Cybersecurity and Compliance Best Practices for Radiology

In the rapidly evolving landscape of healthcare, the integration of technology has become indispensable, particularly in the field of radiology where digital systems are fundamental to diagnosis and treatment. However, as the reliance on digital platforms increases, so does the vulnerability to cyber threats. Hence, ensuring robust cybersecurity measures alongside strict compliance protocols has become imperative for the radiology sector. 

The convergence of sensitive patient data, advanced imaging technologies, and interconnected networks underscores the critical need for tailored cybersecurity and compliance best practices. Not only do these practices safeguard patient confidentiality and data integrity, but they also uphold the reliability and trustworthiness of diagnostic procedures, ultimately contributing to the delivery of high-quality patient care in radiology.

With over a decade of experience in supporting radiology organizations to meet compliance and cybersecurity requirements, our certified experts have identified security tech, policies, training, and testing to enhance your cybersecurity posture. These are in keeping with industry best practices. The price point of implementing these industry best practices varies depending on your set-up. One way to ensure you are making the right choices for your organization is to undergo a Security Risk Analysis to detect areas of improvement and design a comprehensive cybersecurity strategy to integrate the best practices ideal for your organization. 

Cybersecurity Best Practices for Radiology

 

1. Compliance & Customer Contracts for Radiology

1. HIPAA Compliance

Ensure adherence to the Health Insurance Portability and Accountability Act (HIPAA) federal regulations, which govern the security and privacy of patient health information.

2. GDPR Compliance

If applicable, comply with the General Data Protection Regulation (GDPR) standards, particularly when dealing with patient data of European Union residents.

3.Third-party Audits

Conduct regular third-party independent cyber security audits and assessments to ensure compliance with relevant data protection regulations and standards and insurance cybersecurity requirements.

4. Customer Contracts 

Most customers, including hospitals and other entities that share sensitive data, mandate that their vendors perform regular cybersecurity audits and tests.

 

 

2. Cybersecurity Best Practices for Radiology

1. Firewalls

Install and maintain robust firewalls to monitor and control incoming and outgoing network traffic, protecting against unauthorized access. Firewalls safeguard radiology systems by controlling incoming and outgoing network traffic, ensuring data integrity and patient confidentiality. They act as a crucial barrier, shielding radiology networks from unauthorized access and potential cyber threats.

 2. Encryption

Utilize encryption technologies to secure patient data both at rest and in transit, ensuring that even if data is intercepted, it remains unreadable. Encryption in radiology ensures patient data remains secure, safeguarding sensitive medical information from unauthorized access. Through advanced cryptographic techniques, patient confidentiality is maintained, fostering trust in the healthcare system.

 3.Intrusion Detection Systems (IDS) and Intrusion Prevention Systems (IPS)

Deploy IDS and IPS solutions to detect and prevent unauthorized access, malware, and other security threats. In radiology, Intrusion Detection Systems (IDS) monitor network traffic for potential threats, alerting administrators to suspicious activities such as unauthorized access to patient data. Meanwhile, Intrusion Prevention Systems (IPS) in radiology actively intervene to block or mitigate cyberattacks, safeguarding sensitive medical information and ensuring the integrity of diagnostic processes.

4. Regular Security Updates

Stay current with security patches and updates for all software, hardware, and systems to address vulnerabilities and enhance overall security posture. Regular security updates for radiology software ensure continuous protection against evolving cyber threats, safeguarding sensitive patient data and maintaining the integrity of medical imaging systems, prioritizing patient confidentiality and operational stability in healthcare environments.

5. Endpoint Protection

Implement endpoint protection solutions to secure devices such as computers, mobile devices, and medical equipment from malware and other cybersecurity threats. Endpoint Protection for radiology ensures robust security measures, shielding critical medical imaging devices from cyber threats, preserving patient data integrity and confidentiality. With real-time monitoring and advanced encryption, it fortifies the digital perimeter of radiological systems, safeguarding against unauthorized access and potential breaches.

6. Security Information and Event Management (SIEM)

Utilize SIEM tools to collect, analyze, and correlate security event data, enabling proactive threat detection and incident response. Utilizing Security Information and Event Management (SIEM) in radiology ensures robust monitoring and detection of potential threats, safeguarding sensitive patient data and maintaining regulatory compliance. SIEM solutions offer real-time analysis of security events within radiology systems, enabling prompt response to breaches or anomalies, thereby enhancing overall cybersecurity posture in healthcare environments.

7. Identity and Access Management (IAM)

Implement IAM solutions to manage user identities, control access to systems and data, and enforce least privilege principles. Identity and Access Management (IAM) in radiology ensures that only authorized healthcare professionals can access sensitive patient data, safeguarding patient privacy and maintaining compliance. IAM systems in radiology streamline user authentication, facilitating seamless access to critical imaging resources while bolstering security against unauthorized entry or data breaches

8. Data Loss Prevention (DLP)

Deploy DLP solutions to monitor, detect, and prevent unauthorized access or transmission of sensitive patient data, both within the organization and externally. Data Loss Prevention (DLP) in radiology ensures secure handling of sensitive patient information, safeguarding against unauthorized access or inadvertent disclosure, preserving patient confidentiality and regulatory compliance. By implementing DLP measures, radiology facilities mitigate risks of data breaches, maintaining integrity and privacy of medical records essential for patient care.

9. Other security best practices

Based on your environment & architecture, the security technology, policies and procedures need to be appropriately chosen and implemented.

 

3. Policies and Procedures for Radiology

1. Data Classification

Establish a data classification policy to categorize patient data based on sensitivity and define appropriate handling and protection measures for each category. Data classification in radiology involves organizing medical images and patient information into categories based on factors like pathology, anatomy, and imaging technique, aiding in efficient retrieval and analysis for accurate diagnoses and treatment planning. By categorizing radiological data, healthcare professionals can streamline interpretation processes, enhance data security measures, and facilitate research endeavors aimed at improving patient outcomes.

 

2. Access Control Policies

Implement access control policies and procedures to ensure that only authorized individuals have access to patient data, based on the principle of least privilege. Access control policies for radiology ensure only authorized personnel access sensitive patient images and records, safeguarding patient privacy and medical data integrity with strict authentication measures and role-based permissions. Implementation involves meticulous regulation of user privileges, encryption protocols, and audit trails to maintain confidentiality and compliance with healthcare regulations.

 

3.Incident Response Plans and Procedures

Develop a comprehensive incident response plan outlining procedures for detecting, responding to, and mitigating data breaches or security incidents promptly. In radiology, an incident response plan ensures swift and coordinated action in the event of equipment failure or data breach, safeguarding patient information and maintaining operational continuity. By delineating roles, protocols, and communication channels, the radiology incident response plan mitigates risks, minimizes downtime, and upholds quality standards in diagnostic imaging services.

4. Documented Procedures

Document all security-related procedures, including data handling, storage, transmission, and disposal, and ensure that employees are trained on and adhere to these procedures consistently. Documented procedures in radiology ensure precision, guiding technicians through each step with clarity and consistency. These protocols safeguard accuracy and streamline diagnostic processes, enhancing patient care.

