The staff quickly responded and directed that all systems be disconnected from the network, starting with the Electronic Health Record (EHR).
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For zero-day attacks where the signatures are unknown, these systems likely won’t know how to react, but can still alert on an anomaly.įor one impacted health system (Provider A), the security incident and event management (SIEM) and anti-virus consoles captured signatures from the initial infection, sending text alerts to the cybersecurity staff. Once infected, the malware generates signatures that can alert both local anti-virus and network intrusion detection systems if they are properly configured. One common thread is that it can bypass existing controls by using both zero-day and other known, but unpatched vulnerabilities. The details of how the successful ransomware infection spawns exponentially across a network, like dominoes, may vary. Once compromised, that infected device will scan for other vulnerable devices it can see on the network, then propagate the malware. This could be a workstation, server, biomedical device, printer, or anything else connected to the local area network. DiscussionĪ ransomware attack generally starts by infecting a single vulnerable device. For confidentiality purposes and clarity, those organizations will be identified as Provider A, B, and C respectively. The level of preparedness and security architectures at each institution varied widely, but the infection and impacts experienced were remarkably similar. Their willingness to share their experiences and this information is invaluable to the rest of the healthcare community.
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Lessons learned from these events were shared through a series of interviews with key stakeholders at each institution. This article discusses the impacts of three attempted ransomware attacks on three different healthcare organizations. Malware attacks generally take less than an hour to infect all vulnerable systems, yet the operational damage can last for weeks while the recovery takes place. Unless your organization is highly tuned to listen for the whisper and take immediate action, you should expect to lose critical systems. Perhaps the biggest lesson is that ransomware attacks start with a whisper and culminate with a roar. While each attack was different, there are several key lessons that all healthcare executives should heed. Healthcare organizations were not immune, as the malware used to deliver the ransomware was able to wreak havoc on each health system studied. In dissecting three separate events that occurred in the past few years, we learned that ransomware attacks can happen at any time and to any size organization.