Cyberattacks in medical imaging can alter the outcomes of diagnostic and treatment process

The adoption of technology in the healthcare industry has accelerated over the last decade. Especially in the unprecedented and challenging times of the COVID 19 pandemic, technology has been a boon to the healthcare sector. With the help of technological advancements, visualising the anatomy of an organ is possible through medical imaging. Be it in identifying the deflation of lungs due to COVID 19 or accessing the damage done to an organ because of cancer; everything is possible with medical imaging. This new technique is helping the healthcare professionals to carry out the accurate diagnosis and planning out minimally invasive treatment.

Moreover, as medical imaging images can be stored in the cloud or software, multiple healthcare professionals can access the images simultaneously in complicated cases. But as the medicinal sector is proving to be technologically advanced, the sweltering conversation about the challenges and threats with technology is gaining momentum.

Due to the large amount of data generated in medical imaging, maintaining the cybersecurity network is becoming a challenge for healthcare professionals. According to a Global Threat Intelligence report conducted by Nippon Telegraph and Telephone Security in 2017, healthcare is among the top sectors flooded with ransomware and malware.

Though industry leaders and healthcare professionals have taken cognizance of this challenge, we will observe the top five ransomware and malware issues corrupting the cybersecurity in medical imaging.

Corrupted Storage media with Patient’s history

Also known as Malware infection, this type of cybersecurity threat manifests when the storage files or CD containing the patient’s data is corrupted. Once this media is plugged into a different system, the images are imported to the local PACS infrastructure of the hospital. The virus of the corrupted media infects the patient’s file. Once this file is opened into another system, the virus spreads to another system. The malware can then intercept the network traffic, identify login and passwords, and reveal the patient’s personal information to the attackers.

Updating the anti-virus programme is recognized as the best practice by experts to mitigate malware infection. Moreover, disabling the AutoRun feature of CD will ensure safe import. Healthcare organizations must also build up a firewall to vanquish the threat of malware and ransomware.

Cyberattacker Hacking the Hospital Network

Like, in any situation, this type of cyberattack is the most common and threatens a hospital network's cybersecurity. The cyber attacker can access the patient’s personal history, images, and demographic data; the attacker can also retrieve the important hospital documents, reports, and important information in an unauthorized manner, which they can potentially leverage to abuse the organization. This cyberattack can be thwarted by scaling up the security network infrastructure in a hospital. The cabled network ports should not be located in rooms that can be accessed by an unauthorized person easily. Moreover, by integrating wireless networks into the systems for secured configurations, establishing firewalls, and installing network segmentation, this cyberattack can be mitigated to a large extent.

Malware Embedded in Images and Reports

In this cyberattack, the inactive form of virus or malware is embedded in the patient’s images and reports. It only becomes activated when the radiologist retrieves and displays the document. The malware or the virus then spreads to the healthcare system's PACS infrastructure and corrupts relevant information of the patients. Moreover, this malware can overwrite the PACS archive, thus indicating a cyberattack. The best way to mitigate the transfer of inactivated virus into a PACS network is by testing the applications like X-rays and CT scanners, which reads these documents and images. Identifying the loophole at the initial stage will aid in thwarting the spread of the virus. Moreover, these applications should have limited users and sources by assigning a digital signature. By installing Blockchain technology into these applications, it will help analyze the data about the user through its open-source system and ensure that no malicious manipulation is conducted into the system.

Manipulation of Medical Images

Deepfakes! In real life, this threatens the identity of a person. In medical imaging, this corrupts the images and modifies the original image to place a small gateway computer into the software. Though the benefits of machine learning and artificial intelligence in healthcare have been regaled often, this particular algorithmic flaw is the drawback for medical imaging. By integrating the said small gateway software, the attackers can intercept, analyze and forward all images and messages to their advantage; they can start circulating false news, fake information, retrieve the logins and passwords, add lesion, remove the lesion, and can compromise the internal security of a healthcare organization. Since a healthcare set-up is a connected organization, one loophole can threaten the patient’s life. By securing the network plugins and configuring the network switch, the cyberattack can be mitigated.

Network Infiltration of Malicious HL7 messages

HL7 messages are commonly used to share patient’s information across the various departments of a hospital. They connect various systems simultaneously by automatically updating the patient’s information. However, as this message type doesn’t have any means to prevent manipulation, they become the easiest target of hackers and cyberattackers. By installing TLS with bi-directional certificate exchange, the passive interception of the HL7 traffic can be prevented, thus ensuring the infiltration of malicious messages. This will assist in thwarting the unusual patterns of messages and will secure the security network.

Outlook

Globally, Cyberattacks have been a major concern permeating all sectors. Deploying smart cybersecurity strategies and scaling up security network would help in mitigating the cyberattacks.