 

5. Business Continuity Planning

Effective business continuity planning for radiology ensures uninterrupted patient care amidst emergencies, safeguarding critical imaging services. Proactive measures, including redundancy protocols and remote access solutions, mitigate risks and uphold operational resilience in radiology practices.

 

6. Business Associate Contracts

A business associate is a person or company that performs certain functions or activities that involve the use or disclosure of protected health information (PHI) on behalf of the healthcare provider, or provides services to a Radiology firm (i.e. the covered entity). It is important to include all key elements in your business contract.

Key elements of a Business Associate Contract include:

  • The nature of the services being provided by the business associate and the use of PHI involved.
  • Safeguards that the business associate must implement to protect PHI.
  • The business associate’s obligation to report any unauthorized use or disclosure of PHI, including breaches of unsecured PHI, to the covered entity.
  • Requirements for the business associate to ensure that any subcontractors that create, receive, maintain, or transmit PHI on behalf of the business associate agree to the same restrictions and conditions.
  • The radiology firm’s right to terminate the contract if the business associate violates a material term of the agreement.
 

 

4. Staff Training for Radiology

1. Phishing Training

Radiology employees undergo phishing training to enhance their awareness, recognizing and thwarting potential cyber threats lurking in deceptive emails. Through simulated exercises, they learn to identify red flags and safeguard sensitive medical information from phishing attacks.

 

2. Security Awareness Training

Security awareness training for radiology employees ensures vigilant protection of sensitive patient data, fostering a culture of confidentiality and compliance within the healthcare environment. Empowering staff with the knowledge to identify and mitigate cybersecurity risks strengthens the overall security posture, safeguarding both patient privacy and organizational integrity.

 

3.Compliance Training

Compliance-oriented training for radiology employees ensures adherence to rigorous safety protocols and regulatory standards, minimizing risks associated with medical imaging procedures. By emphasizing compliance with industry guidelines and best practices, radiology staff are equipped to deliver quality patient care while maintaining ethical and legal integrity.

4. Policy and procedures training based on roles

Policy and Procedures training tailored to radiology roles ensures precise adherence to safety protocols and regulatory standards, enhancing patient care and operational efficiency within the radiology department. By aligning training with specific job functions, radiology employees gain the expertise needed to navigate complex imaging processes with accuracy and confidence.

 

 

5. Automated and Manual Security Testing for Radiology

 

1. Vulnerability Assessment & Pen Testing

Automated and Manual Vulnerability Assessment & Pen Testing for Radiology involves evaluating and fortifying digital systems to protect sensitive medical data from cyber threats. While there are differences between these 2 types of security testing methods, there are several benefits of conducting both to test different aspects of your cybersecurity strategy.

 

 

2. Areas of Pen Testing for Radiology

While there are several Benefits of Pen Testing for Radiology, there are specific areas which Pen Testers focus on for Radiology organizations. They are:

i. Network Testing: Network testing for radiology ensures seamless transmission of medical images, safeguarding against potential data loss or distortion. Rigorous assessments validate the reliability and efficiency of network infrastructure, critical for accurate diagnoses and timely patient care.

ii. Application Testing: In radiology application testing, precision and accuracy are paramount to ensure reliable diagnostic outcomes. Rigorous testing protocols validate the software’s ability to interpret medical images with utmost clarity and clinical relevance.

iii. Mobile App Testing: Ensuring precision in diagnostic accuracy, mobile app testing for radiology rigorously evaluates image resolution and data transfer reliability. Each pixel scrutinized, every feature vetted, mobile app testing for radiology ensures seamless integration into clinical workflows.

iv. IoT Testing: In IoT testing for radiology, meticulous verification of data accuracy and real-time transmission integrity is imperative to ensure seamless integration with diagnostic imaging systems. Rigorous validation protocols are essential to guarantee the reliability and security of IoT devices, safeguarding the confidentiality and integrity of sensitive patient information in radiological settings.

 

3. Static and Dynamic Code Testing

Static code testing for radiology involves analyzing the source code without executing it, aiming to detect potential issues and vulnerabilities in the software used for medical imaging processes. Dynamic code testing, on the other hand, involves running the software and examining its behavior in real-time to ensure its functionality and reliability in radiology workflows.

 

6. AI in Radiology

AI in radiology has revolutionized medical imaging, enhancing diagnostic accuracy and efficiency. Through advanced algorithms, AI assists radiologists in detecting anomalies and expedites patient care. Its integration promises to streamline workflows and improve patient outcomes in diagnostic processes.

Radiologists need to exercise caution with AI, and ensure that it is used to complement rather than replace their expertise, preserving human judgment and empathy in patient care. They need to remain vigilant in validating AI outputs, recognizing its limitations and potential biases to maintain diagnostic accuracy and patient trust.

 

How databrackets can help you with Security Best Practices for Radiology

 

The rapid progression of radiology digitization brings forth an expanding realm of risks. Weakly secured systems offer hackers straightforward avenues to exploit vulnerabilities, posing considerable threats to business continuity. With radiology infrastructure often accessible externally, it’s crucial for organizations in this field to continuously bolster their security measures and verify their efficacy. Proactive enhancements in security are imperative to mitigate risks and safeguard the integrity of radiological operations amidst the dynamic digital environment.

 The security experts at databrackets bring years of extensive Radiology industry experience to the table, along with a deep understanding of industry-standard security practices. Our Vulnerability Assessment & Pen Testing capabilities have been accredited by the A2LA for ISO 17020 Conformity assessment for inspection bodies. We possess comprehensive knowledge of common pitfalls in system configurations, recognizing factors such as outdated software in medical devices, inadequately configured firewalls, and unpatched systems that often lead to security vulnerabilities. Through meticulous scoping and testing using a variety of tools, we meticulously uncover all potential vulnerabilities visible to attackers, ensuring thorough detection and protection for our clients’ systems and data.

Our client engagement starts with your business objective in mind. Vulnerability Assessment & Pen Testing is requested for several reasons:

  1. To secure your environment
  2. To meet certain regulatory compliance or certification requirements
  3. To fulfill a request made by your customer
  4. A combination of the reasons mentioned above

Once we understand what you require, our exercise focuses primarily on scoping of the engagement and setting expectations. We use a variety of tools depending on the type of test and systems in which we need to identify vulnerabilities & conduct pen testing. Our process includes:

  1. Discovery
  2. Identifying and finalizing assets
  3. Identifying vulnerabilities
  4. Exploitation of the vulnerabilities (Pen Testing)
  5. Validation of the issues identified
  6. Remediation/Recommendations
  7. Re-testing

Apart from using the tools best in the industry, we also focus on remediation and  retesting of the environment. We just don’t give hundreds of pages of reports without any help to eliminate the risks. We help our clients prioritize the risks based on the context, patch the systems and select security tech, policies and procedures that are considered best practices in their industry. We also set up continuous monitoring after our tests to track any changes to your environment & send you timely alerts. 

As we continue to work with our clients, we sharpen our understanding of your specific environment and system. This helps us to design cadence for continuous protection and monitoring using the right tools to ensure continual improvement and proactive identification of issues for the future. You can contact us for a customized quote or schedule a consultation.

