Healthcare organizations are increasingly concerned about medical device security and for good reason – attacks targeting or impacting medical devices are increasing, and those attacks are negatively impacting patient care. Adoption of AI-enabled and AI-assisted medical devices is increasing, despite serious concerns about the cybersecurity risks associated with the devices, and legacy devices continue to be used past end-of-support, despite those devices containing known and unpatched vulnerabilities.
According to a recent survey by RunSafe Security, conducted on 551 healthcare professionals involved in device purchasing decisions in the U.S., UK, and Germany, healthcare organizations are getting better at reducing medical device security risks, although the underlying risks remain significant, and in many cases are increasing in severity and impact. When questioned about medical device cybersecurity, 59% of respondents said they are extremely or very concerned about a cybersecurity incident impacting medical devices, with almost one-quarter reporting that such an attack has already occurred. 80% of respondents who experienced a cyberattack reported that it had a moderate or significant impact on patient care, up from 75% last year.
Hackers may not specifically target medical devices, but they are often impacted by a cyberattack, and the downtime is often significant. Most commonly, an attack results in between 5 and 12 hours of downtime (39% of respondents), with 37% reporting downtime of between 1 and 4 hours. Downtime can be significantly longer, however, with 11% of respondents reporting downtime of between 13 and 24 hours, and 5% reported downtime of more than 3 days.
The most commonly affected systems were electronic medical records (35% of organizations), patient monitoring devices (23%), lab and diagnostic equipment (1%), networked surgical equipment (10%), and medical imaging systems (8%). The survey revealed threat actors are increasingly adapting to the remote access footprint to connected devices, with 38% of respondents reporting incidents involving remote access exploitation. RunSafe Security warns that organizations that have not implemented network segmentation, access controls, or runtime protections are particularly exposed.
Healthcare organizations continue to use legacy devices that cannot easily be replaced and cannot be patched. 28% of respondents said they operate legacy medical devices that are past the end-of-support, and 44% of respondents admitted running end-of-support devices with known, unpatched vulnerabilities. 38% of respondents said they have devices that they are occasionally or frequently unable to patch, and 42% of legacy device users said between 10% and 25% of those devices are running on an unsupported operating system. Those devices are spread throughout critical care environments, including general inpatient wards, emergency departments, outpatient and ambulatory settings, intensive care settings, and operating rooms and procedure suites. The most common reasons for their continued use were no acceptable replacements (38%), budget constraints (36%), regulatory or approval constraints (34%), a lack of vendor upgrade path (24%), or the risk of continued use having not been formally accepted by leadership (17%).
Adoption of AI-enabled and AI-assisted medical devices is growing fast, with 57% of respondents currently using those devices, although 80% of respondents expressed at least a moderate concern about the cybersecurity risks that they introduce, such as model manipulation, data poisoning, and adversarial inputs. According to RunSafe Security, adoption of AI-enabled and AI-assisted medical devices and systems is outpacing confidence in the ability to mitigate cybersecurity risks associated with the devices.
The survey has identified some positives. Healthcare organizations are taking medical device security seriously, with 85% of respondents including basic or detailed cybersecurity requirements in their RFPs, up from 83% last year, and 56% of respondents have rejected a device due to cybersecurity concerns. Almost all respondents understand the importance of an SBOM, with 81% of respondents rating SBOMs as either important or essential for medical devices. Regulation is also increasingly important, as 79% of respondents said FDA cybersecurity guidance or EU MDR requirements have had a meaningful influence on their procurement processes, up from 73% last year. To address the problem of medical devices that have reached end-of-support and cannot be replaced, runtime protection serves as a critical compensating control, with 82% of respondents saying they have widely deployed or are piloting runtime exploit protection.
While genuine progress has been made in improving medical device security, attacks on medical devices are more frequent than they were twelve months ago, and the impact on patient care when incidents occur has worsened. “The lesson of the past year is not that investment and attention are failing but that the risk is moving at least as fast as the response. Closing that gap will require more than procurement rigor and budget growth. It will require security built into devices before they reach clinical environments, as well as the ability to protect devices already in place that cannot be replaced. That is where the industry’s work remains,” wrote RunSafe Security in the report.
The post Frequency and Severity of Hacks of Medical Devices Increasing appeared first on The HIPAA Journal.
