Health

Reality Check (Up): How Cybercrimes Threaten the Future of Healthcare in Growth Economies

7 February, 2019
  • Sophia Van

    Digital Product Strategy Manager, Mercer, Singapore

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“By the end of 2020, about four billion people will be connected via the Internet of Medical Things (IoMT).”

Health is the new wealth. Our physical and mental well-being impacts every aspect of our lives—including our ability to be loving parents, supportive friends and successful professionals. Information about our health is profoundly personal. No one beyond our trusted medical caregivers should have access to our most private details. The sensitive nature of our medical records, however, makes them a coveted target for sophisticated cybercriminals. Growth economies are particularly vulnerable.

Cybercriminals target healthcare for two fundamental reasons: the healthcare industry is a rich source of valuable personal data that commands a high dollar value on the black market, and the healthcare industry’s existing technologies and processes are fraught with vulnerabilities. The exponential growth of personal health data is being generated from an increasing number of connected devices and networks. By the end of 2020, about four billion people will be connected via the Internet of Medical Things (IoMT). According to the INFOSEC Institute, more than 70 percent of IoMT devices lack fundamental security safeguards as applications primarily focus on the features of the software rather than the security of the data. IoMT, therefore, presents cybersecurity experts with unprecedented challenges that require the collaboration of many different stakeholders and care providers within healthcare ecosystems.

This is a growing war. Cyberattacks are increasing in terms of number, scale and level of sophistication. A recent CBI Insights report reveals that, “Since 2017, roughly six billion confidential digital records have been stolen from around the world and counting. Just in the last two years there have been at least three separate data breaches in which at least one billion confidential records were stolen or exposed at once.”1

 

From a single laptop in a rural village to elite teams of experts sponsored by nefarious governments, cybercriminals can operate from any location with an Internet connection, and they are targeting healthcare organizations in growth economies that have not implemented modern, sophisticated defense systems.

Healthcare communities, cybersecurity professionals and governments must acknowledge these five stark realities as they seek ways to combat the persistent and ubiquitous threat of cyberhackers.

1. Healthcare has a target on its back.
 

The three main targets of cybercriminals are electronic health records, healthcare infrastructure and individual medical records. Sensitive information has become a very powerful commodity in modern society. Just as gold, diamonds and printed money have attracted thieves for centuries, information has become one of earth’s most valuable assets. The more sensitive, damaging or revealing the information is, the more value it possesses. Details about how healthy, or unhealthy, individuals and groups are can be ransomed for astronomical prices.

 

 

In July 2018, ransomware targeted SingHealth, Singapore’s largest healthcare institution, and stole the information of 1.5 million patients, including the profile of the country’s Prime Minister, Lee Hsien Loong—who was identified as a specific target in the attack. These types of ransomware attacks are constantly being perpetrated against healthcare facilities as they struggle to implement comprehensive defense strategies. This trend will only escalate as cybercriminals and healthcare institutions attempt to outsmart and outmaneuver each other as bank robbers and banks have done throughout history.2

2. Hacks can mean life or death.
 

One of the most concerning current threats to health information privacy is a serious compromise of the integrity and availability of data. Those risks include possible harm to a patient’s safety and health, loss of protected health information (PHI) and unauthorized access to data. In fact, in 2013 The Washington Post reported that the doctors for Vice President Dick Cheney ordered the disabling of the wireless functionality of his heart implant out of fear that it could be hacked by terrorists.3

It’s arguable that cybercrimes in the healthcare industry can have much more drastic consequences to brand equity for institutions than major financial losses. The fear of not being able to access one’s critical health information is a legitimate, and intense, sense of unease. This anxiety is partially what gives the information its value and power. Data security breaches can directly impact the health and well-being of patients, and even result in fatalities. Destroying medical records and hijacking critical pharmaceutical prescriptions can quickly result in casualties and cause death. By stealing information and manipulating public fear, cybercriminals can leverage their stolen assets in unprecedented ways. The reality is these crimes have life-threatening consequences and can be perpetrated from across the world in the middle of the night.

3. Breaches are inevitable and may be internal.
 

The potential monetary gains for cyberhackers are enormous. Unsurprisingly, more than 70 percent of healthcare industry companies expect a breach from financially-motivated cybercriminals. However, the pervasive image of a lone cyberhacker working from a dark apartment in an anonymous city, or nefarious state-sponsored groups of squinting cyberthieves lined up in rows of bland cubicles, only represents part of the story. Internal employees also pose a great threat to healthcare institutions. Every employee is a human being, and whether or not they are disgruntled, financially distraught or simply unaware of how their behaviors can impact security protocols, there is the potential for corruption. Having the right security clearances, passwords and access to sensitive information may simply be too tempting for internal employees with an ulterior motive. 