You can also meet us in-person at RSNA 2024, at South Hall Level 3 – Booth No. 3174. 

 

databrackets overview


Our team of security experts has supported organizations across a wide variety of industries to align their processes with security frameworks like ISO 27001:2022, SOC 2, HIPAA, 21 CFR Part 11, NIST SP 800-53, NIST Cybersecurity Framework, NIST SP 800-171, GDPR, CMMC 2.0 etc.

We are constantly expanding our library of assessments and services to serve organizations across industries. Schedule a Consultation if you would like to Connect with an Expert to understand how we can customize our services to meet your specific requirements.

Related Links:

Technologies To Detect And Prevent Ransomware Attacks 

Sources of Ransomware Attacks on Healthcare Systems

What are the new controls added to ISO 27001 in 2022?

How to Select a Security Vendor

Author: Aditi Salhotra, Digital Marketing and Business Development, databrackets.com

Aditi is a Digital Marketing and Business Development Professional at databrackets.com. She graduated with honors in Marketing from Sheridan College, Canada. In addition to her current profile, she contributes to Product Development and Content Creation. She is a strong advocate of Good Cyber Hygiene and white hat SEO techniques. She is proud of the company’s mission to safeguard organizations from cyber threats and ensure their business continuity in adverse situations. 

Technical Expert: Srini Kolathur, Director, databrackets.com

The technical information presented in this blog has been carefully reviewed and verified by our Director, Srini Kolathur. Srini is results-driven security and compliance professional with over 20 years of experience supporting, leading, and managing global IT security, compliance, support, and risk assessment in fortune 100 companies. Some of his key areas of focus are SOC 2, ISO 27001, NIST 800-171, NIST 800-53, NIST Cybersecurity Framework,  HIPAA, Security Risk Assessment, CMMC 2.0 among others. He is a CMMC Registered Practitioner (RP), CISSP, CISA, CISM, MBA. He is active in several community groups including Rotary International and TiE.

Benefits of Pen Testing for Radiology

Radiology organizations handle sensitive medical information and rely heavily on secure digital systems to store and transmit patient data. With the increasing prevalence of cyber threats, ranging from ransomware attacks to data breaches, the need for robust cybersecurity measures is paramount. Penetration testing, or pen testing, is essential for radiology organizations to proactively identify vulnerabilities within their network infrastructure, software systems, and protocols. By simulating real-world cyberattacks, pen testing allows the organization to uncover potential weaknesses in specific areas  and in DICOM Images before malicious actors exploit them.

Given the highly sensitive nature of medical data, including imaging scans and patient records, ensuring the integrity, confidentiality, and availability of this information is critical. Pen testing enables radiology organizations to fortify their defenses, mitigate risks, and uphold regulatory compliance, ultimately safeguarding patient privacy and the integrity of healthcare services.

Benefits of Pen Testing for Radiology Organizations

1. Identify Vulnerabilities

Penetration testing helps discover vulnerabilities and weaknesses in radiology systems, such as outdated software, misconfigurations, unpatched systems, or inadequate security controls. This is specifically relevant for Picture Archiving and Communication Systems (PACS), Radiology Information Systems (RIS) and Radiology devices. This information is crucial for Radiology organizations to remediate potential risks before they are exploited by malicious actors.

 

2. Data Protection

Radiology systems contain sensitive patient data, including medical images and protected health information (PHI). Penetration testing helps ensure the confidentiality, integrity, and availability of this data by identifying and addressing security gaps that could lead to data breaches or unauthorized access.

 

3. Compliance and Regulation

The healthcare industry, including radiology, is subject to various regulations, such as the Health Insurance Portability and Accountability Act (HIPAA) and FDA Cybersecurity and CFR Part 11 requirements. Penetration testing assists radiology facilities in complying with these regulations by demonstrating a proactive approach to safeguarding patient information and avoiding costly fines associated with data breaches.

 

4. Improved Security Posture

By uncovering vulnerabilities and assessing the effectiveness of security controls, regular penetration testing allows radiology departments to strengthen their overall security posture. This includes enhancing network security, access controls, and incident response procedures.

 

5. Risk Mitigation

Penetration testing provides a valuable tool for risk assessment and management since it highlights actionable insights into potential security risks, allowing healthcare organizations to prioritize and address them accordingly. This risk-based approach helps allocate resources efficiently to reduce the likelihood of security incidents.

 

6. Realistic Simulation

Penetration tests simulate real-world cyberattacks, helping radiology staff and IT teams understand how attackers may exploit vulnerabilities in their systems. This knowledge is invaluable for proactive threat mitigation and incident response planning.

 

7. Continuous Improvement

Security is an ongoing process, and penetration testing is a vital part of a healthcare organization’s security lifecycle. Regular testing ensures that security measures are continually evaluated and adjusted to adapt to evolving threats and technology.

 

8. Trust and Reputation

Maintaining a strong cybersecurity posture in radiology enhances the trust and reputation of healthcare organizations. Patients and partners are more likely to entrust their sensitive information to facilities with a demonstrated commitment to security.

 

9. Cost Savings

Detecting and proactively addressing vulnerabilities through penetration testing can be more cost-effective than dealing with the aftermath of a successful cyberattack. It can prevent the financial and reputational damage that comes with data breach remediation, legal liabilities, and regulatory fines.

 

10. Enhanced Patient Care

Ultimately, penetration testing contributes to the overall safety and quality of patient care by minimizing the risks associated with security breaches. Ensuring the integrity and availability of medical imaging systems is crucial for accurate diagnoses and timely treatments.

 

11. Business Continuity

Radiology plays a critical role in patient care, and any disruption to its operations can have serious consequences. Penetration testing helps ensure the continuity of radiology services by identifying and mitigating potential threats that could lead to downtime or system failures.

 

12. Detection of Insider Threats

Penetration tests can help detect and address potential insider threats within healthcare organizations. These tests simulate both external and internal threats, allowing organizations to identify any vulnerabilities that could be exploited by malicious employees or contractors.

 

13. Security Awareness

Penetration testing raises awareness about cybersecurity among radiology IT admin and other healthcare professionals. It emphasizes the importance of adhering to security policies, following best practices, and staying vigilant against potential threats.

 

Penetration testing for radiology is a proactive security assessment method that provides multiple benefits, including identifying vulnerabilities, protecting patient data, ensuring compliance, and improving the overall security posture of healthcare organizations, ultimately contributing to better patient care and organizational resilience.

 

How databrackets can help you with Pen Testing for Radiology

The digitization of radiology is advancing rapidly, presenting a growing risk landscape. Systems lacking robust hardening and configuration create ample opportunities for hackers to exploit vulnerabilities using straightforward techniques, potentially causing significant disruptions to business operations. Given the external-facing nature of radiology infrastructure, it is imperative for radiology organizations to consistently invest in fortifying their security posture and validating its effectiveness. Proactive measures in security enhancement are essential to mitigate risks and uphold the integrity of radiological operations amidst the evolving digital landscape.


