FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS

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FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
ForeScout Security for
Healthcare IoT
FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
Agenda

 1.   IoT Trends in Healthcare

 2. Types of Healthcare Attacks

 3. Security Gaps

 4. ForeScout Solution and Its Value

 5. References, Analyst Reports, Recognition

 6. Summary

                                               2
FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
Agenda

 1.   IoT Trends in Healthcare

 2. Types of Healthcare Attacks

 3. Security Gaps

 4. ForeScout Solution and Its Value

 5. References, Analyst Reports, Recognition

 6. Summary

                                               3
FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
Exponential Growth In IoT Devices

It took 25 years                                                        It will take only 5 more
to connect 10B                                                           years to connect 30B
     devices                                                                      devices

                                                                              20B of which will be
                                                                                 IoT devices

                                                                            Healthcare will be a
                                                                            leading IoT adopter

Source: Gartner IoT, PC and Mobile device forecast 2015; ABI research
Reference acronym glossary at the end of presentation                                              4
FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
Other Healthcare Trends

        Fast Adoption of       M&A                HIPAA and
              IoT             Activity             HITECH

          Security team is becoming a key business partner

                                                              5
FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
Popular IoT Use Cases in Healthcare

 Asset Management                               Patient Monitoring   Medical Device Integration Work Flow Optimization

Reference acronym glossary at the end of presentation                                                                    6
FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
Benefits of Healthcare IoT: Real Life Examples

                                                                                Intelligent IoT wearables that
   Using wearables, iPads                                                       measured heart rate,
 and apps to integrate info                                Ochsner     St.      respiration rate etc reduced
  from patients wearables                                   Health   Joseph     mortality rate by 35% and
       into hospitals EHR                                                       hospital stay by half a day
                                                           system     Mercy

Using Google Glass to enter                                Dignity   Aventura    Real-time patient tracking
 patient information reduced                               Health    Hospital   cut emergency department
       EHR charting by 80%                                                      hold times by 68%

   PwC, GE, Beckers Hospital Review, Mobile Health News
   Reference acronym glossary at the end of presentation                                                    7
FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
Agenda

 1.   IoT Trends in Healthcare

 2. Types of Healthcare Attacks

 3. Security Gaps

 4. ForeScout Solution and Its Value

 5. References, Analyst Reports, Recognition

 6. Summary

                                               8
FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
Types of Cyberattacks
Distributed Denial of Service (DDoS) is an attack in which
a master program sends data heavy traffic from multiple            A vulnerability in the system
systems to few targeted servers and cripples them, usually         that bypasses normal
mission critical servers                                           security authentications to     Malicious software that is
                                                                   enter a system                  used to disrupt operations,
                                                                                                   gather or modify sensitive
                                                                                                   information
DDoS
                                                                                                                                 Attacker secretly
Backdoor                                                                                                                         relays/ alters the
                                                                                                                                 communication
Malware                                                                                                                          between two systems

Man in the middle
 Ransomware
Software vulnerability

                                                                               A type of malicious software
                          Some systems run on outdated or                      designed to block access to a
                          unsupported software that have                       computer system until a sum
                          vulnerabilities that are hard to patch               of money is paid                                                  9
    Reference acronym glossary at the end of presentation
FORESCOUT SECURITY FOR HEALTHCARE IOT - EXCLUSIVE NETWORKS
Healthcare is a Prime Target for Cyberattacks

2016: Summary of Reported Cyberattacks Across US Healthcare Systems

450: Total reported
breach incidents

27 Million: Patient
                                                 607: Average days to
records were stolen                              detect breach caused
                                                 by insider

                                                 $402: Cost of per capita   400%: Increase in
                                                 data breach; highest       ransomware attacks with
                                                                            nearly half of them in the
                                                 among all industries       Healthcare sector

Source: HIPAA Journal, Beazley, IBM-Ponemon, Beckers Hospital Review                                     10
Healthcare has Highest Per Capita Cost of Breach

            Media                         $177
                                                                      Uses of a medical record include filing
                                                                      fraudulent insurance claims, obtaining
            Education                                   $220          prescription medication, opening
                                                                      credit accounts, and filing for fictitious
                                                                      government medical care

            Financial                                          $264

            Healthcare                                                                             $402
IBM Ponemon report: Cost of a data breach                                                                          11
Reference acronym glossary at the end of presentation
Agenda

