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All of the EHR systems I have experienced (including the VA and Kaiser systems) have always been more unwieldy than pen and paper. They have their many advantages, but making them quick and intuitive to use would be amazing! Also, the number of workarounds I have seen doctors do that might compromise patient care or system security might decrease significantly.
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It's frustrating to me when IT professionals wash their hands of usability and user error. These are integral parts of design, and the fact that a user screwed up doesn't absolve the designer, just as I, as a nurse, share culpability if I fulfill a doctor's unsafe order. When the stakes are high, one cannot afford to let catastrophe result from a single failure.
IT could have recommended a HTML based system with a UNIX or LINUX server that would not have required faulty windows machines to function and would have been infinitely more robust and secure. But they didn't, they requested a windows based system and now we see the consequences.
Professionals should act like professionals, by following the advice of professionals of other disciplines. If they do not understand the details or consequences, they should defer judgement and decisions to those who do.
I will look into that lockout tool. I think it might be the one we've tried. The one we've tried only lists the DC that initiated the lockout, which isn't terribly helpful. We only have 1 DC, and it doesn't tell us which computer is attempting the logins that are causing the lockouts.
When I worked for a fortune 500 health care company, I often said that it would take a massive lawsuit over a breach of PI data or some disaster like malware killing people by infecting critical systems for hospitals to raise the importance of personal information security. The sad thing, is that you have protections as the consumer/customer when your PI is compromised at a bank. At a health care facility, you're shit out of luck and that's if their IT departments are funded enough to even know if the PI was breached in the first place.
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But I do believe that usability has to be a serious concern. I'm sure that you've seen good professionals who put so much into their jobs that there's never a spare second. Christ, it takes me a fraction of a second to sign my name, and I've put effort into streamlining that. Things like logins seem minor, but when they're repeated hundreds of times a shift, they add up, and the price that is paid in time and attention has consequences.
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So too are embedded devices like Chromebooks, phones, tablets, routers, etc, etc. Linux/BSD/Posix is more secure because of design and continually following good security processes. Windows is catching up. but it will always be playing catch up. No system is 100% secure, but this type of infection that spread throughout the entire infrastructure wouldn't have gotten anywhere in a properly configured Linux-based environment.
Medical decisions are not yet made entirely by flowchart. I'm going to be really grateful when I'm replaced by a superior AI, but it's going to be a while still.
It really doesn't matter whether the users are stupid or not. Hospitals are huge institutions. Yes, some of the users are going to be stupid.
CraigJ, meet drive-by attack vectors; drive-bys, meet CraigJ. There, now you two have met and probably have a lot to discuss after apparently being ignorant of each other for all of these years.
But prevention is only half of this. Everybody wants to pretend that they can make it impossible rather than unlikely; these kinds of claims have a poor history. A recovery plan is at least as important as a prevention plan.
EDIT: trying to find the thing I did to get the info to track down the system. I think once I added more detail to the logging, that was all it took.
Sony’s huge PlayStation Network (PSN) has been down for a week now following the theft of ID and credit card data on some or all of the gaming and video entertainment network’s 77 million customer accounts. Readers have been asking for comment but I stay out of these things unless I have something new to contribute. That something finally comes a week into the crisis as gamers begin to wonder why the network is still not back in operation and speculate on what this all means to Sony? It’s a huge loss of face, if course, but beyond that the damage to Sony is minimal. And the upside for PSN members, including those involved in the many emerging class action lawsuits, is likely to be bupkes.
From the ancient medical related programs such as MediPac (still very much in use today) clear through to EPIC and beyond. All of them are basically forced to be connected to the internet. There is not really another option to transfer data between providers, especially with scripts and/or medical records.
Our XP Eradication project (Yes it was called that, at least on the progress board) took years. There's so much antiquated, locked-in vendor type software (https://aprel-vologda.ru/hack/?patch=7004) that exists in the medical field (also manufacturing). Like EKG viewers that only work in IE6. And replacing those products tends to be its own huge undertaking.