4. Robust security measures are needed.
 

The cat-and-mouse chase and confrontations will continue to evolve as cyberhackers continuously seek new ways to penetrate the defenses of healthcare institutions and stakeholders within the healthcare systems—including the manufacturers of connected medical devices. Today’s international and tech-savvy criminals are determined, sophisticated and creative. Healthcare institutions must be even more so. Though the growing awareness of cybersecurity threats have shaken the entire industry, many companies in growth economies have not set up and executed a holistic security framework that provides comprehensive governance and board oversight. Security measures lack an integrated approach that leverages the talents and acumen of not only healthcare professionals, but cybersecurity forces and policymakers at every level of government.

The seamless integration of defense resources is required to combat cybercriminals who pose a dynamic and evolving threat. All stakeholders dealing with health data should shift from passive cyber defenses, to active cyber defenses. Cybersecurity for IoMT must also be a major agenda for next-generation medical devices. Governments and policymakers should provide security guidance and regulatory protocols for medical device manufacturers. The industry must quickly develop and adopt best-practices, frameworks and architectures for ensuring cybersecurity protections across all of IoMT. Hospitals and health systems need to secure medical devices in the same way that banks ensure the security of the credit cards they issue.

Growth economies must respond, and lead, with appropriate security measures and cybersecurity policies.

5. Healthcare can fight back.
 

Ransomware and cybercrimes can create unimaginable chaos. But businesses, communities and growth economies are not powerless. When working together, they can create a network of systems, assets and protocols that can thwart even the most tenacious hackers. Diligence is key. The healthcare industry must be proactive about preventing cyberattacks before they occur and be smart about responding to them and mitigating damage when they do occur. Though many healthcare institutions have begun to develop effective security strategies, few have implemented a complete plan that addresses preparation, prevention, detection, and response and recovery strategies. 

The healthcare industry and associated stakeholders must approach cybersecurity defense strategies with the same level of seriousness and strength that militaries apply to their own defense strategies. For instance, an effective and aggressive defense program would include the use of deception technologies that stop attacks by deceiving the attackers. Also, artificial intelligence (AI) can monitor traffic in and out of each connected device and differentiate between normal and abnormal behavior in real-time—alerting network security professionals when the device is listening to or talking to criminal networks, servers or individuals. AI can proactively block bad actors in real time before they can gain access and inflict damage. Winning cybersecurity strategies intercept and prevent attacks proactively; after all, once a device has been compromised and higher-level servers have been breached, the damage has been done. Lastly, the healthcare industry should consider other innovative defensive measures such as quantum computing, cybersecurity war rooms that provide around-the-clock security operations centers, and a holistic strategy that leverages not only technology but also human behavior and processes.

To learn more about how cybercriminals are holding healthcare institutions hostage, and what the industry can do to protect itself, read this whitepaper.

 

1 Why Ai, Blockchain, & Enhanced Encryption Are The Future Of Enterprise Data Security
http://www.cbinsights.com/research/ai-blockchain-encryption-enterprise-data-security-expert-intelligence/
2 Singapore Suffers 'most Serious' Data Breach, Affecting 1.5m Healthcare Patients Including Prime Minister
Eileen Yu - https://www.zdnet.com/article/singapore-suffers-most-serious-data-breach-affecting-1-5m-healthcare-patients-including-prime/
3 Intermountain Healthcare Launches Security Operations Center To Combat Health Data Cyberattacks
https://www.modernhealthcare.com/article/20151114/MAGAZINE/311149977

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"Exclusive: An interview with Hilton's Jan van der Putten on expansion in Africa," Africa Outlook Magazine,7 Apr. 2019, https://www.africaoutlookmag.com/news/exclusive-an-interview-with-hiltons-jan-van-der-putten-on-expansion-in-africa. 6. "World Development Report 2019: The Changing Nature of Work," The World Bank Group, 2019, https://www.worldbank.org/en/publication/wdr2019. 7. Moyo, Simbarashe. "4 ways Africa can prepare its youth for the digital economy," World Economic Forum, 29 May 2019, https://www.weforum.org/agenda/2019/05/4-ways-africa-can-prepare-its-young-people-for-the-digital-economy/.

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Employers can, for example, extend the number of covered travel days to up to 1 year and significantly increase the number of potential benefits to include, such as the following: ·  Flat amounts are paid in the case of an accident and for surviving dependents. They are regarded as immediate aid for direct costs incurring and are intended to pre-empt the company accident insurance which offers higher benefits but also requires longer examination processes. ·  Liability insurance is necessary in certain countries as an obligatory requirement for obtaining a visa. ·  Compensation for loss of luggage and/or travel delays is an additional goodie for travelers. If these aspects are covered by insurance, any claims will be addressed directly to the insurance company — reducing the administration effort in your company. These additional benefits are tailored to the specific needs of business travelers and international project assignees. 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Employers need to identify and close gaps, either through local coverage or supplemental global risk coverage plans. Gaps also exist for so-called "global nomads," those assignees going on numerous consecutive assignments. Global nomads are facing benefits fragmentation at its worst, especially gaps in state and supplemental pension benefits due to not being enrolled in local plans or not reaching local vesting conditions. In addition, those employees typically do not have access to suitable long-term financing vehicles that allow for building up adequate private retirement savings with the flexibility to contribute from multiple locations. Companies with a larger global nomad population can use offshore International Pension Plan arrangements to close this gap. As the market has developed significantly over the last decade, streamlined products are available today also for smaller groups of assignees and with limited required administration. Conclusion   These are demanding and challenging times for mobility experts. The number of international project assignments is increasing and calls for special arrangements. However, these are also great times to demonstrate your expertise. To make things easier, look at what you already have: Some solutions are already available for internationally mobile employees in your company and can be used for international project assignments, as well. In the long run, mobility managers should focus on finding and implementing appropriate international project assignment solutions to ease the initial pain mainly caused by the additional workload. As is often true in global mobility, there is no-one-size-fits-all approach, but many options to tailor your (almost) perfect one. If you'd like to learn more, click here to get in touch with a Mercer consultant.  

