SECANT & ENTRUST - Insights from EU Project Coordinators on Advancing Cybersecurity in Healthcare

Insights from EU Project Coordinators on Advancing Cybersecurity in Healthcare

Two EU projects, ENTRUST and SECANT, have recently partnered to raise awareness about cybersecurity in the healthcare sector. This article includes insights from Lina Giannakandropoulou, project coordinator for ENTRUST (Uni Systems), and Anael Le Bihan, project coordinator for SECANT (NTT DATA).

Why is cybersecurity becoming more important in the healthcare sector, and why is research in this area essential?

Lina Giannakandropoulou:  The importance of cybersecurity in healthcare is steadily growing due to the need of healthcare organizations to store vast amounts of sensitive personal and medical data, which makes them prime targets for cyberattacks, as such data is valuable on black market. In addition, the healthcare sector has seen a surge in ransomware attacks, where cybercriminals encrypt data and demand payment for its release. These attacks can disrupt hospital operations, delay patient care, and lead to significant financial losses. Moreover, the growing use of connected medical devices introduces new vulnerabilities. These devices often have weak security protocols, making them susceptible to attacks that could compromise patient safety.

Consequently, focused research in this field is essential, as the continuous changing cyber threats necessitate continuous investigation to create new defensive strategies and technologies specifically designed to meet the unique requirements of the healthcare sector. Above all, it plays a crucial role in patient safety by preventing attacks that could jeopardize patients’ well-being by disrupting healthcare services.

Anaël Le Bihan:  Cybersecurity in the healthcare sector is increasingly critical due to the sector’s growing reliance on digital technologies, which has expanded cyber threats. According to the European Union Agency for Cybersecurity (ENISA), the healthcare sector was one of the most targeted by cyberattacks in 2021, with ransomware incidents and data breaches being particularly prevalent. The European Commission highlights that the healthcare sector accounts for a significant portion of reported data breaches, with healthcare data being 50 times more valuable on the black market than financial information due to its sensitivity and the potential for misuse.

The integration of electronic health records (EHRs), telemedicine, and connected medical devices (CMDs) into healthcare systems has introduced significant efficiencies but also created vulnerabilities. For instance, a 2020 report from the European Commission indicated that 83% of healthcare institutions in the EU had experienced at least one cyberattack, with the number of incidents increasing annually. The COVID-19 pandemic increased these risks, as the rapid adoption of remote healthcare services and the increased use of medical devices are now facing cybercriminalities.

Research in cybersecurity for healthcare is crucial because the threats are becoming more sophisticated. Cyberattacks on healthcare systems can lead to the theft of sensitive patient data, disruption of critical medical services, and even direct harm to patients if medical devices are tampered with. For example, a cyberattack on a hospital’s network could disable critical life-saving equipment or manipulate the data generated by medical devices, leading to incorrect diagnoses or treatments.

The European Commission has recognised the urgency of this issue and has been investing in research through programs like Horizon 2020 and Horizon Europe. These initiatives fund projects like SECANT and ENTRUST, which focus on developing advanced cybersecurity solutions tailored to the healthcare sector. The Commission’s 2020 Cybersecurity Strategy underscores the need for innovative research to build resilience against cyber threats, with particular attention to sectors like healthcare that are vital to public safety and well-being.

Moreover, the EU’s General Data Protection Regulation (GDPR) has set stringent standards for data protection, making cybersecurity research essential for ensuring compliance while also safeguarding patient privacy. The Commission’s Digital Europe Programme also supports the creation of a secure digital infrastructure, emphasizing the importance of cybersecurity in protecting critical sectors such as healthcare.

Exploring the shared approaches of ENTRUST and SECANT in strengthening cybersecurity in healthcare

The ENTRUST and SECANT projects share several similarities, particularly in their focus on enhancing cybersecurity and privacy within complex interconnected systems, with a strong emphasis on the healthcare sector. Both projects aim to address the critical need for robust cybersecurity measures in healthcare by ensuring secure, reliable, and trustworthy systems that protect patient data and ensure the safe operation of medical devices.

Both projects prioritize cybersecurity in healthcare, by recognizing the critical need to protect sensitive data and ensure the safe operation of medical devices and systems:

• ENTRUST is more focused on trust management in connected medical devices.
• SECANT aims to enhance cybersecurity across the broader healthcare ecosystem, including interconnected nodes and industrial ecosystems. The project does this through threat intelligence, risk analysis, and training.

Both projects emphasize the importance of dynamic risk assessment:

• ENTRUST plans to implement dynamic trust assessment models to identify the Required Level of Trustworthiness (RTL) per device, ensuring that devices operate securely in real-time.
• SECANT aims to design a dynamic, evidence-based risk assessment framework capable of handling cascading effects of cyberattacks and propagated vulnerabilities across interconnected systems.

The two projects propose innovative approaches to enhance trust and security:

• ENTRUST introduces a novel remote attestation mechanism to ensure the correct operation of medical devices at runtime, even for resource-constrained systems.
• SECANT plans to implement cutting-edge trust and accountability mechanisms, including the use of distributed ledger systems for data protection and integrity.
   Real-time security is a focus in both projects. 
• ENTRUST emphasizes real-time conformity certificates and attestation mechanisms that operate during the runtime of medical devices.
• SECANT focuses on dealing with real-time threats through dynamic risk assessment and collaborative tools for real-time vulnerability management.

Both projects include plans to validate their solutions through four pilot demonstrations:

• ENTRUST will evaluate its framework in four real-world use cases ranging from wearable and medical devices used for remote patient monitoring to high-end stationary equipment used in hospitals and clinics.
• SECANT will test its platform in scenarios like emergency medical services and healthcare supply chains.

Data protection is a central theme in both projects:

• ENTRUST ensures data integrity, particularly in wearable devices and connected medical devices, safeguarding the privacy and trustworthiness of the data exchanged across the network.
• SECANT addresses data protection and accountability within interconnected healthcare systems.