health information privacy and security

70
TMHG 529 Health Information Privacy & Security Nawanan TheeraAmpornpunt, M.D., Ph.D. Faculty of Medicine Ramathibodi Hospital Mahidol University December 16, 2014 http://www.SlideShare.net/Nawanan

Upload: nawanan-theera-ampornpunt

Post on 12-Jul-2015

785 views

Category:

Technology


2 download

TRANSCRIPT

Page 1: Health Information Privacy and Security

TMHG 529Health Information Privacy & SecurityNawanan Theera‐Ampornpunt, M.D., Ph.D.Faculty of Medicine Ramathibodi Hospital

Mahidol UniversityDecember 16, 2014

http://www.SlideShare.net/Nawanan

Page 2: Health Information Privacy and Security

Introduction to Information Privacy & Security Protecting Information Privacy & Security User Security Software Security Cryptography Malware Security Standards

Privacy & Security Laws will be in next topic

Outline

Page 3: Health Information Privacy and Security

Introduction to Information Privacy & 

Security

Page 4: Health Information Privacy and Security

Malware

Threats to Information Security

Page 5: Health Information Privacy and Security

Sources of the Threats Hackers Viruses & Malware Poorly‐designed systems Insiders (Employees) People’s ignorance & lack of knowledge Disasters & other incidents affecting information systems

Page 6: Health Information Privacy and Security

Information risks Unauthorized access & disclosure of confidential information Unauthorized addition, deletion, or modification of information

Operational risks System not functional (Denial of Service ‐ DoS) System wrongly operated

Personal risks Identity thefts Financial losses Disclosure of information that may affect employment or other personal aspects (e.g. health information)

Physical/psychological harms Organizational risks

Financial losses Damage to reputation & trust

Etc.

Consequences of Security Attacks

Page 7: Health Information Privacy and Security

Privacy: “The ability of an individual or group to seclude themselves or information about themselves and thereby reveal themselves selectively.” (Wikipedia)

Security: “The degree of protection to safeguard ... person against danger, damage, loss, and crime.” (Wikipedia)

Information Security: “Protecting information and information systems from unauthorized access, use, disclosure, disruption, modification, perusal, inspection, recording or destruction” (Wikipedia)

Privacy & Security

Page 8: Health Information Privacy and Security

Information Security

Confidentiality Integrity Availability

Page 9: Health Information Privacy and Security

Examples of Confidentiality Risks

http://usatoday30.usatoday.com/life/people/2007‐10‐10‐clooney_N.htm

Page 10: Health Information Privacy and Security

Examples of Integrity Risks

http://www.wired.com/threatlevel/2010/03/source‐code‐hacks/http://en.wikipedia.org/wiki/Operation_Aurora

“Operation Aurora”Alleged Targets: Google, Adobe, Juniper Networks, Yahoo!, Symantec, Northrop Grumman, Morgan Stanley, Dow ChemicalGoal: To gain access to and potentially modify source code repositories at high tech, security & defense contractor companies

Page 11: Health Information Privacy and Security

Examples of Integrity Risks

http://news.softpedia.com/news/700‐000‐InMotion‐Websites‐Hacked‐by‐TiGER‐M‐TE‐223607.shtml

Web Defacements

Page 12: Health Information Privacy and Security

Examples of Availability Risks

http://en.wikipedia.org/wiki/Blaster_worm

Viruses/worms that led to instability & system restart (e.g. Blaster worm)

Page 13: Health Information Privacy and Security

Examples of Availability Risks

http://en.wikipedia.org/wiki/Ariane_5_Flight_501

Ariane 5 Flight 501 Rocket Launch FailureCause: Software bug on rocket acceleration due to data conversion from a 64‐bit floating point number to a 16‐bit signed integer without proper checks, leading to arithmatic overflow

Page 14: Health Information Privacy and Security

Interesting Resources http://en.wikipedia.org/wiki/List_of_software_bugs http://en.wikipedia.org/wiki/Notable_computer_viruses_and_worms

http://en.wikipedia.org/wiki/Hacktivism http://en.wikipedia.org/wiki/Website_defacement http://en.wikipedia.org/wiki/Hacker_(computer_security) http://en.wikipedia.org/wiki/List_of_hackers

