Health Information Privacy and Security


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Health Information Privacy and Security

  1. 1. TMHG 529Health InformationPrivacy & Security Nawanan Theera-Ampornpunt, M.D., Ph.D. Faculty of Medicine Ramathibodi Hospital Mahidol University April 22, 2013
  2. 2. Outline 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
  3. 3. Introduction toInformation Privacy & Security
  4. 4. Threats to Information Security Malware
  5. 5. Sources of the Threats Hackers Viruses & Malware Poorly-designed systems Insiders (Employees) People’s ignorance & lack of knowledge Disasters & other incidents affecting information systems
  6. 6. Consequences of Security Attacks 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.
  7. 7. Privacy & 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)
  8. 8. Information Security Confidentiality Integrity Availability
  9. 9. Examples of Confidentiality Risks
  10. 10. Examples of Integrity Risks “Operation Aurora” Alleged Targets: Google, Adobe, Juniper Networks, Yahoo!, Symantec, Northrop Grumman, Morgan Stanley, Dow Chemical Goal: To gain access to and potentially modify source code repositories at high tech, security & defense contractor companies
  11. 11. Examples of Integrity Risks Web Defacements
  12. 12. Examples of Availability Risks Viruses/worms that led to instability & system restart (e.g. Blaster worm)
  13. 13. Examples of Availability Risks Ariane 5 Flight 501 Rocket Launch Failure Cause: 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
  14. 14. Interesting Resources nd_worms
  15. 15. Protecting Information Privacy & Security
  16. 16. Common Security Terms Attack  An attempt to breach system security Threat  A scenario that can harm a system Vulnerability  The “hole” that is used in the attack
  17. 17. Class Exercise Identify some possible means an attacker could use to conduct a security attack
  18. 18. Simplified Attack Scenarios Alice Server Bob Eve/Mallory
  19. 19. Simplified Attack Scenarios Alice Server Bob- Physical access to client computer- Electronic access (password)- Tricking user into doing something (malware, phishing & social Eve/Mallory engineering)
  20. 20. Simplified Attack Scenarios Alice Server Bob- Intercepting (eavesdropping or “sniffing”) data in transit- Modifying data (“Man-in-the- middle” attacks) Eve/Mallory- “Replay” attacks
  21. 21. Simplified Attack Scenarios Alice 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
  22. 22. Simplified Attack Scenarios Alice Server BobOther & newer forms of attacks possible Eve/Mallory
  23. 23. Safeguarding Against Attacks Alice Server BobAdministrative 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
  24. 24. Safeguarding Against Attacks Alice Server BobPhysical Security- Protecting physical access of clients & servers - Locks & chains, locked rooms, security cameras - Mobile device security - Secure storage & secure disposition of storage devices
  25. 25. Safeguarding Against Attacks Alice 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
  26. 26. Safeguarding Against Attacks Alice Server BobSystem 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
  27. 27. Safeguarding Against Attacks Alice Server BobSoftware Security- Software (clients & servers) that is secure by design- Software testing against failures, bugs, invalid inputs, performance issues & attacks- Updates to patch vulnerabilities
  28. 28. Safeguarding Against Attacks Alice Server BobNetwork Security- Access control (physical & electronic) to network devices- Use of secure network protocols if possible- Data encryption during transit if possible- Bandwidth monitoring & control
  29. 29. Safeguarding Against Attacks Alice Server BobDatabase 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)
  30. 30. Privacy Safeguards  Security safeguards  Informed consent  Privacy culture  User awareness building & education  Organizational policy & regulations  Enforcement  Ongoing privacy & security assessments, monitoring, and protectionImage:
  31. 31. User Security
  32. 32. User 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
  33. 33. User 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”
  34. 34. User 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
  35. 35. User 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
  36. 36. Need for Strong Password Policy So, two informaticians walk into a bar... The bouncer says, "Whats the password." One says, "Password?" The bouncer lets them in. Credits: @RossMartin & AMIA (2012)
  37. 37. 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.
  38. 38. 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.
  39. 39. Techniques to Remember Passwords 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.