Security Experts at databrackets

Our Vulnerability Assessment & Pen Testing capabilities have been accredited by the A2LA for ISO 17020 Conformity assessment for inspection bodies. The security experts at databrackets bring years of extensive Radiology industry experience to the table, along with a deep understanding of industry-standard security practices. We possess comprehensive knowledge of common pitfalls in system configurations, recognizing factors such as outdated software in medical devices, inadequately configured firewalls, and unpatched systems that often lead to security vulnerabilities. Through meticulous scoping and testing using a variety of tools, we meticulously uncover all potential vulnerabilities visible to attackers, ensuring thorough detection and protection for our clients’ systems and data.

Our client engagement starts with your business objective in mind. Vulnerability Assessment & Pen Testing is requested for several reasons:

  1. To secure your environment
  2. To meet certain regulatory compliance or certification requirements
  3. To fulfill a request made by your customer
  4. A combination of the reasons mentioned above

Once we understand what you require, our exercise focuses primarily on scoping of the engagement and setting expectations. We use a variety of tools depending on the type of test and systems in which we need to identify vulnerabilities & conduct pen testing. Our process includes:

  1. Discovery
  2. Identifying and finalizing assets
  3. Identifying vulnerabilities
  4. Exploitation of the vulnerabilities (Pen Testing)
  5. Validation of the issues identified
  6. Remediation/Recommendations
  7. Re-testing

Apart from using the tools best in the industry, we also focus on remediation and  retesting of the environment. We just don’t give hundreds of pages of reports without any help to eliminate the risks. We help our clients prioritize the risks based on the context, patch the systems and select security tech, policies and procedures that are considered best practices in their industry. We also set up continuous monitoring after our tests to track any changes to your environment & send you timely alerts. 

As we continue to work with our clients, we sharpen our understanding of your specific environment and system. This helps us to design cadence for continuous protection and monitoring using the right tools to ensure continual improvement and proactive identification of issues for the future. You can contact us for a customized quote or schedule a consultation.

You can also meet us in-person at RSNA 2024, at South Hall Level 3 – Booth No. 3174. 

databrackets overview

Our team of security experts has supported organizations across a wide variety of industries to align their processes with security frameworks like ISO 27001:2022, SOC 2, HIPAA, 21 CFR Part 11, NIST SP 800-53, NIST Cybersecurity Framework, NIST SP 800-171, GDPR, CMMC 2.0 etc.

We are constantly expanding our library of assessments and services to serve organizations across industries. Schedule a Consultation if you would like to Connect with an Expert to understand how we can customize our services to meet your specific requirements.

Related Links:

Technologies To Detect And Prevent Ransomware Attacks 

Sources of Ransomware Attacks on Healthcare Systems

What are the new controls added to ISO 27001 in 2022?

How to Select a Security Vendor

Author: Aditi Salhotra, Digital Marketing and Business Development, databrackets.com

Aditi is a Digital Marketing and Business Development Professional at databrackets.com. She graduated with honors in Marketing from Sheridan College, Canada. In addition to her current profile, she contributes to Product Development and Content Creation. She is a strong advocate of Good Cyber Hygiene and white hat SEO techniques. She is proud of the company’s mission to safeguard organizations from cyber threats and ensure their business continuity in adverse situations. 

Technical Expert: Srini Kolathur, Director, databrackets.com

The technical information presented in this blog has been carefully reviewed and verified by our Director, Srini Kolathur. Srini is results-driven security and compliance professional with over 20 years of experience supporting, leading, and managing global IT security, compliance, support, and risk assessment in fortune 100 companies. Some of his key areas of focus are SOC 2, ISO 27001, NIST 800-171, NIST 800-53, NIST Cybersecurity Framework,  HIPAA, Security Risk Assessment, CMMC 2.0 among others. He is a CMMC Registered Practitioner (RP), CISSP, CISA, CISM, MBA. He is active in several community groups including Rotary International and TiE.

Pen Testing for Radiology

Penetration testing, often referred to as “pen testing” or “ethical hacking,” is a proactive security assessment approach used to identify vulnerabilities and weaknesses within a computer system, network, or application. In the context of radiology, penetration testing is specifically designed to evaluate the security of medical imaging systems, including Picture Archiving and Communication Systems (PACS), Radiology Information Systems (RIS), medical devices and associated network and application infrastructure. The primary goal of penetration testing in radiology is to simulate real-world cyberattacks and assess the system’s ability to withstand and defend against these threats as the Radiology industry increasingly handles sensitive electronic patient data with many partners, vendors and customers. 

 

Areas of Pen Testing for Radiology

There are 4 specific areas of pen testing that are of relevance to organizations that work with medical imaging and radiology. They are:

  1. Network Testing
  2. Application Testing
  3. Mobile App Testing
  4. IoT Testing
4 areas of penetration testing for radiology

1. Network Testing for Radiology

Radiology organizations operate various external-facing infrastructures essential for engaging with hospitals, referring physicians, and other collaborators. However, the existence of these interfaces poses significant risks to the organization’s security if not adequately fortified. Ensuring the robustness of network security protocols becomes paramount in safeguarding sensitive data and maintaining the integrity of operations. Proactive measures, including comprehensive vulnerability assessment and penetration testing of network systems, are imperative to identify vulnerabilities and implement necessary defenses, thereby mitigating potential breaches and protecting the confidentiality of patient information.

 

2. Application Testing

Radiology organizations must also prioritize application testing, particularly for Picture Archiving and Communication Systems (PACS), which store vast patient records accessed by numerous radiologists. As part of Vulnerability Assessment and Penetration Testing (VAPT), rigorous evaluation of PACS system infrastructure and applications is essential to verify correct configuration and fortify against potential vulnerabilities. Additionally, given the interconnected nature of many external-facing applications in the radiology domain, comprehensive testing within this context becomes imperative. This includes ensuring the secure implementation of DICOM (Digital Imaging and Communications in Medicine) protocols, which facilitate the exchange of medical images and related information. We conduct a DICOM vulnerability assessment (DVA) to meet this objective. Such assessments serve to identify weaknesses in the system’s architecture and application interfaces, enabling the implementation of robust security measures to safeguard patient data and uphold operational integrity.

 

3. Mobile App Testing

Mobile applications utilized by radiologists frequently establish connections to backend systems to process and display medical images. However, vulnerabilities within these mobile apps pose a significant risk, potentially compromising the integrity of the backend infrastructure if left unidentified and unaddressed. Therefore, it is crucial to conduct thorough testing of mobile applications to uncover any vulnerabilities promptly and implement necessary fixes. This proactive approach ensures the security and stability of the entire system, safeguarding sensitive medical data and maintaining seamless functionality for healthcare professionals.

 

4. IoT Testing

In radiology, numerous devices such as CT, MRI, and X-ray machines are connected to the hospital networks or provider systems. Unfortunately, many of these devices run on outdated software and lack regular patches for identified vulnerabilities. Vulnerability Assessment and Penetration Testing (VAPT) play a crucial role in uncovering these issues, providing a structured framework for prioritizing and addressing them. By identifying vulnerabilities in connected radiology devices, VAPT ensures a proactive approach to cybersecurity, mitigating potential risks and enhancing the overall safety and reliability of diagnostic equipment within healthcare settings.

