Understanding the Growing Threat of Cybercrime Targeting Medical Images and What Hospitals Can Do to Safeguard Patient Data

Medical images are more than just pictures. They hold important clinical information that doctors use to diagnose and treat patients. These images often include protected health information (PHI), which makes them attractive targets for hackers.

Why Medical Images Are Targeted:

• Medical images have visual data and metadata. Metadata may contain patient names, birthdates, exam dates, and doctor notes.
• These images are kept in Picture Archiving and Communication Systems (PACS), many of which connect to the internet for easier access.
• Many PACS systems in the U.S. do not have strong security. Research found more than 170 medical imaging systems connected online without good protection. Of these, 81 were new findings, showing the problem is growing.
• Some systems held over 14 million exams with PHI, including parts of Social Security numbers and patient IDs.

Hackers want this data for identity theft, medical fraud, or blackmail. This exposure can cause stress for patients and big legal problems for hospitals.

The Impact of Data Breaches on Healthcare Providers and Patients

When medical images with PHI are exposed, it is more than a privacy problem. Hospitals and imaging centers face big operational and money losses if hacked.

• The average cost to fix a healthcare data breach is about $408 per stolen record. This is almost three times higher than other industries. This includes investigations, notifications, legal fees, and lost income.
• Cyberattacks can disrupt patient care by blocking access to important services. For example, ransomware can lock workers out of electronic health records (EHR) or image archives.
• The 2017 WannaCry attack on Britain’s National Health Service caused ambulance reroutes and surgery cancellations, which risked lives.
• In the U.S., a ransomware attack in 2021 on the University of Vermont Medical Center caused nearly a month of downtime. This affected everything from EHR access to payroll, and cost about $50 million in lost revenues.
• Attacks on healthcare have been tied to higher patient deaths due to delays in diagnosis and treatment when systems are down.
• Over 60% of healthcare groups hit by ransomware paid the ransom to get access back. This is the highest rate across all sectors. But paying often doesn’t stop future attacks; about 80% of those who pay get attacked again.

Besides ransomware, denial-of-service and phishing attacks also threaten hospitals. This makes cybersecurity even harder.

Challenges in Protecting PHI in Medical Images

One main way to protect PHI in medical images is to anonymize or remove identifying information. But this is not easy.

• Incomplete PHI Removal: Removing PHI by hand often misses things like tattoos, scars, or hidden data saved in the image file.
• Re-identification Risks: Even anonymized data can sometimes be matched with other information to identify patients again.
• Loss of Clinical Information: Removing too much data can erase useful medical details, making the image less helpful for doctors or research.
• Lack of Standardization: Without common rules, anonymization methods vary too much, which hurts data sharing and security.
• High Costs and Time: Manual and uneven anonymization takes a lot of work and money. Smaller clinics or imaging centers may struggle to meet privacy rules fully.

Strengthening Cybersecurity for Medical Images and Healthcare Data

Hospitals and healthcare groups must use a strong cybersecurity plan that covers technology, people, and processes to protect medical images and patient data.

Key Measures Include:

1. Implementing Standardized Anonymization Protocols: Some companies have AI tools that automatically remove PHI from medical images. These tools find all parts of the image and metadata to ensure complete anonymization while keeping needed medical details. Using clear rules reduces mistakes caused by humans.
2. Strengthening Network and System Security: Hospitals should keep PACS and image archives safe behind firewalls and network divisions. Systems should never be open to the public internet. They must update software regularly, use antivirus programs, and have intrusion detection systems.
3. Backing Up Data Using Best Practices: The Cybersecurity Infrastructure and Security Agency (CISA) recommends the 3-2-1 backup rule: keep three copies of data, on two types of media, with one copy stored offsite or offline. This helps recover data even after a ransomware attack.
4. Enabling Multi-Factor Authentication (MFA): MFA should be required on all systems accessing patient data, including PACS, EHR, and imaging software. This reduces the chances of hackers logging in with stolen passwords.
5. Educating Healthcare Staff: Phishing is a common way ransomware gets in. Regular training helps staff spot dangerous emails and avoid clicking on suspicious links or attachments.
6. Designating Cybersecurity Leadership: Healthcare groups should have dedicated security leaders with power and independence to spot risks, plan protections, and respond to incidents.
7. Integrating Cybersecurity into Patient Safety Programs: Treat cybersecurity as part of patient safety—not just IT work. This helps everyone understand their role in keeping patient data safe. It also keeps cyber risk management connected to medical priorities.

Artificial Intelligence and Workflow Automation in Healthcare Cybersecurity

AI and automation are changing how hospitals protect patient data and run day-to-day work. AI can help stop attacks, protect PHI, and reduce human errors.

AI’s Role in PHI Protection and Security:

• AI tools can find PHI in medical images, even hidden details that people might miss.
• They keep needed medical data while removing sensitive patient details carefully.
• Automated systems make work faster and cheaper, allowing IT staff to focus on other important tasks.

Automation in Front-Office Operations:

• Some companies offer AI-powered phone systems for healthcare. These systems lower risks like leaks of information during phone calls.
• Automated answering services handle patient calls safely and quickly. This reduces delays and keeps sensitive details more secure.
• Automation helps keep records of who accessed or changed patient data. This is important for following HIPAA rules and other laws.

AI in Network Security and Threat Detection:

• Advanced AI watches network activity constantly for strange actions that may signal an attack.
• These tools alert staff faster than traditional methods, helping to limit damage.

Specific Considerations for U.S. Healthcare Providers

Hospitals and clinics in the U.S. work in a special legal and operational setting that shapes how they plan cybersecurity.

• HIPAA law requires strict protection of PHI and sets big penalties when breaches happen.
• Many healthcare groups get federal funding tied to meeting cybersecurity rules, creating strong incentives to protect data.
• The quick move to electronic healthcare records after a 2009 law increased cyber risks. Many places still use old systems that are vulnerable.
• Cybercriminals took advantage of healthcare weaknesses during emergencies like COVID-19, especially targeting virus response groups.
• Ransomware attacks on U.S. healthcare have been rising, showing the need for better cyber defenses.
• Collaboration among government agencies like CISA and law enforcement helps give hospitals resources and support to fight cyber threats.

Summary of Key Statistics Highlighting the Threat Landscape

• Over 170 U.S.-based PACS imaging systems were found online without proper security.
• Medical image archives had a 60% rise in exposed data, affecting millions of patient records.
• The average cost to fix healthcare data breaches is $408 per stolen record.
• More than two-thirds of U.S. healthcare groups reported ransomware attacks in 2021, up from 34% in 2020.
• 61% of attacked healthcare organizations paid ransoms, the highest rate of any industry.
• Paying ransom often leads to repeat attacks; up to 80% of paying groups got breached again.
• Cyberattacks on healthcare have caused treatment delays and higher death rates.

Protecting medical images and patient data is important not only to avoid legal and financial problems but also to keep patients safe. U.S. healthcare leaders and IT staff must use strong cybersecurity plans, adopt AI and new technology, and build a culture where patient privacy and safety matter every day.