Page 15: Health Information Privacy and Security

Protecting Information Privacy & Security

Page 16: Health Information Privacy and Security

Attack An attempt to breach system security

Threat A scenario that can harm a system

Vulnerability The “hole” that is used in the attack

Common Security Terms

Page 17: Health Information Privacy and Security

Identify some possible means an attacker could use to conduct a security attack

Class Exercise

Page 18: Health Information Privacy and Security

Alice

Simplified Attack Scenarios

Server Bob

Eve/Mallory

Page 19: Health Information Privacy and Security

Alice

Simplified Attack Scenarios

Server Bob

‐ Physical access to client computer‐ Electronic access (password)‐ Tricking user into doing something (malware, phishing & social engineering)

Eve/Mallory

Page 20: Health Information Privacy and Security

Alice

Simplified Attack Scenarios

Server Bob

‐ Intercepting (eavesdropping or “sniffing”) data in transit

‐ Modifying data (“Man‐in‐the‐middle” attacks)

‐ “Replay” attacksEve/Mallory

Page 21: Health Information Privacy and Security

Alice

Simplified Attack Scenarios

Server Bob

‐ Unauthorized access to servers through‐ Physical means‐ User accounts & privileges‐ Attacks through software vulnerabilities‐ Attacks using protocol weaknesses

‐ DoS / DDoS attacks Eve/Mallory

Page 22: Health Information Privacy and Security

Alice

Simplified Attack Scenarios

Server Bob

Other & newer forms of attacks possible

Eve/Mallory

Page 23: Health Information Privacy and Security

Alice

Safeguarding Against Attacks

Server Bob

Administrative Security‐ Security & privacy policy‐ Governance of security risk management & response‐ Uniform enforcement of policy & monitoring‐ Disaster recovery planning (DRP) & Business continuity 

planning/management (BCP/BCM)‐ Legal obligations, requirements & disclaimers

Page 24: Health Information Privacy and Security

Alice

Safeguarding Against Attacks

Server Bob

Physical Security‐ Protecting physical access of clients & servers

‐ Locks & chains, locked rooms, security cameras‐ Mobile device security‐ Secure storage & secure disposition of storage devices

Page 25: Health Information Privacy and Security

Alice

Safeguarding Against Attacks

Server BobUser Security‐ User account management

‐ Strong p/w policy (length, complexity, expiry, no meaning)‐ Principle of Least Privilege‐ “Clear desk, clear screen policy”‐ Audit trails

‐ Education, awareness building & policy enforcement‐ Alerts & education about phishing & social engineering

Page 26: Health Information Privacy and Security

Alice

Safeguarding Against Attacks

Server Bob

System Security‐ Antivirus, antispyware, personal firewall, intrusion 

detection/prevention system (IDS/IPS), log files, monitoring‐ Updates, patches, fixes of operating system vulnerabilities & 

application vulnerabilities‐ Redundancy (avoid “Single Point of Failure”)‐ Honeypots

Page 27: Health Information Privacy and Security

Alice

Safeguarding Against Attacks

Server Bob

Software Security‐ Software (clients & servers) that is secure by design‐ Software testing against failures, bugs, invalid inputs, 

performance issues & attacks‐ Updates to patch vulnerabilities

Page 28: Health Information Privacy and Security

Alice

Safeguarding Against Attacks

Server Bob

Network Security‐ Access control (physical & electronic) to network devices‐ Use of secure network protocols if possible‐ Data encryption during transit if possible‐ Bandwidth monitoring & control

Page 29: Health Information Privacy and Security

Alice

Safeguarding Against Attacks

Server Bob

Database Security‐ Access control to databases & storage devices‐ Encryption of data stored in databases if necessary‐ Secure destruction of data after use‐ Access control to queries/reports‐ Security features of database management systems (DBMS)

Page 30: Health Information Privacy and Security

Privacy Safeguards

Image: http://www.nurseweek.com/news/images/privacy.jpg

Security safeguards Informed consent Privacy culture User awareness building & education Organizational policy & regulations Enforcement Ongoing privacy & security assessments, monitoring, and protection

Page 31: Health Information Privacy and Security

User Security

Page 32: Health Information Privacy and Security

Access control Selective restriction of access to the system

Role‐based access control Access control based on the person’s role (rather than identity)

