What are insider threat indicators, and how can you avoid data leaks?
As a healthcare worker, you should support your organization’s cybersecurity framework. Storing patients’ protected health information (PHI) under lock and key is an excellent way to keep cybercriminals out. Still, the risk of experiencing a compliance violation or data leak is higher than ever.
Prominent insider threat indicators can help your practice maintain patient privacy. Whether you manage your patients’ medical data in a storage room or an electronic health record (EHR), addressing internal threats can save you from legal trouble.
What Is an Insider Threat?
Cyberattacks pose problems for the broader healthcare sector. In 2023, security experts reported a 37% increase in network breaches worldwide. These disasters compromised around 78 million datasets.
Many hospitals invest in digital safeguards to reinforce their systems against attacks. However, mitigating external threats is only one piece of the cybersecurity puzzle. Few healthcare workers take the time to protect their team against growing insider threats.
An insider threat is an authorized individual who compromises their organization by disclosing sensitive information. At-risk data can include medical records, passwords, and other personal data.
Insider threats have the potential to harm your healthcare company in several ways. Consider the following risks:
- Operational Capacity: Attacks from the inside can hinder operations and technology that contribute to patient care. These problems can result in delayed treatment and staff burnout.
- Overall Security: Inside attacks expose security gaps that others may seek to exploit.
- Digital Infrastructure: A data breach could compromise the entire digital infrastructure of your healthcare organization. Mitigation may require extensive help from your IT department or the total replacement of critical systems.
- Employee Privacy and Safety: Insider threats can expose sensitive information about you or your coworkers. These violations can end in devastating lawsuits, resignations, or financial setbacks.
- Patient Privacy and Safety: Patients who lose sensitive data from an insider attack may leave negative reviews on your website. These attacks could also lead to HIPAA violations that put your healthcare organization out of business.
Who Qualifies as an “Insider”?
Insiders qualify as anyone in your organization or anyone who works with your organization. Examples include:
- Front-desk workers
- Doctors, physicians, or licensed caretakers
- Health IT personnel
- Contractors who perform administrative or operational tasks
- Record management specialists
- Janitorial staff
- Equipment suppliers and technicians
- Finance specialists
- Executive-level employees
- Software and CRM providers
- Assistants
You may think insider attacks won’t affect your company because you trust your coworkers. However, you may want to rethink your optimism. Experts estimate that insider threats affect over a third of U.S. businesses.
Moreover, qualified business partners caused a quarter of these attacks in 2020.
Are you willing to risk your company’s reputation and ability to provide quality care? Let’s cover some fundamental insider threat indicators to identify dangers before they hurt your patients.
Types of Insider Threats
Cybersecurity experts categorize internal threats as intentional or unintentional.
Intentional Insider Threat Attacks
Bad actors can organize malicious attacks to cause harm to a healthcare provider for personal or symbolic reasons.
Suppose one of your coworkers is angry because they did not receive an expected bonus or promotion. Now, assume they “get even” with your practice by resigning after disclosing sensitive information that disrupts your operations. This attack is both intentional and malicious — intended to create immediate or lasting damage.
Intentional attacks may not be this overt. Some bad actors release PHI for days or weeks before security catches wind.
Intentional insider attacks are sometimes persistent. Stopping these threats at the first sign of trouble is vital to prevent far-reaching loss.
Unintentional Harm Caused by Insider Threats
What do you imagine when you read the word ‘cyberattack?’ You probably envision a hooded figure behind a computer screen accessing your organization’s most secure systems.
As it turns out, most insider attacks result from unintentional behavior and accidents during the record exchange process. Here are two accidental behaviors that may result in an insider threat:
Negligence
Careless actions may expose your healthcare organization to threats from the inside. Individuals who carry out these unintentional attacks may be well-versed in your security or IT policies but ignore them.
Suppose one of your coworkers allows an unauthorized assistant into the secure PHI storage area. Some cybersecurity experts refer to this negligent behavior as piggybacking. In these situations, piggybacking may allow insider threats to walk away with sensitive information that ends up in the public sphere.
Negligent insider threat indicators are easy to spot. Reinforcing the importance of your company’s security policies can discourage carelessness around PHI.
Accidental Misuse
As the saying goes, “accidents happen.” Still, accidental insider threats can cost your healthcare organization millions of dollars in recovery fees. Unintentional insider threats can be challenging to deter without the proper training and vigilance.
Let’s say that your coworker mistyped an email address during a patient PHI request. Disclosing private health charts to unauthorized users is a HIPAA violation that may compromise your organization’s reputation.
