Let's begin with a thought-provoking question: among a credit card number, a social security number, and an Electronic Health Record (EHR), which commands the highest price on a dark web forum?

Surprisingly, it's the EHR, and the difference is stark: according to a study, EHRs can sell for up to $1,000 each, compared to a mere $5 for a credit card number and $1 for a social security number. The reason is simple: while a credit card can be canceled, your personal data can't.

This significant value disparity underscores why the healthcare industry remains a prime target for cybercriminals. The sector's rich repository of sensitive data presents a lucrative opportunity for profit-driven attackers. For 12 years running, healthcare has faced the highest average costs per breach compared to any other sector. Exceeding an average of $10 million per breach, it surpasses even the financial sector, which incurs an average cost of around $6 million.

The severity of this issue is further illustrated by a more than threefold increase in reported "hacking or IT incidents" to the US Department of Health & Human Services (HSS) from 2018 to 2022.

Number of breaches reported to the US Department of Health & Human Services (HHS) as per law. A hacking or IT incident is a type of breach that involves a technical intrusion. Source: HHS Breach Portal

The primary adversary in this scenario is a well-known threat: ransomware. This form of cyberattack has increasingly targeted the healthcare sector, exploiting the critical nature of patient care to exert pressure. Ransomware cartels find the healthcare industry an ideal target due to several factors:

Innovations in medical technology, including diagnostic tools, telemedicine, wearable health devices, and digital imaging, have led to an increased reliance on digital systems.

• High Digitalization: The healthcare sector is driven by innovation, with many third parties manipulating very sensitive data like EHRs.
• Resource Constraints: Many healthcare organizations suffer from understaffing and a lack of cybersecurity expertise, leaving their (often legacy) IT environments vulnerable to attacks.
• High Stakes: The imperative to maintain patient care creates strong incentives for healthcare organizations to pay ransoms, making them attractive targets.

Despite these challenges, the situation isn't entirely dire. A key strategy for protecting sensitive data involves adopting the mindset of an attacker.This approach sheds light on the cost-benefit calculus of potential attackers, identifying which assets they might target and their likely methods of attack.

An important realization in this context is that the nature of threats hasn't necessarily become more sophisticated; rather, the attack surface – the range of potential points of vulnerability – has expanded. By focusing on asset inventory and monitoring the attack surface, organizations can gain a strategic advantage. Viewing their own systems from the attacker's perspective enables them to anticipate and counteract potential threats, effectively turning the tables on the attackers.

How ransomware work

The stereotypical image of hackers as solitary figures conducting multi-million dollar cyber heists clad in black hoodies is largely a myth. Today's cybercrime landscape is much more sophisticated, resembling an industry with its own sectors and specializations. This evolution has been facilitated by anonymous networks and digital currencies, which have transformed ransomware into a commodified business.

Cybercrime has indeed become more organized, yet the fundamental tactics remain largely unchanged. The primary strategy still involves exploiting human errors and capitalizing on "low-hanging" vulnerabilities within the vast software ecosystem.

A key insight into the mindset of cybercriminals is recognizing that they operate as businesses. They invariably opt for the most cost-effective and straightforward methods to achieve their goals. This includes specialization in areas like gaining initial access to IT environments, which is then sold to other criminal entities like gangs, affiliates, nation-states, or even other Initial Access Brokers (IABs).

Ironically, hacking web applications might seem almost outdated compared to the simpler strategy of exploiting publicly accessible data for profit. A poignant example is the breach of 23andMe clients' genetic records. This breach was not a result of direct hacking; rather, the attacker used credentials leaked from other sites, accessed the data, and then monetized it on the dark web.

The source of such exploitable data is often surprisingly simple. Sensitive information, including API keys, tokens, and other developer credentials ("secrets"), is frequently left exposed on platforms like GitHub. These credentials are particularly valuable as they provide direct access to lucrative data, making them a prime target for cybercriminals seeking easy profits.

Why catching secrets before they do could be your lifesaver

In 2022, a staggering 10 million secrets were found leaked on GitHub, as reported by the security firm GitGuardian. This represents a 67% increase from the previous year, indicating that roughly one in every ten code authors exposed secrets during this period.

This sharp increase can be attributed to the pervasive nature of secrets in modern software supply chains. These secrets, which are essential for connecting various IT components such as cloud services, web apps, and IoT devices, are also prone to escaping oversight and becoming significant security risks. Cybercriminals are keenly aware of the value of these leaked secrets, as they can provide access to internal IT systems or even direct entry to terabytes of unprotected data.

The recent disclosure by Becton Dickinson (BD) of seven vulnerabilities in their FACSChorus software, as reported by the HIPAA Journal, is a stark reminder of the ongoing application security challenges in the healthcare sector. One notable vulnerability, CVE-2023-29064, involved a hardcoded secret in plaintext that could potentially grant administrative privileges to unauthorized users.

To defend against such vulnerabilities, it's essential for organizations to adopt a stance of continuous vigilance. Automatically monitoring your organization's presence on platforms like GitHub is critical to prevent surprises from exposed secrets. It's equally important to have a dedicated team conducting thorough research to identify any exposed assets, misconfigured data storage, or hardcoded credentials within your digital infrastructure.

Taking proactive measures is key, and one practical step is to consider a free complimentary GitHub attack surface audit provided by GitGuardian. Such an audit can offer valuable insights, including an evaluation of the organization's digital footprint on GitHub. It can highlight the number of active developers using professional emails, the extent of potential leaks linked to the organization, and identify the ones that could be exploited by malicious actors.

Moreover, to further strengthen your cybersecurity posture, integrating honeytokens into your security strategy is advisable. Honeytokens serve as decoys that can lure and detect unauthorized access, significantly reducing the Mean Time to Detection (MTTD) of breaches. This approach adds an additional layer of security, helping to contain the reach of potential attackers and mitigate the impact of a breach.

Wrap up

The healthcare industry, holding a treasure trove of valuable data, finds itself at a pivotal point in its fight against cyber threats. This sector, harassed by cybercriminals, has endured the highest average costs due to breaches for over a decade. The prominent threat comes from ransomware groups, which have evolved into sophisticated, business-like operations. To counter these dangers, healthcare organizations need to engage in vigilant, proactive strategies. Key among these is the regular monitoring of digital footprints on platforms like GitHub and conducting thorough research to identify and safeguard against exposed assets. This approach is vital to protect patient data and privacy. Utilizing services like the free GitHub attack surface audit can provide invaluable insights into potential vulnerabilities.

As technology continues to evolve, the nature of cybersecurity threats will inevitably progress. It's imperative for the healthcare industry to stay ahead of these challenges. This includes not only implementing the latest security technologies but also fostering a culture of security awareness among all staff members.

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