  40. 40. Social Engineering Examples Dear Email Account User, We wrote to you on 11th January 2010 advising that you change the password on your account in order to prevent any unauthorised account access following the network instruction we previously communicated. all Mailhub systems will undergo regularly scheduled maintenance. Access to your e-mail via the Webmail client will be unavailable for some time during this maintenance period. We are currently upgrading our data base and e-mail account center i.e homepage view. We shall be deleting old [ accounts which are no longer active to create more space for new accountsusers. we have also investigated a system wide security audit to improve and enhance our current security. In order to continue using our services you are require to update and re-comfirmed your email account details as requested below. To complete your account re-comfirmation,you must reply to this email immediately and enter your account details as requested below. Username : Password : Date of Birth: Future Password :Real social-engineering e-mail received by Speaker
  41. 41. PhishingReal phishing e-mail received by Speaker
  42. 42. Signs of a Phishing Attack 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)
  43. 43. Ways to Protect against Phishing 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.
  44. 44. Software Security
  45. 45. Software 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 environmentsAdapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  46. 46. Software Security  Feeping creaturism (Creeping featurism)  Log files that contain sensitive information  Configuration bugs  Unnecessary privileges  Monoculture  Security bypassAdapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  47. 47. Example of Weak Input Checking: SQL Injection  Consider a log-in form on a web page  Source code would look something like this: statement = "SELECT * FROM users WHERE name = " + userName + ";"  Attacker would enter as username: or 1=1  Which leads to this always-true query:  statement = "SELECT * FROM users WHERE name = " + " or 1=1" + ";" statement = "SELECT * FROM users WHERE name = or 1=1;"
  48. 48. Secure Software Design Principles  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 PrivilegeSaltzer & Schroeder (1975), Viega & McGraw (2000)Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  49. 49. Secure Software Design Principles  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 spendSaltzer & Schroeder (1975), Viega & McGraw (2000)Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  50. 50. Secure Software Design Principles  Compromise recording  If too expensive to prevent a compromise, record it  Tamper evident vs. tamperproof  Log filesSaltzer & Schroeder (1975), Viega & McGraw (2000)Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271Image source:
  51. 51. Secure Software Design Principles  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 oneSaltzer & Schroeder (1975), Viega & McGraw (2000)Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  52. 52. Secure Software Best Practices  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 processesAdapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  53. 53. Cryptography
  54. 54. Eve Cryptography Alice Bob  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 allAdapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  55. 55. Cryptography  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)Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  56. 56. Encryption Using Secret Key (Symmetric Cryptography) Alice Eve Bob 1. Encrypt message using secret key 3. Decrypt message 2. Send encrypted message to Bob using same secret key Eve doesn’t know secret key (but there are various ways to discover the key)Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  57. 57. Cryptography  What if no shared secret exists?  Public-key cryptography  Each publishes public key publicly  Each keep secret key secret  Use arithmetic to encrypt & decrypt messageAdapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  58. 58. Public-Key Cryptography (Asymmetric Cryptography) Alice Eve Bob 1. Obtains Bob’s public key from public server 4. Decrypt message using 2. Use Bob’s public key to encrypt message own private key 3. Send encrypted message to Bob Even if Eve knows public key, can’t discover message (unless weakness in algorithm)Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  59. 59. Digital Signatures Alice Bob 3. Use Alice’s public key 1. Sign message using own private key against plaintext received 2. Send plaintext and random-looking string to get digital signature (digital signature) to Bob 4. Compare to match Alice’s digital signature Provides nonrepudiation received against signature obtained in #3Adapted from Nicholas Hopper’s teaching slides for UMN Computer Security Class Fall 2006 CSCI 5271
  60. 60. Malware
  61. 61. Malware Malicious software - Any code with intentional, undesirable side effects Virus Worm Trojan Spyware Logic Bomb/Time Bomb Backdoor/Trapdoor Rootkit Botnet
  62. 62. Malware 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
  63. 63. Malware 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
  64. 64. Malware 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)
  65. 65. Defense Against Malware 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
  66. 66. Newer Threats 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
  67. 67. Security Standards
  68. 68. Some Information Security Standards• 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, being a good neighbor 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
  69. 69. More Information US-CERT  U.S. Computer Emergency Readiness Team   Subscribe to alerts & news Microsoft Security Resources   us/security/bulletin Common Vulnerabilities & Exposures 
  70. 70. Q&A