News in the last few days of a large cyber-attack, in the form of "WannaCry" ransomware affecting many sectors including the NHS in the UK, has caused alarm around the world. In this article, we take a look at why the healthcare industry is a particular target for cyber-attacks and how that industry can prepare for the seemingly inevitable rise in cyber and data breach incidents globally and across the Middle East.
Why are healthcare institutions in the Middle-East particularly prone to data breaches and cyber-incidents?
Data from healthcare institutions is particularly valuable because it contains sensitive personal information, such as social security numbers, date of birth, address details and medical histories.
That data could in theory be sold to companies looking to carry out targeted advertising. However, in more worrying cases, the information obtained is held for ransom (usually by locking data and threatening to delete it) and a demand for payment (usually in untraceable bitcoins) is made. Interestingly, the amount of ransom sought is usually low in value as the success of this crime only works if the victim can afford to make the payment.
As well as the data being particularly valuable due to its sensitivity, there has, in the last couple of years been a drive by the governments in the region, especially in the UAE and Qatar to store all patient records digitally.
There are several ongoing projects at hospitals across the UAE seeking to fully digitise their records. Digitisation of patient records is a clinical risk management strategy; which enables doctors to access electronical patient records and be aware of their full medical history when treating them. Digitisation of records can also improve the flow of knowledge and information across hospitals and clinics so that medical histories can be accessed in multiple locations and medication can be cross-referred.
In April 2017, Salama, a new central database was launched by the Dubai Health Authority (the DHA), which unified all the medical records of five healthcare facilities in Dubai for doctors and patients to access. In April, the DHA announced that 1.4 million records had so far been placed onto that system. As part of a planned digital revolution in the UAE, the DHA aims for the healthcare sector in Dubai to be fully digitised within the next few years.
There are great benefits to the digitisation of healthcare institutions, both from an efficiency perspective and a risk management perspective. However, digitisation can lead to an increased risk of data breaches and cyber-crimes occurring.
What can the healthcare industry in the Middle East do to protect itself?
When implementing a new digital system, healthcare institutions need to be aware of the laws and regulations in place which relate to storing and protecting data.
Of particular note is the new Data Protection legislation which was passed in 2016 in Qatar and is shortly due to become effective. This sets out specific requirements on companies, such as maintaining logs and notifying regulators if there are any data breaches. We expect similar legislation to be passed across the region in the near future.
New legislation is also due to be passed in Europe in May 2018, which will have an extra-territorial impact and could apply to companies in the Middle East, including an obligation to notify regulators in the EU within 72 hours of a data breach occurring.
In light of the cyber-attack against the NHS, healthcare institutions in the Middle East need to be fully aware of the risks that they face.
Healthcare institutions should carry out a risk assessment of the systems that they have in place, as well as making sure they have full visibility over who can access sensitive data. Proper consideration should be given to whether that access can be controlled and restricted as appropriate. Systems need to be updated and properly maintained, with all updates and patches installed at all times.
Proper processes should be put into place to report data and cyber breaches, as well as updating employee codes of conflict to reflect best practices with the increased digitisation of sensitive information.
Other mitigation steps could be implemented such as the purchase of cyber insurance and lining up a law firm, forensic IT company, and public relations specialists as part of an incident response plan.
Worldwide experience
The healthcare sector has always been a sector prone to data breaches and is a key target of cyber-crime. Whilst most of the focus has been on the US in the past (which has had laws in place in the US since 2002 which require businesses to notify breaches to their regulators and to their customers/ patients), it is clear that cyber incidents and data breaches are not taking place only in the US, but are a worldwide threat.
A report by Accenture in 2015 predicted that cyber-attacks would cost US health institutions US$ 305 billion in revenue and that roughly 25 million patients would have personal information stolen within the next 5 years. In fact, some of the largest worldwide data breaches have related to healthcare institutions, including a breach in Arizona in 2016 where the records of 3.7 million patients were compromised.
The US compulsory breach notification requirement has meant that businesses cannot keep breaches secret due to a fear of adverse publicity or claims arising against them. By making business notify those breaches, the US authorities been able to compile statistics and monitor the changes that are taking place in the cyber-crime world.
Summary
The recent cyber-attack on the NHS reinforces the risks faced by healthcare institutions, particulars where the sector is undergoing rapid digitalisation, which includes emerging economies across the GCC and wider Middle East.
In addition to being aware of the risks that institutions, it is important that risk management strategies are put into place and that healthcare institutions have an incident response plan ready to deal with any attacks.
The Threat Of Cyber-Attacks And Data Breaches On Healthcare Institutions
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