Impressively, Nvidia is claiming instruction throughput rates comparable to Intel's Haswell-based Core processors. That's probably an optimistic claim based on the sort of situations Denver's dynamic optimization handles well. Nonetheless, Nvidia has provided a quick set of results from a handful of common synthetic benchmarks. These numbers are normalized against the performance of the 32-bit version of the Tegra K1 based on quad Cortex-A15 cores. They show Denver challenging a Haswell U-series processor in many cases and clearly outperforming a Bay Trail-based Celeron. Another word of warning, though: we don't know the clock speeds or thermal conditions of the Tegra K1 64 SoC that produced these results.
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IT dollars are usually only applied as needed. It's not their core business regardless of how important we think it is.
Then run "gpupdate /force" w/out the quotes on your DCs. Then lockout your test account and check the Security event logs on the DC.
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I've had a WIndows PC or entire network of PCs and Macs hooked up to the Internet since 1995. I do not run AV or ans of that shit. I have NEVER* gotten a virus or malware.
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Besides, having to click on a link to get infected is so 2001. All you have to do now is visit a legitimate webpage that happens to have an infected ad on it. That anyone can do.
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How many domain controllers do you have? You need to look on all of them, as the Event Log entries are only logged on one DC.
A: While all credit card information stored in our systems is encrypted and there is no evidence at this time that credit card data was taken, we cannot rule out the possibility. If you have provided your credit card data through PlayStation Network or Qriocity, out of an abundance of caution we are advising you that your credit card number (excluding security code) and expiration date may have been obtained. Keep in mind, however that your credit card security code (sometimes called a CVC or CSC number) has not been obtained because we never requested it from anyone who has joined the PlayStation Network or Qriocity, and is therefore not stored anywhere in our system.
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I don't tell my doctor how to prescribe medicine. My customers do not tell me how to design software (take a look at the site here).
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I can see 4625 IDs on the terminal server where I locked out the dummy account. I'm hoping I don't have to go to each individual computer in order to find out which one is getting the login attempts for all of these accounts. Remote management access on Windows boxes seems to be hit-or-miss at best. Like earlier I was planning on using Powershell with the Get-EventLogs cmdlet, then I found out that it doesn't work on Windows 7 boxen. Then I found a Server Fault answer that showed me how to make it work using Invoke-Command, only to find out that Invoke-Command has changed drastically since the answer was made.
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Linux doesn't get this type of attack for the same reason Mac OS X doesn't: Windows is just a much bigger target - especially in the corporate world. It's why Mac users could brag for so long that there weren't any Macintosh viruses. It wasn't that System 7/8/9 were such strong systems, it was that it wasn't worth the bother. Once the Mac became a big enough target, viruses started popping up.
You have a stockpile of 100% clean USB drives. Use the thumb drive in the secure system to transfer data to the non-secure system. Then you either destroy or securely zero out the thumbstick.
Note, regarding the MRI example, that not only do you need a way to get your MRI data out of the system, you need a way to get the radiologist's report back into the system as well. Now, that's a big difference in size of data, so if you want to go with a bank of phones and make your radiologists connect via 56k modem to a separate network, you might be able to get away with it.
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This was probably needed to help save lives. But its like the grandma that clicks on her spam.
I love the part about it having been a malicious attack. Had the attack been less malicious, would less data have been lost? That is the sound of Sony whining.
I'm biased, too, given I am a physician and sat on hospital IT committees for several years. I think doctors and nurses complain about having trouble "caring for patients" (why is that in quotes? It's the primary function of our professions) because of the very large amounts of time dedicated to sitting in front of the computer with the advent of EHR, electronic ordering, etc. The software is often quite user unfriendly in the time required to achieve what were once simple tasks. Being user friendly to health care providers is a main goal of hospital software, right?