How databrackets can help you with Pen Testing for Radiology

The digitization of radiology is advancing rapidly, presenting a growing risk landscape. Systems lacking robust hardening and configuration create ample opportunities for hackers to exploit vulnerabilities using straightforward techniques, potentially causing significant disruptions to business operations. Given the external-facing nature of radiology infrastructure, it is imperative for radiology organizations to consistently invest in fortifying their security posture and validating its effectiveness. Proactive measures in security enhancement are essential to mitigate risks and uphold the integrity of radiological operations amidst the evolving digital landscape.

Security Experts at databrackets

Our Vulnerability Assessment & Pen Testing capabilities have been accredited by the A2LA for ISO 17020 Conformity assessment for inspection bodies. The security experts at databrackets bring years of extensive Radiology industry experience to the table, along with a deep understanding of industry-standard security practices. We possess comprehensive knowledge of common pitfalls in system configurations, recognizing factors such as outdated software in medical devices, inadequately configured firewalls, and unpatched systems that often lead to security vulnerabilities. Through meticulous scoping and testing using a variety of tools, we meticulously uncover all potential vulnerabilities visible to attackers, ensuring thorough detection and protection for our clients’ systems and data.

Our client engagement starts with your business objective in mind. Vulnerability Assessment & Pen Testing is requested for several reasons:

  1. To secure your environment
  2. To meet certain regulatory compliance or certification requirements
  3. To fulfill a request made by your customer
  4. A combination of the reasons mentioned above

Once we understand what you require, our exercise focuses primarily on scoping of the engagement and setting expectations. We use a variety of tools depending on the type of test and systems in which we need to identify vulnerabilities & conduct pen testing. Our process includes:

  1. Discovery
  2. Identifying and finalizing assets
  3. Identifying vulnerabilities
  4. Exploitation of the vulnerabilities (Pen Testing)
  5. Validation of the issues identified
  6. Remediation/Recommendations
  7. Re-testing

Apart from using the tools best in the industry, we also focus on remediation and  retesting of the environment. We just don’t give hundreds of pages of reports without any help to eliminate the risks. We help our clients prioritize the risks based on the context, patch the systems and select security tech, policies and procedures that are considered best practices in their industry. We also set up continuous monitoring after our tests to track any changes to your environment & send you timely alerts. 

As we continue to work with our clients, we sharpen our understanding of your specific environment and system. This helps us to design cadence for continuous protection and monitoring using the right tools to ensure continual improvement and proactive identification of issues for the future. You can contact us for a customized quote or schedule a consultation.

You can also meet us in-person at RSNA 2024, at South Hall Level 3 – Booth No. 3174. 

 

databrackets overview

Our team of security experts has supported organizations across a wide variety of industries to align their processes with security frameworks like ISO 27001:2022, SOC 2, HIPAA, 21 CFR Part 11, NIST SP 800-53, NIST Cybersecurity Framework, NIST SP 800-171, GDPR, CMMC 2.0 etc.

We are constantly expanding our library of assessments and services to serve organizations across industries. Schedule a Consultation if you would like to Connect with an Expert to understand how we can customize our services to meet your specific requirements.

Related Links:

Technologies To Detect And Prevent Ransomware Attacks 

Sources of Ransomware Attacks on Healthcare Systems

What are the new controls added to ISO 27001 in 2022?

How to Select a Security Vendor

Author: Aditi Salhotra, Digital Marketing and Business Development, databrackets.com

Aditi is a Digital Marketing and Business Development Professional at databrackets.com. She graduated with honors in Marketing from Sheridan College, Canada. In addition to her current profile, she contributes to Product Development and Content Creation. She is a strong advocate of Good Cyber Hygiene and white hat SEO techniques. She is proud of the company’s mission to safeguard organizations from cyber threats and ensure their business continuity in adverse situations. 

Technical Expert: Srini Kolathur, Director, databrackets.com

The technical information presented in this blog has been carefully reviewed and verified by our Director, Srini Kolathur. Srini is results-driven security and compliance professional with over 20 years of experience supporting, leading, and managing global IT security, compliance, support, and risk assessment in fortune 100 companies. Some of his key areas of focus are SOC 2, ISO 27001, NIST 800-171, NIST 800-53, NIST Cybersecurity Framework,  HIPAA, Security Risk Assessment, CMMC 2.0 among others. He is a CMMC Registered Practitioner (RP), CISSP, CISA, CISM, MBA. He is active in several community groups including Rotary International and TiE.

Can you have a Ransomware attack if you are HIPAA-compliant?

Image on Ransomware Attack even if you are HIPAA CompliantThe short answer: Yes

 

The in-depth answer: The Health Insurance Portability and Accountability Act (HIPAA) sets the minimum standards for protecting sensitive patient health information (PHI). The Department of Health and Human Services (HHS) regulates HIPAA compliance, while the Office for Civil Rights (OCRenforces it. The OCR regularly publishes recommendations on new issues affecting healthcare and investigates common HIPAA violations on a regular basis. However, a HIPAA-compliant organization can still be a target for a ransomware attack. Despite having advanced cybersecurity measures in place to comply with HIPAA, no organization is fully impervious to all cyber threats.

Ransomware Attacks in a HIPAA-compliant Organization

 

HIPAA regulations mandate that healthcare providers protect the privacy and security of patient’s health information. This involves implementing safeguards such as access controls, audit controls, integrity controls, and transmission security. However, these measures primarily focus on ensuring data privacy and security, and although they can help reduce the risk of ransomware attacks, they do not eliminate it completely.

 

Ransomware is malicious software that encrypts the victim’s data. Hackers demands a ransom to restore access to the data once they are paid. They also have the ability to modify the data and sell it, even if they are paid the ransom amount. This leads to serious complications in the Healthcare Industry since their data is targeted due to its critical importance for its high value. Even with HIPAA-compliant measures in place, organizations can fall victim to ransomware attacks via various methods:

  1. Not implementing addressable safeguards:

    Organizations tend to overlook implementing addressable safeguards outlined in the HIPAA Security Rule. These safeguards focus on Authorization / Supervision, Workforce Clearance Procedures, Termination Procedures, Access Authorization, Security Reminders, Log-in Monitoring, Password Management, Protection from Malicious Software, Testing Contingency Plans, etc. Due to this oversight, their systems have vulnerabilities that can be exploited through a targeted cyber attack.

  2. Phishing attacks:

    One of the most common ways attackers can breach security defenses is through phishing emails. These emails trick employees into clicking on malicious links or attachments that install ransomware on the network.

  3. Insufficient Backup and Recovery Systems:

    HIPAA requires that covered entities have backup and disaster recovery measures in place. However, if these measures are not adequately and continuously maintained, tested, and updated, ransomware can infect not only the primary data systems but also backup systems, making data recovery impossible without paying the ransom.

  4. Incomplete or Inadequate Implementation of HIPAA Standards:

    Compliance doesn’t always mean complete protection. Organizations may meet the letter of the law without effectively securing all possible points of vulnerability. For instance, they might overlook the security of medical devices, partner networks, or other systems that connect to their main network.

