Rebecca Zisser / Axios

It's been a few months since the worldwide WannaCry ransomware attacks, and a month and a half since the NotPetya attacks that hit U.S. hospitals and the drug company Merck. The cyberattacks were bad enough to get the attention of the health care industry — and the rest of us — but not bad enough to force the industry to solve the underlying problems.

The bottom line: A cyberattack that takes down multiple hospital systems is "the thing that keeps me up at night," said Richard Staynings, principal and cybersecurity healthcare leader at Cisco. "I have no way of knowing the last time a patient received their medication … It essentially renders hospitals near useless."

Here's what's changed and what still hasn't, according to cybersecurity experts.

Changed:

  • Hospitals and other health care facilities have been reluctant to install security patches on devices that have to be available at all times, like CT scanners. But they're becoming more open to it "now that the risk equation has changed significantly," meaning it's clearly more dangerous to be vulnerable to an attack than to take a device offline, according to Staynings.
  • Hospital officials are generally more aware of the importance of cybersecurity. "I think they're interested — I'm not sure they understand what they should be doing," said David Damato, chief security officer at the cybersecurity startup Tanium.

Not changed:

  • Health care organizations still don't spend a lot on cybersecurity, compared to traditional priorities like doctors and researchers. "Health care is now an easy target compared to financial services," said Staynings.
  • It's an increasingly urgent issue as more and more software is added, especially at smaller facilities that don't have a lot of money to spend, said Bryan Sivak, a former chief technology officer at the Department of Health and Human Services.
  • Electronic health records are becoming a big worry. You don't want someone getting in and changing a patient's blood type, for example, or getting access to highly sensitive personal information about them.
  • Old or unpatched operating systems will always leave health care facilities vulnerable. "We've been talking about this for decades and are still running into the same problems," said Sivak.
  • Facilities have to learn to segment their networks, or divide them into subnetworks to make them more secure. (That's a tough task, though, if they don't have a lot of IT resources.)
  • Vendors have to be more willing to patch their medical devices — some don't want to change them for risk of losing their certifications from the Food and Drug Administration. And the FDA "has sat on the fence on this issue, quite frankly, for the last few years," said Staynings.

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