Juliane Gruethner | 31 Oct 2019

International project assignments are one of the current hot topics in global mobility management. A quick poll in conjunction with our Expatriate Management Conference in 2018 showed that, in an increasing number of organizations, the mobility function is responsible for the administration of international project assignments. Nearly 90% of the responding mobility managers confirmed that their organizations have international project assignments, and 80% of respondents are responsible for their administration. With this trend, new challenges are emerging. Let's take a look. Challenge 1: Common Understanding of Terminology   There does not seem to be a common definition of an international project assignment. Mercer's poll showed that about 40% of the responding businesses define an international project assignment as simply an international assignment to a project, regardless of its duration, while 60% specified a period of time. Some organizations also differentiate between project assignments for an external client and internal projects. Apart from the lack of clear definitions, most businesses (73%) do not have any formal policy or regulations for their international project assignments. If they exist, they often overlap with those for traditional long- or short-term assignments. No matter how you approach international project assignments, make sure that your company has a precise definition and corresponding guidelines in place that allow for consistent handling and fair treatment of all internationally mobile employees. For this discussion, we define international project assignments as assignments to client projects abroad, whereas assignments to projects abroad within one organization are called international assignments. Challenge 2: Fair and Equal Treatment   Determining an individual compensation package for an international project assignment differs from traditional forms of international assignment compensation. Some employees may have been hired especially or exclusively for project work. Others are assigned to work on international projects based on short- or long-term assignments or commuter packages. Those differences can lead to inconsistencies in compensation between the assignees — depending on where they come from and how their project assignment is defined in the home country. Clear internal regulations differentiating target groups and assignment types increase the transparency of the mobility program and ultimately increase its acceptance among employees. Challenge 3: Determining the Return on Investment   In Mercer's 2017 Worldwide Survey of International Assignment Policies and Practices, the majority of respondents stated that a business case is required for an international assignment (62%) and that they prepare corresponding cost estimates (96%). However, only 43% track the actual costs against budgeted costs, and only 2% have defined how the return on investment (ROI) of an international assignment is quantified. It is often linked to a mid- to long-term perspective and not easily expressed in pure economic figures. That said, it is possible to track success by means of faster promotions or higher retention rates of expatriates. The ROI of international project assignments, in contrast, is easier to measure. Actual costs can be compared to the original estimate and the price paid by the client. This transparency leads to higher cost pressure, which calls for a greater flexibility with respect to the applicability of existing internal rules and regulations to be able to offer projects at a competitive price. In conclusion, the short-term business value (winning and conducting the project in a profitable manner) and the mid- to long-term value of international assignments (for example, filling a skills gap in the host location or employee development) have to be balanced diligently, which can be achieved by a thoroughly segmented international assignment policy. Challenge 4: Management of Large Numbers of International Project Assignments   Depending on the industry sector, the number of international project assignments in an organization can be extremely high. One of the respondents in the conference poll indicated that they handle about 23,000 international project assignments per year. Therefore, the resources needed in the mobility function will have to be increased or resources reallocated once mobility takes over the responsibility for international project assignments. You should also review the service delivery model, as well as individual procedures, and if necessary, adapt them to enhance the efficiency and effectiveness of the international project assignment administration. Using the right technology can also help streamline processes and make a large number of international project assignments manageable. Challenge 5: Deployment to Unknown Places   International project assignments take place not only in the company's regular assignment destinations but also in new locations at client sites. The company, therefore, may not have any resources in or knowledge about the location. Client resources or external vendors can be used to obtain necessary information or perform necessary services, such as immigration or payroll. In addition, if employees perform services in hardship locations, their safety and security need to be considered. Challenge 6: A Matter of Compliance   When it comes to international project assignments, mobility is regularly asked to deliver results even faster than for traditional international assignments, because requirements tend to come up or change at short notice. However, compliance is as complex as for any other international assignments and needs to be evaluated individually. This is true for external as well as internal compliance issues. Although compliance is regarded as one of the most important aspects by many mobility managers, we have seen that compliance is just the tip of the iceberg, and the list of challenges presented in this first part of the article is not exhaustive. We continue our considerations with the companies' duty of care and possible solutions in part 2  of this article. If you'd like to learn more, click here to get in touch with a Mercer consultant.

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