Remember, untrained individuals are more likely to click malicious email links and malware. These accidents can expose your entire digital infrastructure to harmful attacks.
Adequate training and confirmation modules can reduce your risk of experiencing an accidental insider attack.
Unique Types of Insider Threats
Some bad actors deliver insider threats using a combination of the above methods. Here are a couple of examples:
Collusion
Lone-wolf attacks on your organization can be harmful. However, collusive threats — or threats involving two or more insiders working together — can paralyze your operations.
Collusion is rare but can lead to fraud, espionage, or identity theft involving PHI. Sometimes, a bad actor may trick another employee into conducting an insider attack on their behalf.
For example, a coworker may try to convince you to click on a malicious link while knowing the risks. It’s best to contact your supervisor if you suspect that someone is trying to involve you in this behavior.
Third-Party Attacks
Third-party threats usually involve contractors or vendors who are not members of your healthcare organization. These individuals might have some degree of digital authorization in your EHR systems. In other words, they may have the means to conduct a harmful insider attack with little accountability.
Your healthcare organization should vet third-party contractors to ensure they comply with HIPAA guidelines. You should also monitor their actions to identify suspicious activities. Third-party insider theft can be direct or indirect, so keep your guard up.
Working with reputable record exchange vendors — like ChartRequest — is the best way to avoid insider attacks from bad actors. We prioritize HIPAA compliance, secure record exchange procedures, and real-time alerts. As a top-rated release of information provider, we guarantee maximum safety and transparency during every user interaction.
Motivations for Insider Attacks
You may wonder, “Why would my coworker even want to disclose patient data?”
The motivations for insider attacks vary from person to person. Review the following information to understand the reasons behind these attacks:
Hacktivism
Cybercriminals might attempt to breach your EHRs as a form of hacktivism.
Hacktivism refers to the use of malware or other intrusive methods to make a political or social statement.
Imagine a coworker doesn’t like your hospital’s donations toward a certain politician or program. In this case, they may take advantage of their insider position to create problems for your organization.
Internal and external sources can engage in hacktivism, making it difficult to stop without quality cybersecurity policies in place. You can counter insider hacktivist activity by promoting fair policies in the workplace. Your recruiters should also inform potential employees about the organization’s values before hiring them.
Workplace Harassment and Violence
Over 13% of healthcare workers reported workplace harassment in 2022. These numbers emphasize a growing problem in hospitals and clinics.
A coworker may become an insider threat by harassing or intimidating you. For instance, let’s say someone accesses your employee information via a healthcare network. They may try to blackmail you by holding personal data hostage.
In similar situations, bad actors can threaten to deploy an insider attack that could damage your coworkers’ reputation, safety, and privacy.
Your healthcare organization should adopt a zero-tolerance policy toward workplace harassment and violence. This method is an excellent way to reinforce compliance and protect your team.
Espionage
CISA defines espionage as the covert act of spying on an organization, entity, or government. Spies conduct espionage to leverage private information in future attacks. Take a look at how insider espionage can affect your healthcare facility when undetected:
1. Financial Espionage
An insider may attempt to steal the personal financial information of patients or staff to commit fraud. According to recent data, almost a third of Americans experience identity theft at some point in their lives.
Patients expect you to keep their PHI safe to prevent outside theft. Unfortunately, insider threats remain a serious concern for healthcare professionals. Limiting access to trustworthy individuals via access controls is a practical safeguard for EHR systems.
2. Personal Espionage
Some insiders may spy on patients’ medical information for personal gain. This problem might occur in tight-knit communities where healthcare employees may be neighbors with their patients.
3. Government Espionage
An insider may steal and sell personal data from an EHR to foreign governments. This act of criminal espionage can result in severe penalties, including prison time. Foreign governments can use PHI to gather intelligence on public health, operations, and technology.
Sabotage
Insiders may attempt to sabotage an organization for various reasons. Here are two methods of sabotage they might deploy for the most damage:
1. Physical Sabotage
Insiders may compromise computers, databases, or other operating systems to prevent adequate care coordination. Broken equipment often takes time to repair, preventing patients from getting the attention they need.
2. Virtual Sabotage
Virtual or digital sabotage may refer to cyberattacks, including:
- Ransomware
- Malware
- Phishing scams
- DNS tunneling
- Password exploitation
- SQL injections
Secure platforms like ChartRequest can help protect your patients’ data.
Why Are Insider Threats a Serious Problem for Healthcare Organizations?