  5. Exploiting software vulnerabilities:

    Cybercriminals often exploit known vulnerabilities in software applications that are not patched or updated regularly. Through these vulnerabilities, they gain unauthorized access and deploy ransomware.

  6. Insider threats:

    Employees, vendors, or other insiders with malicious intent or those who are simply careless may inadvertently expose the organization to ransomware attacks deliberately.

  7. Brute force attacks:

    In this method, attackers try numerous combinations to guess passwords and gain access to systems or networks. Once they are in, they install ransomware and infiltrate the entire network.

  8. Advanced Persistent Threats (APTs):

    These are long-term targeted attacks where cybercriminals infiltrate networks to mine data or disrupt services. They can plant ransomware and activate it at the most opportune moment. For example, zero-day exploits take advantage of security vulnerabilities that are unknown to the organization and the public. Such vulnerabilities are thus unpatched, making them a lucrative target for attackers.

  9. Network vulnerabilities:

    Weaknesses in network security, such as unsecured Wi-Fi networks or inadequate firewall protection, can create entry points for ransomware.

  10. Physical breaches:

    Access to physical machines (like a stolen laptop that has not been encrypted) can also lead to a breach. HIPAA requires physical safeguards, but like all security measures, they’re not 100% foolproof.

This list is not exhaustive, and HIPAA compliance can help mitigate these risks through required security measures like regular risk assessments, encryption of electronic protected health information (ePHI), maintaining updated and patched systems, and conducting regular staff training on cybersecurity best practices.

However, the cyber security challenges that organizations face are dynamic. They need a comprehensive approach to cybersecurity that goes beyond just HIPAA compliance. This might involve extensive and customized employee training to recognize phishing attempts, regular audits, and penetration tests to identify and patch vulnerabilities, the use of advanced threat detection and response systems, and robust, isolated backup systems to ensure data can be restored in the event of a ransomware attack. In addition, establishing an incident response plan can help minimize damage if an attack occurs.

Despite all these measures, it’s important to remember that no organization can be completely immune to ransomware attacks. Therefore, continuous improvement of your security posture and preparedness for potential attacks is critical.

In the event of a ransomware attack, HIPAA mandates specific steps and reporting procedures, including notifying affected individuals, the Department of Health and Human Services, and potentially the media depending on the scale of the breach. Therefore, compliance does not guarantee the prevention of attacks, but it does establish a strong foundation for preventing, detecting, and responding to such cyber threats, thereby reducing the possibility of risks in the long run.

 

How databrackets can help you create a secure IT infrastructure

Experts at databrackets have extensive experience working with Healthcare Providers, Cyber Liability Insurance Providers, Managed Service Providers (MSPs), FDA Regulated industries etc. Our services range from Security Risk Analysis, HIPAA compliance, Pen Testing & Vulnerability Scans, Implementation of Cyber Security Technology, Managed Security Services, and Security Risk Analysis for MIPS, among others.

Our team has supported organizations across a wide variety of industries to align their processes with security frameworks like HIPAA, 21 CFR Part 11, ISO 27001SOC 2, NIST SP 800-53NIST Cybersecurity FrameworkNIST SP 800-171GDPRCMMC etc.

We are constantly expanding our library of assessments and services to serve organizations across industries. Schedule a Consultation if you would like to Connect with an Expert to understand how we can customize our services to meet your specific requirements.

Related Links

Sources of Ransomware Attacks on Healthcare Systems

Protect your DICOM from Cyber Attacks

Security Tech Investments for Top 10 trends in 2023

How to Select a Security Vendor

Author: Aditi Salhotra, Digital Marketing and Business Development, databrackets.com

Aditi is a Digital Marketing and Business Development Professional at databrackets.com. She graduated with honors in Marketing from Sheridan College, Canada. In addition to her current profile, she contributes to Product Development and Content Creation. She is a strong advocate of Good Cyber Hygiene and white hat SEO techniques. She is proud of the company’s mission to safeguard organizations from cyber threats and ensure their business continuity in adverse situations. 

Technical Expert: Srini Kolathur, Director, databrackets.com

The technical information presented in this blog has been carefully reviewed and verified by our Director, Srini Kolathur. Srini is results-driven security and compliance professional with over 20 years of experience supporting, leading, and managing global IT security, compliance, support, and risk assessment in fortune 100 companies. Some of his key areas of focus are SOC 2, ISO 27001, NIST 800-171, NIST 800-53, NIST Cybersecurity Framework,  HIPAA, Security Risk Assessment, CMMC 2.0 among others. He is a CMMC Registered Practitioner (RP), CISSP, CISA, CISM, MBA. He is active in several community groups including Rotary International and TiE.

Sources of Ransomware Attacks on Healthcare Systems

Image on how ransomware enters Healthcare SystemsA cohort study published in The Journal of the American Medical Association in December of 2022 revealed that Ransomware attacks targeting Healthcare delivery organizations more than doubled from 2016 to 2021. This exposed the Personal Health Information of nearly 42 million patients. During the study period, it was observed that Ransomware attacks were more likely to target large organizations with multiple facilities.

Healthcare systems are usually targets of Ransomware attacks due to their critical importance and the high value of their data. Therefore, Healthcare providers and their vendors (including business associates and subcontractors) must maintain strong cybersecurity defenses and best practices, use advanced threat detection tools and mitigate the unrelenting risk of Ransomware attacks. While benchmarks under the Health Insurance Portability and Accountability Act (HIPAA) are mandatory, hackers have found ways to create loopholes in HIPAA-compliant systems, embed Ransomware, and trick users (usually employees of Healthcare providers and their vendors) into downloading it.

How Ransomware Enters Healthcare Systems

Ransomware, one of the most malicious software, can enter Healthcare systems in several ways. Hackers usually look for a loophole or create one through a single user’s computer and then infiltrate the network and spread it to other devices. Once Ransomware spreads, the data in the core systems are encrypted using unique keys that are known only to the hackers. Unless the hackers get compensated, the data in the core systems is unusable by the healthcare systems. This severely impacts service delivery and patient care.

There are several ways they can use to enter a healthcare provider, business associate, vendor or, subcontractor’s systems. This includes, but is not limited to:

1. Phishing Emails:

One of the most common methods for Ransomware to enter an IT infrastructure is through phishing emails. These are emails disguised as legitimate, often impersonating a trusted sender like HR, professionals working in the Billing / Finance department, Vendors, or trusted senders from other departments. The emails contain malicious links or attachments. Once an employee clicks on the link or downloads the attachment, the Ransomware can infect their computer and spread to other systems in the network.

2. Malvertising and drive-by downloads:

Malvertising involves injecting malicious code into online advertising networks. When a user clicks on an infected ad, the Ransomware is downloaded onto their system. Drive-by downloads are similar but happen on compromised websites or even legitimate ones with a security weakness.

3. Exploiting vulnerabilities in outdated software or hardware:

Attackers often exploit security vulnerabilities in software or hardware that haven’t been patched or updated regularly. These vulnerabilities can be in operating systems, applications, databases, network equipment, and medical devices. When security patches are released to fix these vulnerabilities, organizations need to update their systems promptly to protect them.