 1.   IoT Trends in Healthcare

 2. Types of Healthcare Attacks

 3. Security Gaps

 4. ForeScout Solution and Its Value

 5. References, Analyst Reports, Recognition

 6. Summary

                                               12
Many New Devices Will be Vulnerable to Attacks

                                                                                  By 2020:
                                                                                  20+ Billion
                                                                                  Unmanaged
                                                                                  Connected

Less than 10% of new devices connecting to the
corporate environment will be manageable through
                                                                                     66%
                                                                                  Devices

traditional methods                                                           of all networks will have an
                                                                             IoT security breach by 2018

                                                                                                 Unmanaged
                                                                                                  Devices

                                                                                                  Managed
                                                                                                  Devices
                    2010                  2012          2014   2016   2018            2020

Source: Gartner, BI Intelligence, Verizon, ForeScout

Reference acronym glossary at the end of presentation                                                        13
Internet of Medical Things Are Very Diverse
 They have different processing capabilities, operating systems and form factors

Patient Vitals Monitor                                    Pulse Oximeter   Smart Infusion Pump    Portable ECG Monitor

                                                                                                  And many
                                                                                                    more

   Telemed Tablet                                         Smart Wearable      Smart Pill Bottle

  Reference acronym glossary at the end of presentation                                                             14
Real Life Examples of Vulnerabilities

                                    FDA has issued warning that the Hospira Symbiq Infusion System can be hacked
                                    remotely from a hospital’s network, enabling an unauthorized user to alter
                                    infusion of critical patient therapies. So when infected, these devices can put
                                    patient health at risk.

                                    Security researchers found that thousands of “critical medical systems” are
                                    vulnerable and exposed online. Most medical devices are running Windows XP or
                                    XP service pack two and generally don’t have antivirus making them easy
                                    targets.

https://www.healthitoutcomes.com/doc/fda-issues-alert-medication-infusion-pump-hacking-alert-0001
https://www.wired.com/2017/03/medical-devices-next-security-nightmare/
Reference acronym glossary at the end of presentation                                                                 15
Facilities Upgrade is Bringing in IoT Devices
As Well
                        DISASTROUS
                        Cause irreversible
                        damage
                                                         Illegal remote            Tampering with
                                                            monitorig            temperature controls

                        DISRUPTIVE
                        Disrupt corporate and
                        operational
                        processes.
                                                        Spying via video    Accessing classified Snooping on calls
                                                        and microphone         information

                        DAMAGING
                        Enable information                          Obtaining user              Extracting Wi-Fi
                        stealing                                     credentials              credentials to carry
                                                                                              out further attacks
Source: ForeScout IoT Enterprise Risk Report
Reference acronym glossary at the end of presentation                                                                16
An Example of IoT Device Risks                            DISASTROUS

 IP-Connected Security Systems
Many use proprietary radio                                Disable camera to allow physical
frequency technology that lack                            break in.
authentication and encryption.
                                                                       Hijack camera to spy on employees
                                                                      usage of computers, passwords,
                                                                      applications, designs.

Attackers can form radio signals
to send false triggers and                                              Use as launching point for DDoS
access system controls.                                                attacks.

                                                                User compute capability to ex-filtrate
                                                                large amounts of datas.
  Reference acronym glossary at the end of presentation                                                   17
Healthcare Regulations
Regulatory mandates will be harder to meet with the introduction of insecure IoT devices

                                     HIPAA

                                                        PCI

                          CIS

                                                            HITECH

                         HITRUST

                                             NIST

                                                                                           18
Agenda

 1.   IoT Trends in Healthcare

 2. Types of Healthcare Attacks

 3. Security Gaps

 4. ForeScout Solution and Its Value

 5. References, Analyst Reports, Recognition

 6. Summary

                                               19
Many IoT Devices Are Vulnerable

                                                          Many IoT                          Many IoT
        Many IoT                                                            Many IoT
                                                        devices run on                     devices lack
     devices cannot                                                      devices cannot
                                                         outdated or                      basic security
      host an agent                                                        be patched
                                                         unsupported                         features
                                                           software

                               ForeScout’s agentless solution helps overcome these limitations

Reference acronym glossary at the end of presentation                                                      20
See
Many IoT devices are invisible to the traditional security systems
                                                                       Manageable with an                              Non-
                                                                            Agent                                  Traditional/IoT

                                                         Computing
                                                           Devices
                                                                                                                                        Who are you?

