explain the still increasing number of malicious incidents reports within the health domain. Data related to health information systems are highly sensitive and subject to severe legal and regulatory restrictions, that aim to protect the individual rights and privacy of patients. Along side with these legislations, security requirements must be analyzed and measures implemented. Within the necessary security requirements to access health data, secure authentication, identity management and access control are essential to provide adequate means to protect data from unauthorized accesses. However, besides the use of simple authentication models, traditional access control models are commonly based on predefined access policies and roles, and are inflexible. This results in uniform access control decisions through people, different type of devices, environments and situational conditions, and across enterprises, location and time. Although already existent models allow to ensure the needs of the health care systems, they still lack components for dynamicity and privacy protection, which leads to not have desire levels of security and to the patient not to have a full and easy control of his privacy. Within this master thesis, after a deep research and review of the stat of art, was published a novel dynamic access control model, Socio-Technical Risk-Adaptable Access Control modEl (SoTRAACE), which can model the inherent differences and security requirements that are present in this thesis. To do this, SoTRAACE aggregates attributes from various domains to help performing a risk assessment at the moment of the request. The assessment of the risk factors identified in this work is based in a Delphi Study. A set of security experts from various domains were selected, to classify the impact in the risk assessment of each attribute that SoTRAACE aggregates. SoTRAACE was integrated in an architecture with requirements well-founded, and based in the best recommendations and standards (OWASP, NIST 800-53, NIST 800-57), as well based in deep review of the state-of-art. The architecture is further targeted with the essential security analysis and the threat model. As proof of concept, the proposed access control model was implemented within the user-centric architecture, with two mobile prototypes for several types of accesses by patients and healthcare professionals, as well the web servers that handles the access requests, authentication and identity management. The proof of concept shows that the model works as expected, with transparency, assuring privacy and data control to the user without impact for user experience and interaction. It is clear that the model can be extended to other industry domains, and new levels of risks or attributes can be added because it is modular. The architecture also works as expected, assuring secure authentication with multifactor, and secure data share/access based in SoTRAACE decisions. The communication channel that SoTRAACE uses was also protected with a digital certificate. At last, the architecture was tested within different Android versions, tested with static and dynamic analysis and with tests with security tools. Future work includes the integration of health data standards and evaluating the proposed system by collecting users’ opinion after releasing the system to real world.Hoje em dia vivemos em um paradigma móvel de acesso em qualquer lugar/hora, sendo que os dispositivos móveis são a tecnologia mais presente no dia a dia da sociedade. Devido à sua portabilidade, disponibilidade, fácil manuseamento, poder de comunicação, acesso e partilha de informação referentes a várias áreas e domínios das nossas vidas, a aceitação e integração destes dispositivos é cada vez maior. No entanto, devido ao seu potencial e aumento do número de utilizadores, os dispositivos móveis são cada vez mais alvos de ataques, e tal como outras tecnologias, aplicações móveis continuam a ser vulneráveis. Sistemas de informação de saúde são compostos por ferramentas e softwares que permitem recolher, administrar, analisar e processar informação médica (tais como documentos de saúde eletrónicos). Portanto, tais sistemas podem potencializar a performance e a manutenção dos serviços de saúde, promovendo assim a disponibilidade, acessibilidade e a partilha de dados vitais referentes ao registro médico geral dos pacientes, entre serviços e instituições que estão geograficamente fragmentadas. O rápido acesso a informações médicas apresenta uma grande importância para o setor da saúde, dado que acelera os processos de trabalho, resultando assim numa melhor eficiência na utilização do tempo e recursos. Consequentemente haverá uma melhor qualidade de tratamento. Porém os sistemas de informação de saúde armazenam e manuseiam dados bastantes sensíveis, o que levanta sérias preocupações referentes à privacidade e segurança do paciente. Assim se explica o aumento de incidentes maliciosos dentro do domínio da saúde. Os dados de saúde são altamente sensíveis e são sujeitos a severas leis e restrições regulamentares, que pretendem assegurar a proteção dos direitos e privacidade dos pacientes, salvaguardando os seus dados de saúde. Juntamente com estas legislações, requerimentos de segurança devem ser analisados e medidas implementadas. Dentro dos requerimentos necessários para aceder aos dados de saúde, uma autenticação segura, gestão de identidade e controlos de acesso são essenciais para fornecer meios adequados para a proteção de dados contra acessos não autorizados. No entanto, além do uso de modelos simples de autenticação, os modelos tradicionais