4. Social Engineering:

This involves manipulating individuals into performing actions or divulging confidential information that can be used to gain unauthorized access to systems or data. It could be a phone call or an online interaction, convincing someone to install a file with Ransomware. Common examples include Pretexting, Baiting, and Tailgating.

5. Third-party vendor attacks:

In this method, attackers compromise a trusted software vendor’s system and insert their Ransomware into software updates. When the healthcare organization installs the infected update, the Ransomware enters its system.

6. Remote Desktop Protocol (RDP) attacks:

RDP is a protocol that allows one computer to connect to another over a network. If an attacker can guess or crack the login credentials for an RDP session, they can install Ransomware on the remote system. This is especially problematic in healthcare settings where RDP is commonly used for telemedicine and remote patient monitoring.

7. Removable Media:

Ransomware can spread through infected USB drives, CDs, or other removable media.

8. Internet of Things (IoT)/Medical Devices:

As healthcare increasingly utilizes connected devices, these devices become targets. Many IoT/medical devices lack robust security, making them an attractive entry point for attackers.

This list is not exhaustive, and there is only one certainty in the field of Ransomware attacks – Hackers continue to find innovative ways to infiltrate healthcare systems. Vendors who directly and indirectly work with Healthcare providers in the US need to be HIPAA compliant. However, following the benchmarks set by HIPAA doesn’t guarantee that your systems will not be vulnerable to a targeted or ransomware attack. We have explored this at length in our blog, ‘Can a HIPAA-compliant Healthcare provider be attacked using Ransomware?’(Easwari-hyperlink to the blog)

Stay tuned for ways to Mitigate the Risk of Ransomware in Healthcare.

How databrackets can help you create a secure IT infrastructure

Experts at databrackets have extensive experience working with Healthcare Providers, Cyber Liability Insurance Providers, Managed Service Providers (MSPs), Business Associates & Subcontractors of Healthcare Providers, and Pharmaceutical and other FDA Regulated industries. Our services range from Security Risk Analysis, Pen Testing & Vulnerability Scans, Implementation of Cyber Security Technology, Managed Security Services, HIPAA compliance, and Security Risk Analysis for MIPS, among others.

Our team has supported organizations across a variety of other industries to align their processes with security frameworks like HIPAAISO 27001SOC 2, NIST SP 800-53NIST Cybersecurity FrameworkNIST SP 800-171GDPRCMMC21 CFR Part 11, etc.

We constantly expand our library of assessments and services to serve organizations across industries. If you would like to Connect with an Expert to understand how we can customize our services to meet your specific requirements, do not hesitate to Schedule a Consultation.

Related Links

Can a HIPAA compliant Healthcare provider be attacked using Ransomware

Protect your DICOM from Cyber Attacks

Security Tech Investments for Top 10 trends in 2023

How to Select a Security Vendor

Author: Aditi Salhotra, Digital Marketing and Business Development, databrackets.com

Aditi is a Digital Marketing and Business Development Professional at databrackets.com. She graduated with honors in Marketing from Sheridan College, Canada. In addition to her current profile, she contributes to Product Development and Content Creation. She is a strong advocate of Good Cyber Hygiene and white hat SEO techniques. She is proud of the company’s mission to safeguard organizations from cyber threats and ensure their business continuity in adverse situations. 

Technical Expert: Srini Kolathur, Director, databrackets.com

The technical information presented in this blog has been carefully reviewed and verified by our Director, Srini Kolathur. Srini is results-driven security and compliance professional with over 20 years of experience supporting, leading, and managing global IT security, compliance, support, and risk assessment in fortune 100 companies. Some of his key areas of focus are SOC 2, ISO 27001, NIST 800-171, NIST 800-53, NIST Cybersecurity Framework,  HIPAA, Security Risk Assessment, CMMC 2.0 among others. He is a CMMC Registered Practitioner (RP), CISSP, CISA, CISM, MBA. He is active in several community groups including Rotary International and TiE.

Comparing Top 5 Security Regulations for Healthcare

Comparing the top 5 security regulations for healthcareThe healthcare industry has been the target of countless hacking attempts despite adopting security protocols outlined in the Health Insurance Portability and Accountability Act (HIPAA) since 1996. Hackers have found innovative ways to create a data breach, leverage the high value of Protected Health Information (PHI) and create severe disruptions in the healthcare ecosystem. Over the last two decades, they have benefitted from loopholes in the IT architecture of healthcare organizations and the lack of security awareness training imparted to healthcare employees. Even today, it is not uncommon to hear about the next big data breach in a reputed chain of hospitals, diagnostic centers, or healthcare insurance companies, despite the growing advancements in security software, firewalls, and numerous methods to prevent a cyber attack. However, the truth about hacking attempts that failed is unknown. 

There are many security regulations with benchmarks that make healthcare organizations consistently vigilant, including HIPAA. These contribute to the hidden success stories of failed hacking attempts and secure patient data. One such initiative is by the Office for Civil Rights (OCR), which enforces HIPAA compliance and shares regular updates about the dynamic nature of cyber threats to ensure the healthcare ecosystem is able to take preventive action. 

Customers, vendors, regulatory bodies, and shareholders associated with the healthcare ecosystem have made a series of demands about compliance, regular attestation, and at times, certification. We have identified the top 5 security regulations in the healthcare ecosystem which are being considered by organizations and would like to share their differences regarding validity, impact of violations, cost, number of controls, etc. for your benefit.

HIPAA: HIPAA is a set of mandatory standards to manage the use and disclosure of patient data or Protected Health Information (PHI). HIPAA compliance is mandatory for all Healthcare Providers, Business Associates (Vendors of Healthcare Providers), Healthcare SaaS companies, subcontractors, and any organization that directly or indirectly works with PHI. HIPAA has been amended to include additional rules that expand its scope and applicability and help the healthcare ecosystem prevent cyber attacks. The Office for Civil Rights (OCRenforces HIPAA, while the Department of Health and Human Services (HHS) regulates HIPAA compliance. The OCR regularly publishes recommendations on new issues affecting healthcare and investigates common HIPAA violations on a regular basis.

Organizations need to demonstrate HIPAA compliance by designing policies and procedures, conducting regular staff training, and ensuring their IT architecture and data privacy protocols are aligned with all HIPAA rules. They are also responsible for ensuring that their vendor contracts include mandatory HIPAA compliance protocols. HIPAA violations can lead to penalties, fines, and even jail time. 

While the healthcare industry has been aware of HIPAA rules, due to the sharp increase in cyber attacks, their customers, vendors, and shareholders have begun asking for proof of compliance with other security regulations. 

ISO 27001: ISO 27001 is a generic standard for information security developed and regulated by the International Organization for Standardization and is officially referred to as ‘ISO/IEC 27001’. It is part of the ISO/IEC 27000 family of standards for information security management. It is a very comprehensive set of controls covering the entire spectrum of information processing. ISO 27002 contains the implementation details and customization details of ISO 27001.