                                                                                                                                     Who owns the device?

                                                                                                                                     What type of device?
                                                                                             Antivirus
                                                           Network                           out-of-date
                                                           Devices                                                                    Where/how are you
                                                                                             Vulnerability                              connecting?
                                                        Applications                         Broken agent
              AGENTLESS                                                                                                               What is the device
                                                                                                                                         hygiene?
             CONTINUOUS                                                           See with
                                                                IoT
                                                                        Visible                              Not Visible

                                                                                                                                                            21
Reference Acronym Glossary at the end of presentation
Control
                                                           Less Privileged
                                                              Access

                                                                             Quarantine

                                                                                           Notify

                                                                                           Comply

           POLICY-DRIVEN                                                                   Restrict
                                                      Guest
              AUTOMATED                              Network
                                                                             Data Center

                                                               Corporate
                                                                Network
Reference acronym glossary at end of presentation.                                                    22
Orchestrate

                                                        ATD       EMM        EDR/EPP        ITSM        NGFW    SIEM        VA

                                                                                       VENDOR OPTIONS

                                                          Share Contextual               Automate                 Automate
                                                              Insights                   Workflows             Response Actions

   BREAK DOWN SILOS

   MAXIMIZE EXISITING
     INVESTMENTS

  *As of April 2017
                                                                                                                                  23
Reference Acronym Glossary at the end of presentation
Security Benefits of a ForeScout Solution
IDC interviewed 7 ForeScout customers, and on an average, benefits were

                                              24%          24% more devices discovered

                                                      18%     18% more devices in compliance
             Faster
            Time To
             Value
                                                     42%      42% reduction in network-related breaches

                                              38%          38% reduction in device-related breaches
IDC Paper: https://www.forescout.com/idc-business-value/
                                                                                                          10
Business Benefits of a ForeScout Solution
IDC interviewed 7 ForeScout customers, and on an average, benefits were

                                                                         $2M average savings
   Average benefits
  for an organization
   with 43K devices
                                                           392% ROI over 5 years

                                              13 months to break even

IDC Paper: https://www.forescout.com/idc-business-value/
Reference acronym glossary at the end of presentation
Agenda

 1.   IoT Trends in Healthcare

 2. Types of Healthcare Attacks

 3. Security Gaps

 4. ForeScout Solution and Its Value

 5. References, Analyst Reports, Recognition

 6. Summary

                                               26
RWJBarnabas Health Case Study

https://www.forescout.com/company/resources/rwjbarnabas-health-case-study/
                                                                             27
RWJBarnabas Health

  “ForeScout lets us quickly discover and classify devices and infrastructure on
  heterogeneous networks as hospitals and clinics join RWJBarnabas Health.”

     - Hussein Syed, Chief Information Security Officer, RWJBarnabas Health

https://www.forescout.com/solutions/industries/healthcare/
Reference Acronym Glossary at the end of presentation
                                                                                   28
RWJBarnabas Health Challenge: Add New Types of
   Devices Without Adding Vulnerabilities
   How ForeScout helped…

        Diverse                       Medical IoT                   Virtual                Auto Classification
      Device Types                     Devices                     Machines                and Segmentation

   Agentless approach secures       Automatically see and   See which VMware Virtual      Auto device classification and
traditional, BYOD and IoT devices   classify thousands of   Machines are live, patched    network segmentation based
as they connect and continuously     medical IoT devices    and running the right tools   on device type, hygiene, user
              thereafter                                                                     profile and applications

                                                                                                                           29
RWJBarnabas Health: Real Life Example of
Safe Onboarding of Devices
                                    Traditional, BYOD and IoT devices detected, classified,
                                1
                                    segmented and controlled in real time

                                2   Devices monitored continuously

                                    ForeScout orchestrates security response and quarantines
                                3
                                    devices in real time if a problem is found

     ForeScout’s agentless approach helped secure diverse types of devices,
     even those that cannot host an agent and also reduced OPEX related to
                        installing and managing agents.

