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Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

cs.dartmouth.edu

51–60 of 61 posts

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#51
post #35

Earlier quoted context omitted.

Only tangentially related but my wife used to work at a private institute research lab which was affiliated with a large university, and therefore used computing resources. The University IT security staff did a great job enabling 2FA across the entire network.. big job, well done. They didn’t do the slightest bit of requirements analysis of those people using the network such as affiliated research labs. One day my…

Great case in point. In a well run org, that would've been elevated to a "security incident" just the same as a hack, with their jobs potentially on the line, rather than a week of pleading to them to have mercy.

a company may very well consider this a “security incident” or other high-priority issue, but at least in my experience, the method of reporting something like this can be vague. While the right answer should be a place to submit a ticket, even internal systems nowadays seem to not let the users set the priority on tickets and instead let L1s try to resolve everything, who may not have the experience to recognize something needs to be elevated. At that point, it seems the only good option is to run the issue up the chain and back down through the right department (which is probably more effective, at the end of the day).

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#52

Earlier quoted context omitted.

"The moment they're under carrot-and-stick for not interfering with productivity, as well as preventing intrusions, you get more acceptable outcomes." Suggestions on how to do this?

Give the COO/CTO the last say, not the CISO. Usually it's the opposite, due to the asymmetry of a terrible unknown and claimed unquestionable remedies vs "it'll certainly slow us down to some degree". The person making the latter argument needs to have far more knowledge in areas outside their domain, and far better debate skills, to prevail. The person arguing the former need only say "hackers" in a solemn tone, to…

> Give the COO/CTO the last say, not the CISO.

The problem with this is that when the COO/CTO doesn't understand or respect the CISO or their job, you end up with easily-preventable security breaches.

There need to be places where security is paramount.

There need to be places where user access/experience is paramount.

There are no hard and fast rules as to where these are. Human judgement is required, however messy that ends up being.

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#53

I'm not in healthcare, but I've evaded annoying/inconvenient security crap. One method I used for evading VPNs and using SSH was to have an script running inside the protected network, making an active connection to a SSH server on my machine at home, and set up a tunnel. Then I could use remote desktop through the tunnel. I use the following TXR Lisp program to defeat screen timeouts on Windows: (typedef UINT uint)…

You are likely compromising your employer with this. This is a reverse connection trojan basically and have been around since 2000+. It's weird you haven't been caught yet.

I am not using that now. It was in the past.

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#54
post #34

I've spent a lot of time working as an academic in / out of hospitals. There's a big difference between an academic research centre (where you have, comparatively speaking, a lot of time to sit and think) and the "coal face" of clinical medicine (where the opposite is true). Literally every high-level doctor I have ever worked with: – Knows the passwords of their juniors and shares their password with them – Has a lo…

Imagine that your embarrassingly slow software literally costs people's health (and maybe even lives in the long run). But we will still pretend like everything is fine, because "the DEveLopEr eXPeRiEncE", and "jUsT buY beTTeR hArDWaRe". And sure, hospital issued PCs aren't fast, but if they are anything from past decades, they still have processors running billions operations per second. And such managing software i…

This is not only in healthcare. This is everywhere. Although computers are much faster, we need to wait for them more.

And although i run 2d programs 99,99 % of the time, developers optimize for 3d. Although they are not able to draw a 3d button, the whole screen is drawn on a surface.

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#55
post #23

All healthcare employees have badges they carry everywhere. Just get new ones with chips in them and an associated pin. Add the card scanner dongles for the computers. Access to rooms and supplies that don't need tight security is simply a card tap. Require the pin as well for more important stuff (computer login). Require a biometric as well for really important stuff. Make sure employees know they must report lost/…

You forgot the most important thing: make them work without failure. When an access system must communicate with the mothership and the mothership or network is down (hello Microsoft), you're doing it wrong.

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#56
post #2

Original paper was posted here 7 years ago and also go no interest: https://news.ycombinator.com/item?id=13332184

(well an hour after it was posted it was only at 3 votes and looked like it was going nowhere...)

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#57
post #51

Earlier quoted context omitted.

Great case in point. In a well run org, that would've been elevated to a "security incident" just the same as a hack, with their jobs potentially on the line, rather than a week of pleading to them to have mercy.

a company may very well consider this a “security incident” or other high-priority issue, but at least in my experience, the method of reporting something like this can be vague. While the right answer should be a place to submit a ticket, even internal systems nowadays seem to not let the users set the priority on tickets and instead let L1s try to resolve everything, who may not have the experience to recognize som…

Yeah she was on the L1 helpdesk ticket merry-go-round for a couple of days before I told her what she needed to say to them to have a security team member look at it

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#58
post #12

Earlier quoted context omitted.

I don’t have the source on hand, but during my clinical informatics rotation it was mentioned that many early EMR implementations actually increased drug errors

I wonder if that was a true rate change or a change in detection.

It was an increased rate of adverse effects due to drug mistakes, which is monitored and easily detected so unlikely due to just an increase in detection

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#59
post #35

Earlier quoted context omitted.

Only tangentially related but my wife used to work at a private institute research lab which was affiliated with a large university, and therefore used computing resources. The University IT security staff did a great job enabling 2FA across the entire network.. big job, well done. They didn’t do the slightest bit of requirements analysis of those people using the network such as affiliated research labs. One day my…

Great case in point. In a well run org, that would've been elevated to a "security incident" just the same as a hack, with their jobs potentially on the line, rather than a week of pleading to them to have mercy.

> with their jobs potentially on the line

That would be a bit much and not accomplish improvements.

Re: Workarounds to Computer Access in Healthcare: Password or a Dead Patient? (2015)

#60

Earlier quoted context omitted.

"The moment they're under carrot-and-stick for not interfering with productivity, as well as preventing intrusions, you get more acceptable outcomes." Suggestions on how to do this?

Give the COO/CTO the last say, not the CISO. Usually it's the opposite, due to the asymmetry of a terrible unknown and claimed unquestionable remedies vs "it'll certainly slow us down to some degree". The person making the latter argument needs to have far more knowledge in areas outside their domain, and far better debate skills, to prevail. The person arguing the former need only say "hackers" in a solemn tone, to…

We did that for years and got more breaches and vulnerabilities…
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