Your facility may rely on complex, interconnected systems — prime targets for attacks. Human errors and malicious intent can lead to significant data breaches despite stringent regulations.
Here are a few factors to consider when assessing insider threat indicators in your organization:
- High-Value Data: Patient medical records contain sensitive information that an insider may try to sell on the black market.
- Multiple Access Points: Many individuals within your company have access to patient data.
- Lack of Training: Your coworkers might lack adequate training for cybersecurity best practices.
- Insufficient Oversight: Malicious actions by insiders may succeed without robust internal security measures and regular audits.
- Rapid Digitalization: Fast-paced digitization in healthcare increases your dependency on EHR and telemedicine platforms, creating more opportunities for breaches.
Examples of Insider Threats in Healthcare
Here are some real examples of insider threats in the healthcare sector:
Stradis Healthcare Hack
In March 2020, Stradis Healthcare furloughed Christopher Dobbins during a round of layoffs. After hearing the news, he created a secret account to access the company’s critical shipping information and deleted several entries. This attack delayed the shipments of vital personal protective equipment.
Texas Hospital Breach
One Texas hospital fell victim to an insider named Jesse McGraw after he created a botnet using the facility’s network. He filmed himself infiltrating the hospital network and posted the video on YouTube, exposing his crime. His data breach compromised dozens of medical machines, including nursing stations with critical patient records.
He also hacked the hospital’s HVAC unit, which could have damaged drugs and affected vulnerable patients during a hot summer day. After pleading guilty to the attack, McGraw received a nine-year prison sentence and thousands of dollars in fines.
Pharmaceutical Espionage
A reputable U.S. pharmaceutical company launched an investigation after an insider illicitly downloaded over 12,000 records on a company system. The individual resigned from their position and began working with a competitor shortly after, signaling their motivation for the theft.
Top Insider Threat Indicators
Identifying common insider threat indicators shouldn’t be confusing. Here are five behaviors that may suggest someone in your organization is attempting an attack:
1. Frequent Unauthorized Access Attempts
Employees trying to access data or systems beyond their privilege is a major red flag. It can indicate a malicious intent to gather private information. A coworker might attempt to gain unauthorized access to high-value systems or snoop on data they have no business viewing.
If the wrong person uncovers this intrusion, they could file a complaint with the Department of Health and Human Services. This alert could land healthcare organizations in hot water with HIPAA.
Don’t ignore bad behavior. Deploy systems to notify staff about frequent access attempts.
Sometimes, frequent attempts may indicate that someone simply forgot a password.
2. Unusual Working Hours
If your coworker frequently logs into systems outside regular working hours, it may indicate a potential insider threat.
This action could be an attempt to perform unauthorized activities at a time when security systems are less likely to observe and flag them. However, it’s also important to consider changes in coworkers’ work patterns or lifestyles that might explain these unusual hours before jumping to conclusions.
3. Sudden Change in Digital Habits
A sudden surge in data downloads or unusual email activity, especially involving large files or sensitive information, suggests an insider threat. This activity might mean someone is collecting data for unsanctioned reasons, such as selling it to a third party, using it for personal gain, or taking it to a new employer.
Your organization should have systems to monitor and limit data transfers. Flagging any unusual activity can help during investigations.
4. Negative Workplace Behavior
Sudden employee behavior changes, such as increased conflicts with colleagues and lower productivity, are strong insider threat indicators. These changes suggest that your coworker is upset and may retaliate against the organization. Retaliation can take many forms, from minor sabotage to severe data security breaches.
Your managers and HR department must intervene to avoid potential harm to your organization.
5. Violations of Security Policies
Repeated violations of an organization’s security policies can be another indicator of a potential insider threat. This problem could take the form of:
- Sharing passwords
- Turning off security software
- Using unauthorized software
- Bypassing security protocols
These actions can expose the network to potential external attacks. It may also indicate that the person is trying to conceal their activities from security systems or colleagues. It’s crucial to enforce decisive security policies and deal with violations as soon as they occur.
What To Do if You Suspect an Insider Attack on Your PHI
It’s paramount to act if you suspect that an insider attack compromised your patients’ PHI.
Your first step should be reporting the issue to your organization’s information security officer or administrator. They should have the resources to start an investigation and take appropriate countermeasures. Methods could involve restricting access to specific systems, changing access credentials, or monitoring suspected individuals.
Next, your organization should audit its EHR and user activity to identify any abnormal behavior. Advanced analytics and User and Entity Behavior Analytics (UEBA) systems are beneficial for detecting patterns in high-volume data generated within healthcare systems. Depending on the audit results, involving law enforcement or other external authorities may be necessary.
