July 19, 2022 By Mike Elgan 3 min read

Major ransomware attacks are scary, but against hospitals, they are even worse. One notable attack in August 2021 forced Ohio’s Memorial Health System emergency room to shut down (patients were diverted to other hospitals). In all hospital attacks, the health, safety, privacy and lives of patients face risk. But this incident also shows that whether targets are hospitals or any other kind of organization, the time and money spent preventing attacks is almost always worth it.

But what do you do if protective measures fail? What can be done once an attack is already happening?

One health care IT director set a fantastic example of what to do when an active ransomware attack was detected.

His name is Jamie Hussey, and he works for Jackson Hospital in Florida, one of the dozens of hospitals to have been targeted for ransomware attacks in the U.S. recently. It all started near midnight on a Sunday night in early January. Staff in the emergency room called IT to say doctors couldn’t access patient charting records. Hussey found that ransomware had infected the charting software, which an outside vendor maintained.

All IT departments should study what happened next as an example of what to do right.

How to contain a ransomware attack

Hussey quickly urged radical action. Shut the entire hospital’s computer systems down right away, he urged. They complied. Under a planned contingency called downtime procedures, hospital staff started using pen and paper to record data and communicate. Health care workers wrote prescriptions out by hand.

IT staff then looked into the nature of the attack. They found that attackers encrypted files using the Mespinosa ransomware on a computer Jackson Hospital used to store documents not related to patient records. (Attackers have used Mespinoza against hundreds of targets, including health care and health-related organizations.)

The team then thoroughly checked their complete list of hospital computer systems for infection. Once found clean, they re-connected them to the network one by one. Lastly, the team brought the infected ER charting system back online.

The diagnosis

The main takeaway is not that organizations can thwart a ransomware attack after it has begun, but that preparation enabled containment. Everything that occurred at Jackson Hospital was part of a plan.

For example, the moment a ransomware attack is discovered is not the time to gather stakeholders or leaders together to begin arguing and negotiating over whether or not to shut down computer systems organization-wide.

In hospitals, doctors and surgeons are in the positions of highest authority over life-and-death issues. It’s easy to imagine that in the heat of the moment, doctors could overrule security staff over shutting down computer systems in an emergency room, causing needless risk to patients and patient records.  The decision to shut down in the event of the discovery of a ransomware attack in progress must be made in advance and agreed to by all involved.

In press interviews, Hussey acknowledged extreme organizational pushback against taking all systems offline. But as he pointed out, that’s often the difference between a major and minor disruption.

Ransomware preparedness

As part of the policy and cybersecurity training, a set of practices and policies for functioning while systems are down is a big part of surviving a ransomware attack. Systems may be down for hours, days or weeks.

The bottom line is that ransomware prevention is the best medicine. But, prevention is only one part of preparation. The other part is acting fast and doing the right things if a ransomware attack actually occurs. Quick action by the hospital’s IT director saved the organization from a widespread and catastrophic ransomware attack.

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