                                                                                               30
RWJBarnabas Health Challenge: Secure
Heterogeneous Environments; Onboard M&A Networks
How ForeScout helped...

     Secure
                                    Onboard M&A                        Faster                   Multi-Vendor
    Access to
                                      Networks                      Time To Value               Environment
     Partners

    Securely connect         Quickly onboard mixed environment       Three year complex           Deploys within
clinicians, labs, insurers    with 802.1X, non 802.1X and also    integration project turned   existing multi-vendor
     and contractors                inventory new assets         into two year success story       infrastructure

                                                                                                                       31
RWJBarnabas Health: Secure Heterogeneous
Environments; Onboard M&A Networks
                                    M&A brought in a hybrid IT environment with mix of 802.1X, non-
                                1
                                    802.1X, various device hygiene, device types and applications

                                2   Implementing 802.1X became very cost-prohibitive and complex

                                    ForeScout’s agentless approach and ability to plug into the
                                3
                                    network out of band reduced integration effort

       ForeScout immediately brought in higher value and ROI, turning a
        3 year complex integration project into a 2 year success story.

                                                                                                      32
RWJBarnabas Health Challenge: Fast
Remediation and Containment of an Attack
How ForeScout helped...

        Fast                          SIEM                       EMM                BMC Remedy
     Remediation                   Integration                Integration            Integration

   For some use cases,         Integration with SIEM      EMM integration brings    Enables Helpdesk in
remediation reduced from 30   module enables quick risk      agility to managing     fast resolution of
  minutes or longer to few        data correlation        risks on mobile devices        problems
          seconds

                                                                                                          33
RWJBarnabas Health: Real Life Example of
Containment of an Attack
                                       Alert received in the endpoint security system of a computer
                                   1
                                       infected with ransomware

                                       Location of the system had to be determined quickly to contain
                                   2
                                       the problem

                                       ForeScout determined the system location and removed it from the
                                   3
                                       network in real time

    Before ForeScout, it took 30 mins or longer to locate a device and disable it,
    now it is done in real time. ForeScout also cut down on staff time as the team
   only had to re-image one device compared to multiple if the virus had spread.
                                                                                                        34
RWJBarnabas Health: Real Life Example of
Fast Remediation

                               1   Weekly threat report is generated to show risk level

                                   Report shows assets on network that are not reporting to Asset
                               2
                                   Management system

                                   ForeScout helps IT team remediate by locating and registering
                               3
                                   these devices

      ForeScout reduced time to remediate by 83% (3 hours to 30 mins).

                                                                                                    35
RWJBarnabas Health Challenge : Regulations
and Framework Adoption
How ForeScout helped...

       HIPAA                        HITECH                         CIS                        NIST
      Regulation                   Regulation                   Framework                  Framework

Includes real-time controls    Includes real-time controls   Helps with adoption of    Does reporting to enable
and automated reporting to    and automated reporting to         top three Critical       adoption of NIST
enable HIPAA compliance       enable HITECH compliance       Infrastructure Controls   Cybersecurity Framework

                                                                                                                  36
RWJBarnabas Health: Real Life Example of
CIS Adoption

                          1   CSC 1: Inventory of Authorized and Unauthorized Devices

                          2   CSC 2: Inventory of Authorized and Unauthorized Software

                          3   CSC 3: Secure Configurations for Hardware and Software on
                              Mobile Devices, Laptops, Workstations and Servers.

             ForeScout enables CIS framework adoption.

                                                                                          37
38
ForeScout Accolades

  Gartner IoT Security     JP Morgan Chase Hall of Fame          Cloud100 World’s Best           Deloitte’s Fastest Growing   20 Fastest Growing Security
    Market Guide         Innovation Award for Transformative       Cloud Companies              Companies in North America            Companies
      Gartner, 2016              Security Technology                Forbes, 2016, 2017                 Deloitte, 2016         The Silicon Valley Review, 2016
                                     JPMC, 2016

  Gartner NAC Market            Excellence Award for           Computer Reseller News Top                 Inc. 5000               9 Hot Cybersecurity
         Guide                    Threat Solutions                 Security Company              Fastest Growing Companies             Startups
      Gartner, 2016                 Gartner, 2016                      CRN, 2016                       Inc. 5000, 2016                Nanalyze, 2016

       Scale                              Engineering                                    Customers                                 Service

     1M+                                            3x                                   2500+                                87 NPS
 Devices in a single                          Increase                                        In over                           Net Promoter
    deployment                           in ForeScout R&D                                   70 countries                           Score

                                                                                                                                                                39
Agenda

 1.   IoT Trends in Healthcare

 2. Types of Healthcare Attacks

 3. Security Gaps

 4. ForeScout Solution and Its Value

 5. References, Analyst Reports, Recognition

 6. Summary

                                               40
Summary

IoT devices are entering Healthcare industry in a big way.