ISO 27001 is a triennial certification with annual surveillance audits. Organizations usually pursue this voluntary certification to become eligible for RFQs for B2B or B2G contracts owing to its extensive list of controls, which prove that they can secure customer data. The impact of a violation is severe since they stand to lose their reputation and revenue from contracts that were signed with the condition that they maintain their ISO 27001 certification. While healthcare customers have a moderate level of acceptance for ISO 27001 certification, it is being considered by larger organizations in addition to HIPAA.  

SOC 2: SOC 2 is a data privacy standard for compliance developed by the American Institute of CPAs (AICPA). It defines the criteria for managing customer data based on five ‘trust service principles’ – security, availability, processing integrity, confidentiality, and privacy. Organizations undergo a SOC 2 examination and receive a SOC 2 Report, commonly referred to as a SOC 2 Certificate. The SOC 2 Certificate only assesses the maturity of controls during the time of the SOC 2 Audit period. Organizations need to renew their certification at regular intervals to prove their continuous compliance.

SOC 2 is popular in the US and is considered by healthcare organizations since it is moderately challenging to implement. At databrackets, we have supported several healthcare SaaS companies to prepare for their SOC 2 examination and test their controls before their SOC 2 audit. In our experience, the commitment to data privacy it commands is rigorous, and the benefits far exceed the financial investment. 

NIST Security Guidelines: The NIST security guidelines are voluntary guidance based on existing standards, policies, and practices for organizations to better manage and reduce cybersecurity risks. NIST 800-53 and NIST Cybersecurity Framework (NIST CSF) are the leading security guidelines for managing and communicating cybersecurity posture amongst internal and external organizational stakeholders. While NIST guidelines do not lead to a certification by external authorized personnel, organizations use attestation to prove they comply with the specific NIST standard.

Regular maintenance and consistent vigilance are required to ensure you continue to comply with NIST CSF and NIST SP 800-53 rev 5. However, you don’t need to get re-assessed until a new version of the standard is published. Despite this flexibility, vendor contracts may require an attestation to a specific NIST Security Guideline because of the extensive controls which require substantial investment. 

HITRUST CSF: HITRUST is specifically developed for organizations in the Healthcare ecosystem that want to leverage other leading security standards along with HIPAA regulations. HITRUST created and maintains the Common Security Framework (CSF), a certifiable framework to help healthcare organizations and their providers demonstrate their security and compliance in a consistent and streamlined manner. Several organizations view HITRUST CSF as the ideal benchmark for the healthcare ecosystem, which needs security protocols beyond HIPAA. Though this annual certification may sound like a panacea, the financial investment in implementing its dynamic mix of controls from various security standards is not viable for many organizations.

Comparisons

Comparing Top 5 Security Regulations for Healthcare
HIPAA and HITECH
ISO 27001
SOC 2
NIST Security Guidelines
HITRUST CSF (Common Security Framework)
Description
HIPAA is mandated by the HHS and enforced by the OCR. HIPAA Compliance is mandatory for covered entities, business associates and subcontractors. Under the Act, there are 18 HIPAA identifiers or types of PHI that must be protected by all organizations that store, process and transmit it. HIPAA applies to the entire healthcare ecosystem.
ISO 27001 is a generic standard for information security developed by ISO. It is a very comprehensive set of controls covering the entire spectrum of information processing. ISO 27002 contains the implementation details and customization details of ISO 27001.
SOC 2 is a standard for compliance developed by the American Institute of CPAs (AICPA). It defines the criteria for managing customer data based on five ‘trust service principles’ – security, availability, processing integrity, confidentiality, and privacy.
The NIST security guidelines are voluntary guidance based on existing standards, policies, and practices for organizations to better manage and reduce cybersecurity risks. NIST 800-53 and NIST Cybersecurity Framework (NIST CSF) are the leading security guidelines for managing and communicating cybersecurity posture amongst internal and external organizational stakeholders.
HITRUST is specifically developed for organizations in the Healthcare ecosystem that want to leverage other leading security standards alongwith HIPAA regulations. HITRUST created and maintains the Common Security Framework (CSF), a certifiable framework to help healthcare organizations and their providers demonstrate their security and compliance in a consistent and streamlined manner.
Type of Data
PHI and ePHI – 18 HIPAA Identifiers
All processes included in the ISMS
Customer data
Depends on what is decided as the scope. It may be all the data that the organization works with.
PHI and ePHI
Controls based on
HIPAA Rules with emphasis on 3 safeguards – Physical, Technical & Administrative
ISO 27001 & ISO 27002 controls (140+ controls)
5 Trust Services Criteria (61 controls)
NIST CSF Version 2 (75+ controls) and NIST SP 800-53 revision 5 (390+ controls)
150+ controls
Certification / Assessment
Assessment
Certification
Certification / Examination
Assessment
Certification
Frequency / Validity
Annual
Triennial (once every 3 years) with annual surveillance audits
Annual
Maintenance is required to ensure you are continue to comply with NIST CSF / NIST SP 800-53 rev 5. You need to undergo a new assessment everytime a new version of the standard is published.
Annual
Cost of Implementation, Readiness Prep and Assessment / Certification
>= $25,000
$25,000 – $50,000
$25,000 – $50,000
>= $25,000
$50,000 – $200,000
Readiness Prep
Optional
Recommended
Recommended
Optional
Recommended
Mandatory / Voluntary
Mandatory
Voluntary
Voluntary
Voluntary
Voluntary
Reports are reviewed by
OCR/HHS
B2B, B2C or B2G customers / vendors
B2B, B2C or B2G customers / vendors
B2B, B2C or B2G customers / vendors
B2B, B2C or B2G customers / vendors
Level of Difficulty while implementing
Low
Moderate
Moderate
Moderate
High level of complexity
Impact of violation
Penalties, Fines, Jail time
Certification will be revoked. Loss of business if clients make it mandatory.
SOC 2 Report will be revoked. Loss of business if clients make it mandatory.
It is a voluntary compliance standard. Loss of business if clients make it mandatory.
Certification will be revoked. Loss of business if clients make it mandatory.
Acceptance Level by Clients
Mandatory / High Acceptance
Voluntary / Moderate Acceptance
Voluntary / High Acceptance
Voluntary / Moderate Acceptance
Voluntary / High Acceptance

* This comparison is based on our experience while supporting healthcare clients for over a decade.

** The cost is indicated in USD.

With over a decade of experience with healthcare clients, we have observed the benefits of complying with a security standard beyond HIPAA. While customer requirements, RFQs, and vendor contracts usually drive this choice, we recommend organizations review their cyber hygiene from the perspective of risks they want to be prepared for and business priorities while selecting the appropriate additional standard to manage them.

Partner with databrackets to secure patient data

The only way to defend everything you’ve worked so hard to create is to be protect your systems from security lapses. With over a decade of industry experience and technical excellence, a dedicated team at databrackets can help you protect your organization from threats and adapt to healthcare industry’s unique requirements.

Our certified experts have developed specialized Do-It-Yourself Assessments and we offer consulting and hybrid services for HIPAA, SOC 2, ISO 27001 and NIST. We conduct readiness prep assessments for SOC 2 and ISO 27001 as well. Contact us to know more about how our services can help your company.

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