Audit trails Logs/records that provide evidence of sequence of activities

User Security

Page 33: Health Information Privacy and Security

Identification Identifying who you are Usually done by user IDs or some other unique codes

Authentication Confirming that you truly are who you identify Usually done by keys, PIN, passwords or biometrics

Authorization Specifying/verifying how much you have access Determined based on system owner’s policy & system configurations

“Principle of Least Privilege”

User Security

Page 34: Health Information Privacy and Security

Nonrepudiation Proving integrity, origin, & performer of an activity without the person’s ability to refute his actions

Most common form: signatures Electronic signatures offer varying degrees of nonrepudiation PIN/password vs. biometrics

Digital certificates (in public key infrastructure ‐ PKI) often used to ascertain nonrepudiation

User Security

Page 35: Health Information Privacy and Security

Multiple‐Factor Authentication Two‐Factor Authentication

Use of multiple means (“factors”) for authentication Types of Authentication Factors

Something you know Password, PIN, etc.

Something you have Keys, cards, tokens, devices (e.g. mobile phones)

Something you are Biometrics

User Security

Page 36: Health Information Privacy and Security

Need for Strong Password Policy

So, two informaticianswalk into a bar...

The bouncer says, ʺWhatʹs the password.ʺ 

One says, ʺPassword?ʺ 

The bouncer lets them in. 

Credits: @RossMartin & AMIA (2012)

Page 37: Health Information Privacy and Security

Recommended Password Policy Length

8 characters or more (to slow down brute‐force attacks) Complexity (to slow down brute‐force attacks)

Consists of 3 of 4 categories of characters Uppercase letters Lowercase letters Numbers Symbols (except symbols that have special uses by the system or that can be used to hack system, e.g. SQL Injection)

No meaning (“Dictionary Attacks”) Not simple patterns (12345678, 11111111) (to slow down  brute‐force attacks & prevent dictionary attacks)

Not easy to guess (birthday, family names, etc.) (to prevent unknown & known persons from guessing)

Personal opinion. No legal responsibility assumed.

Page 38: Health Information Privacy and Security

Recommended Password Policy Expiration (to make brute‐force attacks not possible)

6‐8 months Decreasing over time because of increasing computer’s speed

But be careful! Too short duration will force users to write passwords down

Secure password storage in database or system (encrypted or store only password hashes)

Secure password confirmation Secure “forget password” policy Different password for each account. Create variations to help remember. If not possible, have different sets of accounts for differing security needs (e.g., bank accounts vs. social media sites) Personal opinion. No legal responsibility assumed.

Page 39: Health Information Privacy and Security

Techniques to Remember Passwords http://www.wikihow.com/Create‐a‐Password‐You‐Can‐Remember Note that some of the techniques are less secure!

One easy & secure way: password mnemonic Think of a full sentence that you can remember Ideally the sentence should have 8 or more words, with numbers and symbols

Use first character of each word as password Sentence: I love reading all 7 Harry Potter books! Password: Ilra7HPb! Voila!

Personal opinion. No legal responsibility assumed.

Page 40: Health Information Privacy and Security

Dear mail.mahidol.ac.th Email Account User,

We wrote to you on 11th January 2010 advising that you change the password onyour account in order to prevent any unauthorised account access followingthe network instruction we previously communicated.

all Mailhub systems will undergo regularly scheduled maintenance. Accessto your e‐mail via the Webmail client will be unavailable for some timeduring this maintenance period. We are currently upgrading our data baseand e‐mail account center i.e homepage view. We shall be deleting old[https://mail.mahidol.ac.th/l accounts which are no longer active to createmore space for new accountsusers. we have also investigated a system widesecurity audit to improve and enhanceour current security.

In order to continue using our services you are require to update andre‐comfirmed your email account details as requested below. To completeyour account re‐comfirmation,you must reply to this email immediately andenter your accountdetails as requested below.

Username :Password :Date of Birth:Future Password :

Social Engineering Examples

Real social‐engineering e‐mail received by Speaker

Page 41: Health Information Privacy and Security

Phishing

Real phishing e‐mail received by Speaker

Page 42: Health Information Privacy and Security

Poor grammar Lots of typos Trying very hard to convince you to open attachment, click on link, or reply without enough detail

May appear to be from known person (rely on trust & innocence)

Signs of a Phishing Attack

Page 43: Health Information Privacy and Security

Don’t be too trusting of people Always be suspicious & alert An e‐mail with your friend’s name & info doesn’t have to come from him/her

Look for signs of phishing attacks Don’t open attachments unless you expect them Scan for viruses before opening attachments Don’t click links in e‐mail. Directly type in browser using known & trusted URLs

Especially cautioned if ask for passwords, bank accounts, credit card numbers, social security numbers, etc.