                                                                       Do you know how many
                                                                         devices are in your
Many IoT devices lack basic security features and are invisible               network?
to traditional security systems, posing bigger security risk!

                                                                        Request a ForeScout
                                                                          POC to find out.
Many organizations underestimate number of IoT devices in
their networks thereby opening up vulnerabilities.

  ForeScout’s agentless approach has helped companies discover on an average 24% more devices
                                  on their networks – IDC Report.

IDC Paper: https://www.forescout.com/idc-business-value/                                        41
Thank you!
Cyberattack Example
Los Angeles, CA

Overview: Hackers seized control of hospital’s computer systems and demanded $17,000 ransom in bitcoins
Devices: Malware infected computer systems
Industry: Healthcare
Description: Hollywood Presbyterian Medical Center paid a $17,000 ransom in bitcoin to a hacker who seized control of the
hospital's computer systems and would give back access only when the money was paid.

“The malware locks systems by encrypting files and demanding ransom to obtain the decryption key. The quickest and most
efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key,” Chief
Executive of the hospital, Stefanek said.

 http://www.latimes.com/business/technology/la-me-ln-hollywood-hospital-bitcoin-20160217-story.html
                                                                                                                          43
Cyberattack Example
Columbia, MD

Overview: MedStar health in alleged ransomware attack
Devices: Malware infected institution Computers
Industry: Healthcare
Description:
MedStar Health, which calls itself the largest healthcare provider in Maryland and Washington, D.C., was forced to disable
their network after an alleged Ransomware attack infected several systems. According to a statement from MedStar, their
network was "affected by a virus" preventing certain users from logging-in to their systems.
MedStar Health patients were being turned away or treated without important computer records Tuesday as the health-care
giant worked to restore online systems crippled by a virus. Later MedStar staff could read — but not update — thousands of
patient records in its central database. Health-care provider paid 45 bitcoins — equivalent to about $19,000 — in exchange for
the digital key that would release the data.

“You just have 10 days to send us the Bitcoin,” the note read, “after 10 days we will remove your private key and it’s impossible
to recover your files.”
 https://www.washingtonpost.com/local/medstar-health-turns-away-patients-one-day-after-cyberattack-on-its-
 computers/2016/03/29/252626ae-f5bc-11e5-a3ce-f06b5ba21f33_story.html?utm_term=.9953b8f99ba6                                  44
                                                                                                                              44
Cyberattack Example
Hospital in Austria

Overview: Patients hack their own IV pumps
Devices: IV morphine pump
Industry: Healthcare
Description:
Patients could severely hurt themselves by hacking their own IV pumps. Recently at an unnamed Austrian hospital, there were
two incidents where patients hooked up to an infusion pump and felt their pain management wasn’t enough. The unidentified
patients had to be treated for addiction after becoming dependent on high doses of morphine. Their usage was so severe,
according to the Austrian Times, that one of the patients suffered respiratory arrest.

The patients didn’t need sophisticated tools or savvy to hack the machines. They had simply learned control codes for the
machines online, the Times reported. The hospital has since taken steps to update its drug pumps with new codes and is
gradually swapping out all of the older pumps with newer devices that have unmodifiable codes.
http://www.massdevice.com/hospital-patient-hacks-his-own-morphine-pump-massdevicecom-call/
https://www.zingbox.com/blog/the-medjacking-of-connected-healthcare-devices-can-harm-patients/
                                                                                                                            45
Cyberattack Example
Boston, MA

Overview: Hospital Targeted by Anonymous DDoS (Distributed Denial of Service) campaign
Devices: Denial of Service of Hospital computers
Industry: Healthcare
Description:
Boston Children's Hospital was targeted by a days-long Anonymous DDoS campaign, as the hacktivist group protested the
controversial case of Justina Pelletier, who was then being held at the hospital against the wishes of her parents. The Pelletier
family brought their daughter, who they claim has a difficult-to-diagnose mitochondrial disorder, to Children’s Hospital to help
her get treatment for digestive issues. While there, Children’s Hospital doctors began to think that Pelletier’s symptoms
stemmed from psychiatric issues and that she had possibly been abused by her parents. The hospital brought child abuse
charges against her parents that were upheld by the Massachusetts Department of Children and Families, and a juvenile court
judge. The Boston Globe reports that though the hospital can't identify Anonymous by the hacks alone, the hacker collective
did post a YouTube video outlining its problems with the way Children's Hospital handled Pelletier's situation.

