Cyber armour for a healthcare industry under attack

Armand Kruger, Head of Cyber Security at NEC XON.

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In the wake of recent large-scale ransomware attacks targeting the healthcare sector, the vulnerabilities within the industry are starkly evident. Malicious actors have exploited compromised credentials – a clear and present danger when healthcare providers' reliance on remote access software creates avenues for adversaries to disguise themselves as legitimate users and gain unauthorised access to critical environments.

A prime example is the breach at UnitedHealth, where compromised credentials were abused to infiltrate internet-facing remote access services. South African healthcare organisations aren’t immune and, similarly, need proactive measures to enhance cyber security posture and mitigate the risk of ransomware attacks.

These escalating cyber threats necessitate urgent collaborative efforts between government agencies, private organisations, cyber security experts, policymakers and industry leaders. These players must prioritise investments and initiatives aimed at safeguarding patient, provider and insurer data and infrastructure.

Implementing a ruthless privileged access model and engaging competent managed security providers (MSPs) with razor-like precision in removing adversaries' access are critical steps in mitigating these risks. Sharing knowledge and lessons learned from past breaches is also vital for proactive threat anticipation and containment.

There are some critical steps healthcare players can take today to fortify cyber security defences. NEC XON employs continuous threat exposure management (CTEM) to monitor customer environments from the adversary's perspective, promptly resetting compromised credentials and removing internet-facing systems to limit exposure. Our managed detection and response (MDR) team monitors internal anomalies and traces them back to their source, enhancing our ability to counter evolving threats. Here’s a specific list of the tactics NEC XON teams employ in protecting customer systems:

• Minimise external exposure: Only expose systems, applications or services to the internet if absolutely necessary. Remove any unnecessary internet-facing elements from your infrastructure to reduce the attack surface.
• Implement multi-factor authentication (MFA): Ensure that all internet-facing systems, applications and services have MFA enabled. This includes requiring MFA for third-party contractors, suppliers and vendors accessing your network.
• Enforce MFA for internal logins: Implement MFA for all internal application logins to limit the ability of attackers to pivot within the environment. This includes custom applications such as electronic medical record (EMR) systems, network devices, databases, ERP systems, payroll systems, backup systems, ordering systems and payment processing systems.
• Adopt a strict privileged access model: Reduce privileged access roles to limit lateral movement opportunities for adversaries. Implementing a strict privileged access model helps mitigate the risk of unauthorised access and reduces the blast radius in the event of a breach.
• Deploy endpoint detection and response (EDR) solutions: Ensure all servers and workstations have fully functional EDR solutions installed to detect abnormal activities. Modern adversaries are adept at blending in with legitimate IT professionals, making detection challenging. EDR solutions help identify and respond to suspicious behaviour promptly.
• Establish robust backup processes: Implement a robust and isolated backup process that includes key systems such as Active Directory, EMR systems and other line of business (LOB) solutions. Regularly test backup restoration procedures to ensure data integrity and minimise downtime in the event of a ransomware attack.
• Engage a competent managed security provider (MSP): Partner with a competent MSP that understands and studies modern adversaries, their tactics, techniques and procedures. An MSP focused on continuous threat detection and removal can enhance your organisation's cyber security posture and response capabilities.

Proactive measures, collaboration and investments in cyber security are imperative to safeguard South Africa's healthcare sector against cyber threats. Patient data safety is non-negotiable – direct damage to involved parties is potentially huge, and indirect reputational damage is almost impossible to restore once the genie is out of the proverbial bottle.