Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Over the past decade, clinical care has become globally dependent on information technology. The cybersecurity of healthcare information systems is now an essential component of safe, reliable, and effective healthcare delivery. Objective: The objective of this study is to provide an overview of the literature at the intersection of cybersecurity and healthcare delivery. Methods: A comprehensive search was conducted using PubMed and Web of Science (WoS) for English-language peer-reviewed articles. We carried out chronological analysis, domain clustering analysis, and text analysis of the included articles to generate a high-level concept map composed of specific words and the connections between them. Results: Our final sample included 472 English-language journal articles. Our review results revealed that the majority of articles are focused on technology: Technology-focused articles made up more than half of all the clusters, while only 32% were managerial. This focus on the technological aspects of cybersecurity suggests that non-technological variables (human-based and organizational aspects, strategy and management) may be understudied. Also, software development security, business continuity, and disaster recovery planning each accounted for 3% of the studied articles. Our results also show that physical security is lacking in research, with only 1% of the literature being categorized as such. Cyber vulnerabilities are not all digital. Many physical threats contribute to breaches, and these threats potentially affect the physical safety of patients. Conclusions: Our results revealed an overall increase in research in this area, and identified major gaps and opportunities for future work.

Cyber attacks are increasingly menacing businesses. Based on the literature review and publicly available reports, this article conducts an extensive and consistent survey of the services used by the cybercrime business, organized using the value chain perspective, to understand cyber attack in a systematic way. Understanding the specialization, commercialization, and cooperation for cyber attacks helps us to identify 24 key value-added activities and their relations. These can be offered “as a service” for use in a cyber attack. This framework helps to understand the cybercriminal service ecosystem and hacking innovations. Finally, a few examples are provided showing how this framework can help to build a more cyber immune system, like targeting cybercrime control-points and assigning defense responsibilities to encourage collaboration.

The 2019 Capital One data breach was one of the largest data breaches impacting the privacy and security of personal information of over a 100 million individuals. In most reports about a cyberattack, you will often hear that it succeeded because a single employee clicked on a link in a phishing email or forgot to patch some software, making it seem like an isolated, one-off, trivial problem involving maybe one person, committing a mistake or being negligent. But that is usually not the complete story. By ignoring the related managerial and organizational failures, you are leaving in place the conditions for the next breach. Using our Cybersafety analysis methodology, we identified control failures spanning control levels, going from rather technical issues up to top management, the Board of Directors, and Government regulators. In this analysis, we reconstruct the Capital One hierarchical cyber safety control structure, identify what parts failed and why, and provide recommendations for improvements. This work demonstrates how to discover the true causes of security failures in complex information systems and derive systematic cybersecurity improvements that likely apply to many other organizations. It also provides an approach that individuals can use to evaluate and better secure their organizations.

Almost everyone recognizes the salience of cyberspace as a fact of daily life. Given its ubiquity, scale, and scope, cyberspace has become a fundamental feature of the world we live in and has created a new reality for almost everyone in the developed world and increasingly for people in the developing world. This paper seeks to provide an initial baseline, for representing and tracking institutional responses to a rapidly changing international landscape, real as well as virtual. We shall argue that the current institutional landscape managing security issues in the cyber domain has developed in major ways, but that it is still “under construction.” We also expect institutions for cyber security to support and reinforce the contributions of information technology to the development process. We begin with (a) highlights of international institutional theory and an empirical “census” of the institutions-in-place for cyber security, and then turn to (b) key imperatives of information technology-development linkages and the various cyber processes that enhance developmental processes, (c) major institutional responses to cyber threats and cyber crime as well as select international and national policy postures so critical for industrial countries and increasingly for developing states as well, and (d) the salience of new mechanisms designed specifically in response to cyber threats.

Physical control systems are increasingly controlled by reconfigurable, network-enabled devices to increase flexibility and ease commissioning and maintenance. Such capability creates vulnerabilities. Devices may be remotely reprogrammed by a malicious actor to act in unintended ways, causing physical damage to mechanical equipment, infrastructure, and life and limb. In this paper, past examples of actual damage to cyber-physical systems are shown, threats posed by software-controlled Variable Frequency Drives (VFDs) are analyzed, and a small-scale version of an attack on ubiquitous VFD equipment is demonstrated.

Recent cyber-physical attacks, such as Stuxnet, Triton etc., have invoked an ominous realization about the vulnerability of critical infrastructure, including water, power and gas distribution systems. Traditional IT security-biased protection methods that focus on improving cyber hygiene are largely impotent in the face of targeted attacks by advanced cyber-adversaries. Thus, there is an urgent need to analyze the safety and security of critical infrastructure in a holistic fashion, leveraging the physics of the cyber-physical system. System-Theoretic Accident Model & Processes (STAMP) offers a powerful framework to analyze complex systems; hitherto, STAMP has been used extensively to perform safety analyses but an integrated safety and cybersecurity analysis of industrial control systems (ICS) has not been published. This paper uses the electrical generation and distribution system of an archetypal industrial facility to demonstrate the application of a STAMP-based method – called Cybersafety – to identify and mitigate cyber-vulnerabilities in ICS. The key contribution of this work is to differentiate the additional steps required to perform a holistic cybersecurity analysis for an ICS of significant size and complexity and to present the analysis in a structured format that can be emulated for larger systems with many interdependent subsystems.