https://www.bostonglobe.com/business/2014/04/24/hacker-group-anonymous-targets-children-hospital-over-justina-pelletier-
case/jSd3EE5VVHbSGTJdS5YrfM/story.html                                                                                       46
Cyberattack Example
Russian Healthcare Ministry

Overview: Russian healthcare ministry faces DDoS (Distributed Denial of Service) attack
Devices: Servers
Industry: Healthcare
Description:
In Feb 2017, the Russian healthcare ministry’s information assets were hit by a Distributed Denial of Service (DDoS) attack
with four million requests per minute at its height. The ministry’s site was not functioning for 14 minutes during the DDoS
attack.

Russia Healthcare Ministry’s technical services have repelled cyberattacks, the largest in recent years, but fell susceptible to
this DDoS attack. The (cyber) attack had no consequences. According to the sources, the work of the ministry’s official
website was temporarily suspended, neither personal data nor medical confidential information were affected since they are
stored in a protected area, not connected to the Internet.

https://en.news-front.info/2017/02/12/russian-healthcare-ministry-hit-by-large-cyber-attack/
                                                                                                                              47
Known Vulnerability

Overview: FDA issues warning on device
Devices: Hospira’s Symbiq Infusion pump
Industry: Healthcare
Description:
FDA issues warning that the Hospira’s Symbiq Infusion pumps can be hacked remotely from a hospital’s network. If an
unauthorized user controls the device and change the dosage the pump delivers, it could alter infusion of patient therapies.

The alert warns healthcare facilities using this system of potential unauthorized access and control of these systems, and
includes a recommendation that users transition to alternative infusion systems and discontinue use of the affected pumps
until further notice. The alert reads, in part, “The FDA, the U.S. Department of Homeland Security’s Industrial Control Systems
Cyber Emergency Response Team (CS-CERT), and Hospira are aware of cybersecurity vulnerabilities associated with the
Symbiq Infusion System. Hospira and an independent researcher confirmed that Hospira’s Symbiq Infusion System could be
accessed remotely through a hospital’s network.
https://www.healthitoutcomes.com/doc/fda-issues-alert-medication-infusion-pump-hacking-alert-0001
https://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm456815.htm                                                     48
Known Vulnerability

Overview: Investigators detected malware on medical devices at major healthcare providers
Devices: Various medical devices
Industry: Healthcare
Description:
Investigators at San Mateo-based TrapX Security detected malware on medical devices at major healthcare providers across
the globe. TrapX says the infected medical devices create a backdoor security breach that puts tens of thousands of patients
records at risk. The exact number of stolen records is yet to be determined.

Enriquez, the CEO, says TrapX found malware planted on several types of medical devices including an x-ray printer, an
oncology unit's MRI scanner, a surgical center's blood gas analyzer and a Healthcare provider's communication system.
Malware planted on a blood gas analyzer could impact the information a surgeon uses to determine the amount of anesthesia
a patient needs, malware planted on a heart monitor or dialysis machine could result in a fatal breach.

https://trapx.com/trapx-reveals-2016-healthcare-breaches-increased-63-percent-year-over-year-medical-device-hijacks-and-
ransomware-on-the-rise/
http://abc7news.com/technology/san-mateo-cyber-security-firm-uncovers-malware-on-medical-devices/1757268/                  49
Known Vulnerability

Overview: Medical Devices Running Windows XP are easy Targets
Devices: Various Medical Devices
Industry: Healthcare
Description:
Security researchers found that thousands of “critical medical systems” are vulnerable and exposed online. One example was
a US healthcare organization that had more than 68,000 exposed medical systems. Exposed were 21 anesthesia, 488
cardiology, 67 nuclear medical, and 133 infusion systems, 31 pacemakers, 97 MRI scanners and communications gear.
The healthcare org was merely one of "thousands" with equipment discoverable through Shodan, a search engine for things
on the public internet.
Research found that hospital machinery is at the fingertips of miscreants. Once researchers started changing [Shodan search
terms] to target specialty clinics like radiology or podiatry or pediatrics, they ended up with thousands of misconfigured and
direct attack vectors.