de controlo de acesso são normalmente baseados em políticas de acesso e cargos pré-definidos, e são inflexíveis. Isto resulta em decisões de controlo de acesso uniformes para diferentes pessoas, tipos de dispositivo, ambientes e condições situacionais, empresas, localizações e diferentes alturas no tempo. Apesar dos modelos existentes permitirem assegurar algumas necessidades dos sistemas de saúde, ainda há escassez de componentes para accesso dinâmico e proteção de privacidade , o que resultam em níveis de segurança não satisfatórios e em o paciente não ter controlo directo e total sobre a sua privacidade e documentos de saúde. Dentro desta tese de mestrado, depois da investigação e revisão intensiva do estado da arte, foi publicado um modelo inovador de controlo de acesso, chamado SoTRAACE, que molda as diferenças de acesso inerentes e requerimentos de segurança presentes nesta tese. Para isto, o SoTRAACE agrega atributos de vários ambientes e domínios que ajudam a executar uma avaliação de riscos, no momento em que os dados são requisitados. A avaliação dos fatores de risco identificados neste trabalho são baseados num estudo de Delphi. Um conjunto de peritos de segurança de vários domínios industriais foram selecionados, para classificar o impacto de cada atributo que o SoTRAACE agrega. O SoTRAACE foi integrado numa arquitectura para acesso a dados médicos, com requerimentos bem fundados, baseados nas melhores normas e recomendações (OWASP, NIST 800-53, NIST 800-57), e em revisões intensivas do estado da arte. Esta arquitectura é posteriormente alvo de uma análise de segurança e modelos de ataque. Como prova deste conceito, o modelo de controlo de acesso proposto é implementado juntamente com uma arquitetura focada no utilizador, com dois protótipos para aplicações móveis, que providênciam vários tipos de acesso de pacientes e profissionais de saúde. A arquitetura é constituída também por servidores web que tratam da gestão de dados, controlo de acesso e autenticação e gestão de identidade. O resultado final mostra que o modelo funciona como esperado, com transparência, assegurando a privacidade e o controlo de dados para o utilizador, sem ter impacto na sua interação e experiência. Consequentemente este modelo pode-se extender para outros setores industriais, e novos níveis de risco ou atributos podem ser adicionados a este mesmo, por ser modular. A arquitetura também funciona como esperado, assegurando uma autenticação segura com multi-fator, acesso e partilha de dados segura baseado em decisões do SoTRAACE. O canal de comunicação que o SoTRAACE usa foi também protegido com um certificado digital. A arquitectura foi testada em diferentes versões de Android, e foi alvo de análise estática, dinâmica e testes com ferramentas de segurança. Para trabalho futuro está planeado a integração de normas de dados de saúde e a avaliação do sistema proposto, através da recolha de opiniões de utilizadores no mundo real

Securing mHealth - Investigating the development of a novel information security framework

The deployment of Mobile Health (mHealth) platforms as well as the use of mobile and wireless technologies have significant potential to transform healthcare services. The use of mHealth technologies allow a real-time remote monitoring as well as direct access to healthcare data so that users (e.g., patients and healthcare professionals) can utilise mHealth services anywhere and anytime. Generally, mHealth offers smart solutions to tackle challenges in healthcare. However, there are still various issues regarding the development of the mHealth system. One of the most common diffi-culties in developing the mHealth system is the security of healthcare data. mHealth systems are still vulnerable to numerous security issues with regard to their weak-nesses in design and data management. Several information security frameworks for mHealth devices as well as information security frameworks for Cloud storage have been proposed, however, the major challenge is developing an effective information se-curity framework that will encompass every component of an mHealth system to secure sensitive healthcare data. This research investigates how healthcare data is managed in mHealth systems and proposes a new information security framework that secures mHealth systems. Moreover, a prototype is developed for the purpose of testing the proposed information security framework. Firstly, risk identification is carried out to determine what could happen to cause potential damage and to gain insight into how, where, and why the damage might happen. The process of risk identification includes the identification of assets those need to be protected, threats that we try to protect against, and vulnerabilities that are weaknesses in mHealth systems. Afterward, a detailed analysis of the entire mHealth domain is undertaken to determine domain-specific features and a taxonomy for mHealth, from which a set of the most essential security requirements is identified to develop a new information security framework. It then examines existing information security frameworks for mHealth devices and the Cloud, noting similarities and differences. Key mechanisms to implement the new framework are discussed and the new framework is then presented. Furthermore, a prototype is developed for the purpose of testing. It consists of four layers including an mHealth secure storage system, Capability system, Secure transactional layer, and Service management layer. Capability system, Secure transactional layer, and Service management layer are developed as main contributions of the research