How Often Should Healthcare Employees Receive Security Awareness Training?

Security awareness training is a requirement of HIPAA, but how often should healthcare employees receive security awareness training?

Recent Phishing and Ransomware Attacks Highlight Need for Better Security Awareness Training

Phishing is one of the biggest security threats for healthcare organizations. Cybercriminals are sending phishing emails in the millions in an attempt to get end users to reveal sensitive information such as login credentials or to install malware and ransomware. While attacks are often ransom, healthcare employees are also being targeted with spear phishing emails.

In December last year, anti-phishing solution provider PhishMe released the results of a study showing 91% of cyberattacks start with a phishing email. Spear phishing campaigns rose 55% last year, ransomware attacks increased by 400% and business email compromise (BEC) losses were up by 1,300%.

In recent weeks, there have been several phishing attacks reported to the Department of Health and Human Services’ Office for Civil Rights. Those attacks have resulted in email accounts being compromised. In July alone, 9 email-related security incidents have been reported to OCR.

The recent WannaCry ransomware attacks may have exploited unaddressed vulnerabilities, but email remains the number one vector for spreading ransomware and malware. Many of these email attacks could have been prevented if employees had been trained to detect threats and knew how to respond appropriately.

Regular Security Awareness Training is a Requirement of HIPAA

Security awareness training is more than just a checkbox item to tick off to demonstrate compliance with HIPAA Rules. If fact, a one-off training session does not meet the requirements of the Health Insurance Portability and Accountability Act (HIPAA) Security Rule.

45 C.F.R. § 164.308(a)(5)(i) requires covered entities to “Implement a security awareness and training program for all members of its workforce (including management)”. As OCR recently pointed out in its July Cybersecurity Newsletter, all members of staff in an organization “can, knowingly or unknowingly, be the cause of HIPAA violations or data breaches.” It may not be possible to reduce risk to zero, but security awareness training can help to reduce risk to an acceptable level.

How Often Should Healthcare Employees Receive Security Awareness Training?

Cybercriminals are constantly changing tactics and new threats are emerging on an almost daily basis.  An effective security awareness program must therefore provide ongoing training; raising awareness of new threats as they emerge and when threat intelligence is shared by Information Sharing and Analysis Organization (ISAOs).

After the provision of initial training, HIPAA requires healthcare employees to receive periodic security updates – 45 C.F.R. § 164.308(a)(5)(ii)(A). While HIPAA does not stipulate how often these “periodic security updates” should be issued, OCR points out that monthly security updates work well for many healthcare organizations, with additional training provided bi-annually.

Some healthcare organizations may require less or more frequent updates and training sessions, which should be determined through the organization’s risk analyses.

The security updates should include details of the latest security threats including phishing and social engineering scams that have been reported by other covered entities or shared by an ISAO. The security alerts can take many forms – email bulletins, posters, newsletters, team discussions, classroom-based training or CBT sessions. It is up to the covered entity to determine which are the most appropriate. Annual or biannual training sessions should be more in-depth and should cover new risks faced by an organization and recap on previous training.

OCR also points out in its recent newsletter that covered entities must document any training provided to employees. Without documentation on the training provided, newsletters sent, updates issued and evidence of workforce participation, it will not be possible to demonstrate to OCR auditors that training has taken place. HIPAA requirements for documenting training are covered in 45 C.F.R. §§ 164.316(b) and 164.530(j).

OCR provides some training materials on privacy and security, with third-party training companies and anti-phishing solution providers offering specific HIPAA training courses on the full range of cybersecurity threats.

Tailoring training to the needs of the individual will help to ensure that all employees become security assets and organizations develop a robust last line of defense against phishing attacks.

Author: Steve Alder has many years of experience as a journalist, and comes from a background in market research. He is a specialist on legal and regulatory affairs, and has several years of experience writing about HIPAA. Steve holds a B.Sc. from the University of Liverpool.