Cybersecurity Training 101- Building the Human Firewall

Mike Whaley, Director of IT Security for CRC TechnologiesThis is an article written for Sally McKenzie’s newsletter The Dentist’s Network which can be found Here

By Mike Whaley, Director of IT Security for CRC Technologies and DIA Member

 

It has been estimated that it can cost the victim of a healthcare data breach (the patient) $13,500 to recover after their medical data has been stolen. A Ponemon Institute Study on Medical Identity Theft (publication date 2015) compiled these costs based on credit restoration, reimbursement to healthcare providers for fraudulent claims, and correcting inaccuracies in health care records. Due to HIPAA privacy regulations, victims of medical identity theft must be involved in the resolution of the crime. Those who have resolved their crime spent, on average, more than 200 hours working with their insurer or healthcare provider to make sure their personal medical credentials are secured and can no longer be used by an imposter, and verifying their personal health information, medical invoices, claims and electronic health records are accurate.

Dental professionals are keepers of some very sensitive, embarrassing, and potentially discriminatory data. Dental professionals are also keepers of enough information for one person to easily create a false identity – therefore it is necessary to take measures to keep patient data safe.

Most of a dental practice’s technical security controls are provided by their IT vendor, such as firewalls and antivirus. Hopefully the practice is already taking their IT vendors technical security control recommendations seriously and implementing them. Controls are also driven by the practice, such as security cameras or security policies and procedures, and access controls like door locks and server room locks. Even if a practice has their security locked down, it could easily take only one of their employees to accidently download and run a malicious program delivered by email or a website and BOOM – the practice data is ransomed, or the computers are suddenly being remotely viewed and staff keystrokes logged while login credentials are stolen.

If properly trained, staff can become the biggest guard against cybersecurity threats. They will become the human firewall. Security threats can come from many different directions like email phishing, the internet, phone calls, or an in-person visitor. Training employees on a regular basis about cybersecurity threats is called Cybersecurity Awareness Training.

Ongoing cybersecurity training helps to prevent bad outcomes from threats like phishing, which is when the bad guys trick a person into following a malicious link in an email or downloading an email attachment. A study reported by the INFOSEC Institute reports that, “…26% to 45% of the employees of the chosen companies were susceptible to phishing. With the security awareness program, that percentage decreased by 75%.”

Ransomware is a big moneymaker for the bad guys. If a practice downloads malware that ends up encrypting their patient data and demands money to unencrypt the data, this can cost a practice thousands of dollars in ransom to decrypt the data. Plus, if hit by ransomware, HIPAA requires practices to prove their data wasn’t taken by the bad guys, so it could be a double whammy with fines.

Cybersecurity Awareness Training programs aren’t expensive and there are plenty of options out there. Implementing a Cybersecurity Awareness program shouldn’t be a one-time event, it needs to be ongoing and training needs to take place quarterly at a minimum to be effective. The National Institute of Standards and Technology (NIST) of the U.S. Department of Commerce recommends training modules, testing users, simulations, posters, and newsletters as part of the program.

Popular security awareness training vendors include KnowBe4 and PhishMe. KnowBe4 includes phishing, fake voice calls, and they can even send a USB drive to the practice to see if staff will plug it in. PhishMe is one of the more senior companies in the space and has perfected the phish and training that goes along with it. If an end user clicks on a link in a phishing email, it will send them to a training web site. One organization to consider is SANS for their cybersecurity training. They are an organization made up of cybersecurity professionals and have a good reputation for being on the forefront for training end users.

Practices should be on the lookout for cybersecurity training that is offered from their HIPAA consultants or their bank if enrolled in a PCI compliance program. They may have training modules included with their online solutions. The practice’s IT vendor might have some good options for cybersecurity awareness training programs and may already have a program they can refer to or administer.

Rather than a costly breach or a down server do to ransomware, Cybersecurity Awareness Training can help build the human firewall and keep out the bad guys. Loss of patient data can cost not only the practice time and money, but it can cost the patients time and money also. Training programs are easy to find and easy to administer. Stay safe out there!

 

Mike Whaley is the Director of IT Security for CRC (www.crctechs.com ), a managed service provider based in Seattle, Washington. Mike has more than 20 years of client and project management along with a formalized education in Network Administration.

CRC is a proud member of the Dental Integrators Association, a network of leading independent dental technology integration firms from across the country. It was formed to create and deliver a higher standard of quality and care for dental practice technology integration.

Mike can be reached at: mike@crctechs.com

 

 

 

 

 

 

 

 

HIPAA: As Easy as…PPT?

This is an article written for Sally McKenzie’s newsletter The Dentist’s Network which can be found Here

By Amy Wood, President of ACS Technologies, LLC

 

Wouldn’t it be great if HIPAA was as easy as 123 or even ABC? Well, turns out it can be as easy as People, Process and Technology – or as I like to call it, PPT. Additionally, when you have PPT in place, it benefits many other aspects of your practice as well.