I'm certainly a little biased, but your comment is extremely rude. Clearly doctors and nurses shouldn't be dictating IT policy, but do you think you could do their job? The difference is, they have to interact with your IT systems. No one's asking you to care for patients.
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That says I should just be able to search the Security log on the domain controller for event 4740 and be happy. My domain controller doesn't have any 4740 events. I created a dummy login, and got that locked out, no events. Do lock out events need to be enabled somewhere? Or is there an easy way of collecting the Security logs from each computer on the network (only about 15-20 computers)? I do have the makings of a Powershell script to do this with Get-EventLogs, but the command doesn't reliably get logs.
Those can likewise get lost or left unsecured. Wherever humans are involved, humans become a potential weak link.
What I don't understand is why the ERM system had mapped shares to a computer that could be exploited this way. ERM data should have been its own little sandbox.
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The real heist is not the $17,000. It's the half-mill the 'consultants' will be paid to pass around memos. And don't even get started on the lawyers.
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This outage comes in large part because Sony has been so aggressive against hackers, who finally decided to slap-down the electronics giant. This is not to argue that Sony shouldn’t defend itself, but it is to argue that Sony should have expected elevated attacks as a result of its actions. Maybe they did expect more trouble, but the fact that they were so easily compromised shows corporate hubris at a reckless level.
Will they be in the offending machine's logs, or the domain controller's logs? Because right now the domain controller is only logging a couple of logins' failed login attempts. I presume this is these users attempting to login to SQL Server. But if I RDP to the terminal services server and lockout my dummy account, the domain controller logs exactly nothing.
Now let’s consider for a moment why this outage is continuing a week after the break-in. Speaking with a few experts and reading the official Sony FAQ gives some insight into what may really be going on. Sony says it is investigating, but should an investigation really take this long? Can’t the server logs and other network data be locked-down in a few minutes and examined at leisure?
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Recent history suggests Sony’s likely gift to users as an apology for losing their personal data will be some period of free credit monitoring and a free month of PSN service. If that sounds generous you might be surprised to learn that the going price for wholesale monitoring from the big U. S. credit reporting firms is approximately five cents per account per month or $3/85 million if all 77 million PSN accounts have been compromised. The usual terms for a mea culpa of this sort are three months of monitoring for a total cost to Sony of around $10 million.
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The way this ransomware works though is it runs on a workstation. It then scans the local hard drive along with any mapped network drives and then begins encrypting data it finds.
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That is why my secondary back-up is a removable USB3 hard drive kept cold except when I am doing back-ups. Unless there is something seeded with a trigger condition of plugging in that hard drive, my back-up data will be preserved even if someone cryptolocks my desktop and my server, which mirrors the data on my desktop (and also functions as my iTunes and Calibre servers as well as making file generally available to my mobile devices and laptop).
If you are hoping for big bucks from a class action lawsuit, go back and read PSN’s Terms of Service you clicked on without reading when you first joined the network. As with nearly all such legal agreements, you signed away any significant right to compensation beyond the direct cost of the service for the time it is disrupted. Only the lawyers will make a dime from this.
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Crypto ransomware doesn't need escalated permissions to do its damage. It merely encrypts files that the user owns, so if it runs under the Users' permission, it still does its damage. No need to exploit security holes in the OS which gets harder and harder to do every year.
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I have another friend who's a highly respected computer security expert. He was called by someone claiming to be from his bank. The CID showed the bank's name and phone number. The caller claimed there was some suspicious transactions on his account, and needed to verify they were okay. The suspicious chagers were from Netflix and his cable company. He verified that these were legitimate transactions, and then the caller asked for my friends social security number and credit card to verify he is the customer.
Auditpol shows that my DC is getting the policy, but my RDP server is not. I imagine this is expected since I moved the GPO settings from their own GPO to the Default Domain Controllers GPO. Though maybe it was meant to go in the Default Domain Policy GPO?