How secure is the Electronic Patient Record?

Since the beginning of the month, the Electronic Patient Record has been available in Germany, in which insured persons can store and manage their data in a central location. The central storage of their health data is intended to facilitate communication between patients and doctors. In the initial phase, however, patients will have to take care of filling their digital files themselves. There are also still data protection concerns: Patients will not be able to select which doctor has access to which parts of the medical record until 2022. For the time being, anyone who wants to use the Electronic Patient Record provides their doctor with all the information it contains – or none at all.

What is an Electronic Patient Record?

The Electronic Patient Record allows patients to voluntarily store their health and diagnostic data centrally in one place. The information it contains can be shared with doctors, pharmacies, and hospitals to shorten treatments. Or prevent duplicate examinations. In the future, patients will also be able to use the app to manage the information it contains. They can then decide which doctor can see which information. The digitization of bonus books, vaccination cards, and maternity records is also planned for the future.

When does the Electronic Patient Record come into effect?

Patients will be able to have their health insurers issue the Electronic Patient Record from the beginning of 2021. For the time being, however, they will have to fill it out themselves. Until July, it will only be available to around 200 practices and hospitals on a trial basis; only then will its use be extended to the whole of Germany. The health insurers, on the other hand, have no insight into the stored data, even though the Electronic Patient Record is intended to provide communication channels to their own health insurer. This prevents the insured person from suffering any disadvantages as a result of diagnoses or findings.

How secure is my data?

The Electronic Patient Record stores patient data in encrypted form. Data is exchanged with doctors and other healthcare facilities via the so-called telematics infrastructure network. However, critics have still identified security deficiencies here: For example, the TI’s virus protection is said to be insufficient to actually protect sensitive health data reliably. Also, too lax IT security measures in medical practices can be a security risk. Easy-to-guess passwords or shared admin and access rights are unfortunately still commonplace in many medical practices. You can also read a comprehensive review of the current data security in healthcare as well as the criticism of the telematics infrastructure in our blog post here.

Cases from abroad, such as a successful hacker attack in Finland, have also shown how weakly protected our sensitive healthcare data still is. Experts, therefore, advise being selective about what information you want to include in the Record. The inclusion of psychotherapeutic documents is currently not advisable. This is because such data could have negative consequences for those affected when looking for new insurance companies or employers, should this data fall into the hands of third parties without authorization.

Unfortunately, the risks and benefits of the Electronic Patient Record must be weighed up here as well. On the one hand, centrally stored data enables faster and more favorable treatment success. This saves time, costs, and nerves on both sides. However, if this sensitive data falls victim to a cyberattack, the insured person may suffer disadvantages, the consequences of which cannot yet be assessed.

Will you use the Electronic Patient Record? Join the discussion here.

DDoS-Angriff auf Impfportal

DDoS attack on vaccination portal

At the end of December, vaccination against the COVID-19 virus began in the European Union; it has now become known that a cyberattack on the vaccination portal of the Association of Statutory Health Insurance Physicians in Thuringia and the Thuringian Ministry of Health had already occurred in December. This was probably a so-called DDoS (Distributed Denial of Service) attack. As the vaccination center announced, the servers were overloaded by a high number of requests and collapsed as a result. Booking vaccination appointments via the site was therefore initially not possible.

What is a DDoS attack?

This form of cyberattack is an attempt to paralyze a server, a website, or even just parts of a website. For this purpose, countless (and pointless) requests are sent to the respective server within a very short time. How many requests are necessary depends on the server’s capacity. In Thuringia, about 158,000 requests were necessary.

The requests are usually sent by a mixture of botnets and reflectors. Botnets are infected devices that can be directly controlled by the hacker by means of malware. These “zombie” computers then send misleading connection requests to other computers, which are then called reflectors. These reflectors do not necessarily have to be infected themselves. Because here, hackers exploit the characteristics of our modern devices to also want to “answer” queries. In this way, they manage to build up a comparatively small botnet and also cover their tracks, since devices that are not involved in themselves now also support the attack.

Who is the target of DDoS attacks?

The good news, if you will, upfront: the target of such attacks is not private individuals. Such attacks usually target large websites and opinion leaders – but also, as the current case shows, the healthcare sector, governments, or banks. In other words, important and critical infrastructure. This is why some security experts classify DDoS attacks in the realm of digital warfare, as they can paralyze critical civilian networks and thus harm society.

It is important to note, however, that a DDoS attack does not primarily have monetary goals. It is often about protesting against a site that does not correspond to one’s own political opinion. Or even just to prove that one has the skills to carry out such hacks. These attacks become really critical when the primary goal is not to cripple the site, but other actions are running in the background. The superficial distraction facilitates the cover-up of a more serious hack in the background. If critical infrastructures are affected, a ransom demand can also follow in order to release the server as quickly as possible and get it up and running again.

For the current case, however, the background of the act is not further known.

How can you protect yourself from a DDoS attack?

Since you as a private individual are not the primary target of such an attack, the sobering answer here is: very little to nothing. However, your primary goal should always be to protect your PC as best as possible against malware being installed. After all, this is how you can at least prevent yourself from becoming part of the botnet. Therefore, always update your virus software on the devices you use in a timely manner. The router also plays an important role in protecting your network and should therefore always be up to date. The same applies to your passwords. Wherever possible, set up modern password protection with multifactor authentication. A password manager can help you keep track of your passwords.

As a web administrator, you basically have options available to defend against such attacks. For example, if you notice an unusual data stream in time, you can redirect it to a “black hole” (= a non-existent server). A bandwidth management tool as well as good virus software will help you in advance to fend off simple DDoS attacks if necessary. The last option is to rent a higher bandwidth to ensure availability despite high traffic. For your users, unfortunately, the only option is to wait until your service is available again.