As confusing as HIPAA may be, especially for smaller practices to decipher, it can be broken up into three simple things: People, Process and Technology. If you look at all aspects of HIPAA with these three things in mind, it becomes easy to decode and then implement in your practice.

 

Let’s start with People. As an employer, if you properly train your staff and then provide tools to enforce that training, your people will become one of your strongest defenses. When training your team, you have many options to choose from. There are pre-recorded videos, webinars, and consultants that offer live trainings to review the basics of HIPAA – where you and your staff can ask pertinent questions and receive personalized answers. In addition, it is imperative that you review the Process and Technology parts of your Compliance Program with your staff, meaning your HIPAA Policies and Procedures as well as the technology vulnerabilities and security. When it comes to training, the best offense is a good defense.

Next comes the Process. The Policies and Procedures that you are supposed to be training your staff on must be created. You could purchase a manual with stock templates or try to find them on the internet, but I’ve found the most comprehensive policies are a joint effort between the practice staff, the doctor, a HIPAA consultant and the IT Provider. This way, what is written on paper is actually what is being done.

For example, if your policy says you will have Business Grade Anti-Virus on all computers that is updated at least daily and documented as such (as is recommended), but you buy an anti-virus license once per year and set it to ‘auto update’, your policy really isn’t being followed.

Last, and often most confusing, is the Technology. While this part of HIPAA is only about 20% of the puzzle, it tends to be the most talked about because it’s constantly changing. Think about it – ten years ago you were just implementing computers to schedule appointments, and now you are doing appointment reminders, patient health histories, and 2D/3D images of the teeth and head. You can access it from home and send it to colleagues to collaborate. The changes over the years have been incredible.

Unfortunately, the same goes for cyber threats. As information becomes easier to create and move, the more vulnerable that information becomes and the more frequently you have to adapt to new threats.

What exactly is the best way to secure your technology?

It used to be that locking the door and buying an anti-virus program was enough to keep the bad guys out. That’s not the case anymore. Now there’s encryption, cages and cables, firewalls, patching and updates, ‘smart’ equipment and lots of backups. Unless you are fluent in Geek, this can be daunting. Many of the programs and tools that automate this are only accessible to larger businesses.

Fortunately, many IT Providers are adopting a Managed Services Provider Model, where they provide a set of these programs and tools within your price range because they can be aggregated across many clients. This type of IT Provider essentially acts as your Systems Administrator, meaning they are an outsourced IT Department for your practice.

This is a different type of engagement than most dentists are used to and is still relatively new in this space. Most dental practices are used to calling the tech guy when something is broken. Personally, I miss those days. We were the smart guys who were like knights in shining armor. Things have certainly changed in the last few years. With all the malware, ransomware and hacking that has been happening, now if something happens we are the guys who ‘let you get hacked’. It’s no longer about fixing broken things; it’s about preventing things from being broken into. 

There is baseline security that can not only thwart most attempts to get into your business, but can also have all the tools in place proactively if something does get past all your defenses. I call this the ‘Magic Bullet Theory’. If you remember the initial reports of the JFK assassination, they talked about this ‘Magic Bullet’ that had an abnormal and impossible trajectory. Using that same theory, if you think about a threat to your Protected Health Information, in a secured and managed system, that threat would have to get past multiple layers of defense that have different points where they overlap. With all of these defenses in place, the likelihood of something getting through is extremely low.

If your IT Provider isn’t doing these things, someone needs to – whether it be you, your team or another vendor. You stay up on current standards of care for patient treatment. It’s worth it to have a conversation regarding the current standards of care about your digital security.

 

Amy Wood is President of ACS Technologies, LLC. She utilizes her experience as a Data Breach Consultant and a Healthcare IT Provider to provide comprehensive education with real and relatable examples, ensuring that practices are addressing HIPAA proactively, rather than reactively, in a reasonable and appropriate manner.

Amy educates to private practices and clinics, dental associations, study clubs and disability groups as well as to vendors and Business Associate practices. She runs ACS with her husband, Scott, and lives in Santa Rosa, CA with their three daughters. 

Amy can be reached at hipaa@acsdt.com

 

 

 

 

 

 

Business Intelligence – The Next Big Thing in IT

DentalPC - Clay ArcherThis is an article written for Sally McKenzie’s newsletter The Dentist’s Network which can be found Here

 

Over the last few years we have heard a lot about the cloud and “big data”. But isn’t all that for big companies like Walmart and Amazon? The short answer is not anymore. Platforms like the cloud are allowing small business to look at their data like big companies traditionally have. Third party plugins and applications can look at your practice management data and dissect it in a more approachable way. “That’s great but how does it affect my Dental practice?” In the short term, it will change the way dental practices use their data in three major ways.