https://www.theregister.co.uk/2015/09/29/thousands_of_directly_hackable_hospital_devices_found_exposed/                   50
Known Vulnerability

Overview: Investigators detected vulnerabilities in devices with Windows XP operating system
Devices: Various medical devices running Windows XP
Industry: Healthcare
Description:
Medical Devices Running Windows XP are Easy Targets: Security researchers found that thousands of “critical medical
systems” are vulnerable and exposed online. One example was a US healthcare organization that had more than 68,000
exposed medical systems. Most medical devices are running Windows XP or XP service pack two and generally don’t have
antivirus making them easy targets.

https://www.theregister.co.uk/2015/09/29/thousands_of_directly_hackable_hospital_devices_found_exposed/
https://www.wired.com/2017/03/medical-devices-next-security-nightmare/                                            51
Known Vulnerability

Overview: Symantec Reports that Healthcare is most targeted by the Gatak Trojan
Devices: Various medical devices
Industry: Healthcare
Description:
The group behind the Gatak Trojan (Trojan.Gatak) continues to pose a threat to organizations, with the healthcare sector in
particular heavily affected by attacks. Gatak is known for infecting its victims through websites promising product licensing
keys for pirated software. While the group focused on US targets, it has diversified over the past two years and attacks are
now taking place against organizations in a broad range of countries. The majority of Gatak infections (62 percent) occur on
enterprise computers. Analysis of recent enterprise attacks indicates that the healthcare sector is by far the most affected by
Gatak. Of the top 20 most affected organizations (organizations with the most infected computers), 40 percent were in the
healthcare sector. In the past, the insurance sector was also heavily targeted by the group.