Ways to Protect against Phishing

Page 44: Health Information Privacy and Security

Software Security

Page 45: Health Information Privacy and Security

Most common reason for security bugs is invalid programming assumptions that attackers will look for

Weak input checking Buffer overflow Integer overflow Race condition (Time of Check / Time of Use vulnerabilities)

Running programs in new environments

Software Security

Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Page 46: Health Information Privacy and Security

Feeping creaturism (Creeping featurism) Log files that contain sensitive information

Configuration bugs Unnecessary privileges Monoculture Security bypass

Software Security

Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Page 47: Health Information Privacy and Security

Consider a log‐in form on a web page

Example of Weak Input Checking: SQL Injection

Source code would look something like this:statement = ʺSELECT * FROM users WHERE name = ʹʺ + userName + ʺʹ;ʺ

Attacker would enter as username:

ʹ or ʹ1ʹ=ʹ1

Which leads to this always‐true query: statement = ʺSELECT * FROM users WHERE name = ʹʺ + ʺʹ or ʹ1ʹ=ʹ1ʺ + ʺʹ;ʺ

statement = ʺSELECT * FROM users WHERE name = ʹʹ or ʹ1ʹ=ʹ1ʹ;ʺ

http://en.wikipedia.org/wiki/SQL_injection

Page 48: Health Information Privacy and Security

Economy of Mechanism Design should be small & simple

Fail‐safe default Complete mediation Check every access to every object

Open design Separation of privilege / Least Privilege

Secure Software Design Principles

Saltzer & Schroeder (1975), Viega & McGraw (2000)Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Page 49: Health Information Privacy and Security

Least common mechanism Minimize complexity of shared components

Psychological acceptability If users don’t buy in to security mechanism or don’t understand how to use it, system is insecure

Work factor Cost of attack should exceed resources attacker will spend

Secure Software Design Principles

Saltzer & Schroeder (1975), Viega & McGraw (2000)Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Page 50: Health Information Privacy and Security

Compromise recording If too expensive to prevent a compromise, record it

Tamper evident vs. tamperproof Log files

Secure Software Design Principles

Saltzer & Schroeder (1975), Viega & McGraw (2000)Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 Image source: http://www.flickr.com/photos/goobelyga/2340650133/

Page 51: Health Information Privacy and Security

Defense in Depth Multiple layers of security defense are placed throughout a system to provide redundancy in the event a security control fails

Secure the weakest link Promote privacy Trust no one

Secure Software Design Principles

Saltzer & Schroeder (1975), Viega & McGraw (2000)Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 http://en.wikipedia.org/wiki/Defense_in_depth_(computing)

Page 52: Health Information Privacy and Security

Modular design Check error conditions on return values Validate inputs (whitelist vs. blacklist) Avoid infinite loops, memory leaks Check for integer overflows Language/library choices Development processes

Secure Software Best Practices

Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Page 53: Health Information Privacy and Security

Cryptography

Page 54: Health Information Privacy and Security

Goal: provide a secure channel between Alice & Bob A secure channel Leaks no information about its contents Delivers only messages from Alice & Bob Delivers messages in order or not at all

Cryptography

Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Alice Bob

Eve

Page 55: Health Information Privacy and Security

Use of keys to convert plaintext into ciphertext Secret keys only Alice & Bob know History: Caesar’s cipher, substitution cipher, polyalphabetic rotation

Use of keys and some generator function to create random‐looking strings (e.g. stream ciphers, block ciphers)

Cryptography

Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Page 56: Health Information Privacy and Security

Encryption Using Secret Key (Symmetric Cryptography)

Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Alice BobEve

1. Encrypt message using secret key2. Send encrypted message to Bob

3. Decrypt message using same secret key

Eve doesn’t know secret key (but there are various ways to discover the key)

Page 57: Health Information Privacy and Security

What if no shared secret exists? Public‐key cryptography Each publishes public key publicly Each keep secret key secret Use arithmetic to encrypt & decrypt message