Implementing a recovery plan to mitigate the damage and prevent future insider attacks is essential. This strategy could include strengthening security protocols or implementing more robust data monitoring tools.
Communication is key to your recovery plan. Your entire team should know established security policies and the potential consequences of violations.
How To Prevent Insider Attacks in Your Healthcare Facility
Insider threats may breed paranoia in your workplace. Fortunately, you can deploy best security practices to prevent attacks in the future. Here are some proven measures your facility can take to reduce risk:
Implement Strict Access Control Measures
Strict access control measures are effective at preventing insider attacks. Limit access to sensitive information to employees who require it to perform their duties. Your organization should apply the principle of least privilege (PoLP), granting employees the minimum access necessary to complete their work.
This method reduces the risk of accidental data exposure and limits the potential damage from a malicious insider.
Consider implementing role-based access control (RBAC). RBAC assigns network access based on specific organizational roles. Regular audits of access privileges guarantee these rights stay up-to-date as roles change within your organization.
Provide Regular Cybersecurity Training
Many insider threats stem from a lack of cybersecurity prowess. Regular training sessions can help your team understand the importance of cybersecurity, equip them with the knowledge to identify potential threats and teach them how to handle sensitive data securely.
Training should be comprehensive, covering various topics such as:
- Phishing prevention
- Password management
- Safe internet use
- Conflict de-escalation
- EHR and physical record storage
You should train on cybersecurity best practices, including how to report suspected incidents.
Establish a Security Culture
Establishing a strong security culture is vital in preventing insider attacks. Your organization’s leadership should demonstrate a commitment to security by prioritizing it at all levels. You play a crucial role in maintaining your organization’s security and must understand the potential impact of your actions.
A security culture will encourage your team to stay vigilant and report any suspicious activities. This strategy involves regular communication about database status, celebrating good security practices, and taking swift action when breaches occur.
Use Advanced Security Technology
Advanced electronic exchange technology can streamline secure record transfers and prevent insider attacks. Don’t forget to monitor network activity for abnormal login time or large data transfers. Intrusion detection systems (IDS) or intrusion prevention systems (IPS) can also detect and block malicious activities on other healthcare systems.
Artificial intelligence (AI) advancements improve many workflows in the healthcare sector. LLM models learn standard user behavior patterns and alert security teams when they detect activities that indicate an insider threat. Automated solutions are best for freeing up your team and monitoring problems within your organization.
Create an Incident Response Plan
An incident response plan is a step-by-step guide that outlines the actions to take during a security incident. This plan should define roles and responsibilities, outline communication strategies, and detail how to resolve incidents.
Your staff should test incident response plans and drills, updating them when necessary. You should also learn what to do and who to contact if you suspect an insider threat.
Implement Two-Factor Authentication (2FA)
Two-factor authentication (2FA) adds a layer of security to the standard username and password credentials. It requires you to provide two distinct forms of identification before accessing sensitive data. Identification could be a physical token, a biometric verification, or a unique one-time password.
2FA makes it difficult for insiders to gain unauthorized access to systems or data, even if they have obtained someone else’s login credentials. It’s particularly beneficial in healthcare settings, where patient data needs robust protection.
Monitor Employee Behavior
Nearly half of all healthcare employees experience burnout at some point in their careers.
Keeping an eye on the happiness of your coworkers can help you detect potential insider threats. Look out for the insider threat indicators mentioned in the sections above and report incidents of concern.
This strategy is not about invading coworker privacy but safeguarding PHI in your organization. Your vigilance should be ethical and transparent. Remember, a disgruntled coworker can pose a significant risk to your security.
Enforce Strict Sanctions for Policy Violations
It’s wise to enforce strict sanctions for violations of security policies. Staff are likely to adhere to the rules if they know that non-compliance has serious consequences.
These sanctions could include:
- Initial warnings
- Retraining
- Temporary suspensions
- Termination
The key is to maintain a balance. While enforcing security measures is crucial, fostering a supportive work environment is also important.
ChartRequest Eliminates Your Risk of Experiencing an Insider Attack
Beat insider threats by educating yourself on modern solutions for success. At ChartRequest, our staff can handle all your record exchange requests without compromising sensitive PHI.
Hundreds of healthcare companies trust us for our five-star service and quick turnaround times.
Our encrypted platform ensures that your information release process goes according to plan. No matter how big or small your organization is, we deliver outstanding results during every interaction.
Don’t let insider threat indicators slip past your team — partner with ChartRequest to secure your release of information.