https://www.symantec.com/connect/blogs/gatak-healthcare-organizations-crosshairs
                                                                                                                             52
Acronym Glossary
AAA    Authentication, Authorization and Accounting   DB        Database                                            IDaaS     Identity as a Service                         NIC         Network Interface Card
ACL    Access Control List                            DDoS      Distributed Denial of Service                       iDRAC     Integrated Dell Remote Access Controller      NIST        National Institute of Standards and Technology
ACS    Access Control Server [Cisco]                  DHCP      Dynamic Host Configuration Protocol                 IM        Instant Messaging                             Nmap        Network Mapper
AD     Active Directory                               DLP       Data Loss Prevention                                IMAP      Internet Message Access Protocol              NOC         Network Operations Center
ANSI   American National Standards Institute          DNS       Domain Name Server                                  IOC       Indicator of Compromise                       OS          Operating System
API    Application Programming Interface              EDR       Endpoint Detection and Response                     iOS       iPhone Operating System [Apple]               OT          Operational Technology
ARP    Address Resolution Protocol                    EM        Enterprise Manager                                  IoT       Internet of Things                            OU          Organizational Unit
ATD    Advanced Threat Detection                      EMM       Enterprise Mobility Management                      IP        Internet Protocol                             OVAL        Open Vulnerability and Assessment Language
ATP    Advanced Threat Prevention                     ePO       ePolicy Orchestrator                                IPMI      Intelligent Platform Management Interface     P2P         Peer-to-Peer
AUP    Acceptable Use Policy                          EPP       Endpoint Protection Platform                        IPS       Intrusion Protection System                   PAM         Privileged Access Management
AV     Antivirus                                      FERC      Federal Energy Regulatory Commission                ISE       Identity Services Engine [Cisco]              PAN OS 7.x Palo Alto Networks Operating System 7.x
AWS    Amazon Web Services                            FIPS      Federal Information Processing standards            IT        Information Technology                        PC          Personal Computer
BYOD   Bring Your Own Device                          FQDN      Fully Qualified Domain Name                         ITAM      Information Technology Access Management      PCI         Payment Card Industry
C&C    Command and Control                            FTP       File Transfer Protocol                              ITSM      Information Technology Service Management     PKI         Public Key Infrastructure
CA     Certificate Authority                          FW        Firewall                                            LAN       Local area Network                            PoE         Power over Ethernet
CAM    Content Addressable Memory                     GCP       Google Cloud Platform                               LDAP      Lightweight Directory Access Protocol         POP3        Post Office Protocol
CASB   Cloud Access Security Broker                   GPO       Group Policy Object                                 LLDP      Link Layer Discovery Protocol                 pxGrid      Platform Exchange Grid [Cisco]
CCE    Common Configuration Enumeration               GUI       Graphical User Interface                            MAB       Mac Authentication Bypass                     RADIUS      Remote Authentication Dial-In User Service
CDP    Cisco Discovery Protocol                       HA        High Availability                                   MAC       Media Access Control                          RAP         Roving Analysis Port
CEF    Cisco Express Forwarding                       HBSS      Host Based Security System                          MAPI      Messaging Application Programming Interface   RDP         Remote Desktop Protocol
CIS    Center for Internet Security, Inc.             HIP       Host Information Policy [Palo Alto Networks]        MDM       Mobile Device Management                      Reauth      Reauthorization
CIUP   Cumulative Infrastructure Update Pack          HIPAA     Health Insurance Portability & Accountability Act   MTP       Mobile Threat Prevention [FireEye]            RI          Remote Inspection
CLI    Command Line Interface                                   Health Information Technology for Economic and      MTTD      Mean Time to Detection                        RM          Recovery Manager
                                                      HITECH
CMDB   Configuration Management Database                        Clinical Health                                     MTTR      Mean Time to Resolution                       RMM         Remote Monitoring and Management
CoA    Change of Authorization                        HITRUST   Health Information Trust Alliance                   NA        Not Applicable                                RO          Read Only
                                                      HPS       Host Property Scanner
CPPM   ClearPass Policy Manager                                                                                     NAC       Network Access Control                        ROI         Return on Investment
                                                      HR        Human Resources
CPU    Central Processing Unit                                                                                      NAT       Network Address Translation                   RPC         Remote Procedure Call
                                                      HTML      Hypertext Markup Language
CSC    Critical Security Controls                                                                                   NBT       NetBIOS over TCP/IP                           RRP         Remote Registry Protocol
                                                      HTTP      Hypertext Transfer Protocol
CSV    Comma Seperated Value                                                                                        NERC      North American Electric Reliability Corp.     RTU         Remote Terminal Unit
                                                      IaaS      Infrastructure as a Service
CUP    Cumulative Update Pack                                                                                       NetBIOS   Network Basic Input/Output System             RW          Read/Write
                                                      ICMP      Internet Control Message Protocol
CVE    Common Vulnerabilities and Exposures                                                                         NGFW      Next-Generation Firewall                      SaaS        Software as a Service                    53
                                                      ID        Identification
Acronym Glossary
         System Administration, Networking and Security     UDP     User Datagram Protocol
SANS
         Institute                                          URL     Universal Resource Locator
SCADA    Supervisory Control and Data Acquisition           USB     Universal Serial Bus
SCAP     Security Compliance Automation Protocol            VA      Vulnerability Assessment
SCCM     System Center Configuration Manager                vCT     Virtual CounterACT
SDN      Software Defined Network                           VDI     Virtual Desktop Infrastructure
SEL      System Event Log                                   vFW     Virtual Firewall
SGT      Security Group Tags [Cisco]                        VGA     Video Graphics Array
SGT      Security Group Tags [Cisco]                        VLAN    Virtual Local Area Network
SIEM     Security Information and Event Management          VM      Virtual Machine
SMS      Short Message Service                              VoIP    Voice over IP
SNMP     Simple Network Management Protocol                 VPN     Virtual Private Network
SOC      Security Operations Center
                                                            WAF     Web Application Firewall
SOX      Sarbanes-Oxley
                                                            WAN     Wide Area Network
SPAN     Switch Port Analyzer
                                                            WAP     Wireless Application Protocol
SQL      Structured Query Language
                                                            WMI     Windows Management Instrumentation
SSH      Secure Shell
                                                            WSUS    Windows System Update Services
SSID     Service Set Identifier
                                                                    The Extensible Configuration Checklist Description
SSL      Secure Sockets Layer                               XCCDF
                                                                    Format
SSO      Single Sign On
                                                            XML     Extensible Markup Language
STIG     Security Technical Implementation Guide
SYSLOG   System Log
TACACS   Terminal Access Controller Access Control System
TAM      Threat Assessment Manager [FireEye]
TAP      Threat Analytics Platform [FireEye]
TCO      Total Cost of Ownership
TCP      Transmission Control Protocol
TIP      Threat Intelligence Platform
TLS      Transport Layer Security
UBA      User Behavior Analytics

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