For years, since the Internet of Things (IoT) made it possible to connect things that had never been designed to be connected, there have been increasing warnings that medical devices were vulnerable to attacks – potentially catastrophic attacks.
If online attackers can control your implanted heart device, they can blackmail you, damage you, even kill you.
Based on a couple of sessions at the SOURCE Boston conference last week, the bad news is that things have not measurably improved in the several years since former Vice President Dick Cheney famously had the wireless functionality of his implanted defibrillator and heart pump disabled because of fears that it could be hacked and used to assassinate him.
The somewhat better news is that it is possible to improve the security of those devices, and there are organized efforts to do that without compromising their access and value to practitioners and patients.
Chris Schmidt, chief guidance officer at Codiscope, was the bearer of most of the bad news. In a talk titled, “The Bad Guys Have Your Pacemaker: How to Stop Attacks on Your IoT Devices,” he said that in a recent investigation of “smart” pacemakers, “we discovered a lot of scary things,” indicating that application security still, “gets the least amount of attention.”
- Cross-site Scripting (XSS): ): “This combined with issues in State Management could make it possible for an attacker to gain access to an ongoing session in the command and control app,” Schmidt said.
- Insecure two-factor authentication: “This is a bigger problem than some people realize,” he said. “The token is your only defense if someone has your password. If I guess your token, it’s game over.”
- Backdoors: They create a way into command and control.
- Remote Command Execution: The kind of thing that made Dick Cheney nervous.
- Man-in-the-Middle vulnerability: “It’s not hard to get into the middle of a network,” he said. “Government is in the middle of every network, at least they try to be.”
Schmidt said he could spend three weeks talking about successful intrusions into IoT devices – baby monitors, thermostats, refrigerators, printers, cars and more.
“And those are just the ones we know about,” he said. “There are probably at least 10 times that amount.”
There are other systemic factors that make medical device security difficult, according to Penny Chase and Steve Christey Coley, of the MITRE Corporation.
In a talk titled, “Toward Consistent, Usable Security Risk Assessment of Medical Devices,” they noted that those devices:
- Generally incorporate third-party software, operating systems and workstations.
- Are subject to regulation, which can limit ability to patch and reconfigure them.
- Are exposed to limited clinical trials, so many flaws aren’t discovered until devices are on the market.
- Are made by manufacturers who don’t incorporate security testing.
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