Firewalls and medical devices are extremely vulnerable, and everyone’s pointing fingers
In the fall of 2013, Billy Rios flew from his home in California to Rochester, Minn., for an assignment at the Mayo Clinic, the largest integrated nonprofit medical group practice in the world. Rios is a “white hat” hacker, which means customers hire him to break into their own computers. His roster of clients has included the Pentagon, major defense contractors, Microsoft, Google, and some others he can’t talk about.
He’s tinkered with weapons systems, with aircraft components, and even with the electrical grid, hacking into the largest public utility district in Washington state to show officials how they might improve public safety. The Mayo Clinic job, in comparison, seemed pretty tame. He assumed he was going on a routine bug hunt, a week of solo work in clean and quiet rooms.
But when he showed up, he was surprised to find himself in a conference room full of familiar faces. The Mayo Clinic had assembled an all-star team of about a dozen computer jocks, investigators from some of the biggest cybersecurity firms in the country, as well as the kind of hackers who draw crowds at conferences such as Black Hat and Def Con. The researchers split into teams, and hospital officials presented them with about 40 different medical devices. Do your worst, the researchers were instructed. Hack whatever you can.
“Every day, it was like every device on the menu got crushed,” Rios says. “It was all bad. Really, really bad.”
Last fall analysts with TrapX Security, a firm based in San Mateo, Calif., began installing software in more than 60 hospitals to trace medical device hacks. TrapX created virtual replicas of specific medical devices and installed them as though they were online and running. To a hacker, the operating system of a fake CT scan device planted by TrapX would appear no different than the real thing. But unlike the real machines, the fake devices allowed TrapX to monitor the movements of the hackers across the hospital network. After six months, TrapX concluded that all of the hospitals contained medical devices that had been infected by malware.
“Someone is going to take it to the next level. They always do,” says Rios. “The second someone tries to do this, they’ll be able to do it. The only barrier is the goodwill of a stranger.”
In several cases, the hackers “spear phished” hospital staffers, luring them into opening e-mails that appeared to come from senders they knew, which infected hospital computers when they fell for the bait. In one case, hackers penetrated the computer at a nurses’ station, and from there the malware spread throughout the network, eventually slipping into radiological machines, blood gas analyzers, and other devices. Many of the machines ran on cheap, antiquated operating systems, such as Windows XP and even Windows 2000. The hospital’s antivirus protections quickly scrubbed the computer at the nurses’ station, but the medical devices weren’t so well guarded.