In a recent report published on Wednesday by research conducted by Proofpoint, an email security company, around 90% of healthcare organizations have experienced at least one cybersecurity incident in the past year.
In the past two years, more than half of the healthcare organizations have reported to have experienced an average of four ransomware attacks. 68% of the organizations surveyed noted that the attacks “negatively impacted patient safety and care.”
The aforementioned report conducted by Proofpoint includes a survey of more than 650 IT and cybersecurity professionals in the US healthcare sector, highlighting the healthcare sector's ongoing susceptibility to common attack methods. It occurs as the Cybersecurity and Infrastructure Security Agency works to provide greater assistance to small, rural hospitals that are underfunded and wilting under constant cyberattacks.
As healthcare organizations struggle to find alternatives to their outdated technology so they can keep providing services, these efforts are using up more and more of their resources. Between 2022 and 2023, the cost of the time spent minimizing the attacks' consequences on patient care rose by 50%, from around $660,000 to $1 million.
In the case of ransomware assault in hospital systems, where computer networks shut down, the impact is rapid and extensive.
Stephen Leffler, president and chief operating officer of the University of Vermont Medical Center, spoke about how a ransomware assault in October 2020 brought about a catastrophe at his facility during a congressional hearing in September. For 28 days, senior physicians had to train junior physicians on how to use paper records as the National Guard assisted the IT department in a round-the-clock operation to wipe and reconfigure every computer in the network.
Leffler remarked, "We literally went to Best Buy and bought every walkie-talkie they had." This was due to their internet-based phone system being offline. Between 2022 and 2023, the cost of patient care grew by 50%, from about $660,000 to $1 million.
Leffler, who has been an emergency medicine doctor for 30 years, further commented “I've been a hospital president for four years. The cyberattack was much harder than the pandemic by far.”
Malicious actors are adapting their strategies, techniques, and procedures in response to Microsoft's move to automatically block Excel 4.0 (XLM or XL4) and Visual Basic for Applications (VBA) macros across Office programs (TTPs).
Malicious Microsoft Office document attachments sent in phishing emails often contain VBA and XL4 Macros, two short programs designed to automate repetitive processes in Microsoft Office applications that threat actors use to load, drop, or install malware.
Sherrod DeGrippo, vice president of threat research and detection at Proofpoint, stated "the threat landscape has changed significantly as a result of threat actors shifting away from directly disseminating macro-based email attachments."
The change was made as a result of Microsoft's announcement that it will stop the widespread exploitation of the Office subsystem by making it more challenging to activate macros and automatically banning them by default.
New tactics
Use of ISO, RAR, and Windows Shortcut (LNK) attachments to get around the block has multiplied by 66%, according to security firm Proofpoint, which calls this activity 'one of the largest email threat landscape shifts in recent history.' Actors spreading the Emotet malware are also involved in this activity.
The use of container files like ISOs, ZIPs, and RARs has also increased rapidly, increasing by about 175 percent. These are rapidly being used as initial access mechanisms by threat actors, between October 2021 and June 2022, the use of ISO files surged by over 150 percent.
Since October 2021, the number of campaigns including LNK files has climbed by 1,675%. Proofpoint has been tracking a variety of cybercriminal and advanced persistent threat (APT) actors who frequently use LNK files.
Emotet, IcedID, Qakbot, and Bumblebee are some of the famous malware families disseminated using these new techniques.
According to Proofpoint, the usage of HTML attachments employing the HTML smuggling approach to put a botnet on the host system has also increased significantly. Their distribution volumes, however, are still quite limited.
Finally, with a restricted range of potential threats to assess, email security systems are now more likely to detect hazardous files.