Cryptography

Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Page 58: Health Information Privacy and Security

Public‐Key Cryptography (Asymmetric Cryptography)

Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Alice BobEve

1. Obtains Bob’s public key from public server2. Use Bob’s public key to encrypt message3. Send encrypted message to Bob

Even if Eve knows public key, can’t discover message (unless weakness in algorithm)

4. Decrypt message using own private key

Page 59: Health Information Privacy and Security

Digital Signatures

Adapted from  Nicholas Hopper’s teaching slides for UMN Computer Security Class  Fall 2006 CSCI 5271 

Alice Bob

1. Sign message using own private key2. Send plaintext and random‐looking string (digital signature) to Bob

Provides nonrepudiation

3. Use Alice’s public key against plaintext received to get digital signature4. Compare to match Alice’s digital signature received against signature obtained in #3

Page 60: Health Information Privacy and Security

Malware

Page 61: Health Information Privacy and Security

Malicious software ‐Any code with intentional, undesirable side effects

Virus Worm Trojan Spyware Logic Bomb/Time Bomb Backdoor/Trapdoor Rootkit Botnet

Malware

Page 62: Health Information Privacy and Security

Virus Propagating malware that requires user action to propagate

Infects executable files, data files with executable contents (e.g. Macro), boot sectors

Worm Self‐propagating malware

Trojan A legitimate program with additional, hidden functionality

Malware

Page 63: Health Information Privacy and Security

Spyware Trojan that spies for & steals personal information

Logic Bomb/Time Bomb Malware that triggers under certain conditions

Backdoor/Trapdoor A hole left behind by malware for future access

Malware

Page 64: Health Information Privacy and Security

Rogue Antispyware (Ransomware) Software that tricks or forces users to pay before fixing (real or hoax) spyware detected

Rootkit A stealth program designed to hide existence of certain processes or programs from detection

Botnet A collection of Internet‐connected computers that have been compromised (bots) which controller of the botnet can use to do something (e.g. do DDoS attacks)

Malware

Page 65: Health Information Privacy and Security

Installed & updated antivirus, antispyware, & personal firewall Check for known signatures Check for improper file changes (integrity failures) Check for generic patterns of malware (for unknown malware): “Heuristics scan”

Firewall: Block certain network traffic in and out Sandboxing Network monitoring & containment User education Software patches, more secure protocols

Defense Against Malware

Page 66: Health Information Privacy and Security

Social media spams/scams/clickjacking Social media privacy issues

User privacy settings Location services

Mobile device malware & other privacy risks Stuxnet (advanced malware targeting certain countries)

Advanced persistent threats (APT) by governments & corporations against specific targets

Newer Threats

Page 67: Health Information Privacy and Security

Security Standards

Page 68: Health Information Privacy and Security

• ISO/IEC 27000 — Information security management systems —Overview and vocabulary

• ISO/IEC 27001 — Information security management systems —Requirements• ISO/IEC 27002 — Code of practice for information security management• ISO/IEC 27003 — Information security management system implementation guidance• ISO/IEC 27004 — Information security management —Measurement• ISO/IEC 27005 — Information security risk management• ISO/IEC 27031 — Guidelines for information and communications technology readiness 

for business continuity• ISO/IEC 27032 — Guideline for cybersecurity (essentially, ʹbeing a good neighborʹ on 

the Internet)• ISO/IEC 27033‐1 —Network security overview and concepts• ISO/IEC 27033‐2 —Guidelines for the design and implementation of network security• ISO/IEC 27033‐3:2010 — Reference networking scenarios ‐ Threats, design techniques 

and control issues• ISO/IEC 27034 — Guideline for application security• ISO/IEC 27035 — Security incident management• ISO 27799 — Information security management in health using ISO/IEC 27002

Some Information Security Standards

Page 69: Health Information Privacy and Security

US‐CERT U.S. Computer Emergency Readiness Team http://www.us‐cert.gov/ Subscribe to alerts & news

Microsoft Security Resources http://technet.microsoft.com/en‐us/security http://technet.microsoft.com/en‐us/security/bulletin

Common Vulnerabilities & Exposures http://cve.mitre.org/

More Information

Page 70: Health Information Privacy and Security

Q & A