 

Dashboards/Score Cards. It’s the old proverb “what gets measured gets managed.” Business Intelligence in its simplest form comes in the shape of gadgets or apps that display simple management numbers. Whether it is number of new patients/month or Hygiene production/day, these “widgets” let you quickly see how the practice is doing in certain defined parameters. Unlike traditional reports, you don’t have to look through lists or dropdowns, the numbers are simply presented in whatever form you want. If you want to go deeper into details you can click on the widget and the underlying data will be displayed. Score cards are a wonderful tool for positive reinforcement, variable pay (bonus) and team contests. It is all about clarity of message and goal attainment. These are great for morning huddles or monthly staff meetings to review where the practice is on specific goals. Then the staff can use them on a constant basis to review progress. We have several offices who display a dashboard of widgets in the staff room so the data is always top of mind.

 

Enforcing Systems/Training. As a simple extension of the what gets measured gets managed proverb, the staff now knows what numbers are important. They can more efficiently use their time and effort towards making the appropriate changes or reinforce the things that they are doing well. We can use the information to create best practices and training around what best affects the bottom line. When goals are clearly defined it is much easier to train staff to a system. These types of process driven training programs have until now been the domain of larger corporate organizations.

 

Benchmarking. Traditionally Dentists have not shared much practice management information and have essentially practiced alone. Because most of these Business Intelligence tools have many users there is an ability to “benchmark” across the user base. Now not only can you look at the numbers inside the practice you can see how you stack up against your peers. From customer satisfaction ratings to overhead costs and margins you can see how your practice is performing against others in your region/specialty/etc. Because the data is looked at in aggregate and individual results are anonymous there is no reason to worry about competitive forces. This allows smaller individual practices to take advantage of large sample sizes like corporate dentistry does. A few possible examples would be fee optimization, revenue per procedure, frequency of procedures, procedure duration, the list goes on and on.

 

The reason that I stated that these are the main changes in the short term is that Business Intelligence is a rapidly evolving arena. It won’t take long for these technologies to evolve into different aspects of the practice. The next generation of Business Intelligence will actually “learn” and provide information based on data. Think of a recall system that tailors messages based on past interactions. Or a forecasting system that raises goals based on unscheduled treatment or Insurance benefits. The next generation will change the way you interact with patients, vendors and employees.

The bottom line is that you have a ton of very valuable information inside of your Practice Management system. These new tools help you mine it for the relevant information to more efficiently manage your practice. There are quite a few of these tools in the marketplace right now and the list is growing. Choosing the right one for your practice will depend on the features you are looking for and the integration with your specific Practice Management software.

The first step is to work with a professional IT company. The Dental Integrators Association is an organization dedicated to educating IT professionals. To be sure you have cutting edge knowledge on your side you can find a professional at the Dental Integrators Association website www.dentalintegrators.org

 

Clay Archer is the CEO and Founder of DentalPC, a dental specific IT solutions provider serving the Southeastern United States since 1995. Clay can be reached at clay@dentalpc.com

There is Hope

“A Match Made in _____”
Cyber Threats and HIPAA Compliance – There is Hope

By Patrick Jacobwith, Sunset Dental

President, DIA

Guest Writer for Sally McKenzie

 

Are we at the beginning, middle or end?  Please let it be the end.  Recent events have caused many in the business community to think these thoughts, especially in healthcare.
Cyber Crime has exploded.  The global cost of cybercrime will reach $2 trillion by 2019, a threefold increase from the 2015 estimate of $500 billion.  Last year, IDG detected 38 percent more cybersecurity incidents than the year prior.  Source – SecurityIntelligence by IBM
HIPAA enforcement is real.  Due to the intensity of compliance and regulations, the costs per breach to organizations in the health care and financial services sectors top all other industry groups, according to the Ponemon study.
Small Business Beware!  Small and midsized organizations (SMBs), defined as those with less than 1,000 employees, are hardly immune to cybercrime — actually quite to the contrary.  According to Keeper Security’s “The State of SMB Cybersecurity” report, a staggering 50 percent of small and midsized organizations reported suffering at least one cyberattack in the last 12 months.
A Cyber Attack may be considered a HIPAA breach according to the OCR’s Wall of Shame and as outlined in the following headline from HealthITSecurity.

“Cybersecurity Attacks Leading 2016 Data Breach Cause
The top 10 healthcare data breaches of 2016 were mainly caused by cybersecurity attacks, including ransomware and unauthorized access.”

So the marriage has been made.  Cyber-attacks are directly linked to HIPAA breaches.  This presents a real and present risk to all dental practices.  As we know, a breach can occur at any time and many dental practices are still open doors for cyber criminals.
We are not at an end, we are more near the beginning.  Cyber criminals are well-funded and becoming increasingly organized.
Ransomware – the latest wave
What is ransomware?  Ransomware is a virus designed to block access to the data in a system until money is paid.  Ransomware usually is planted in a clinic’s network environment via an attachment to an email.  The virus immediately does three things:
1. Begins encrypting data on the computers
2. Sends the decryption key to their own “secret” location
3. Grabs all contacts and forwards the nasty email (then it looks like a “friendly email”)

There is Hope
What can we do?  In the IT Managed Services arena, the Dental Integrators Association (DIA) recent national conference discussed this topic at length with guests from the FBI Cybersecurity Division.  DIA member companies are well aware of the threats and have been working diligently to create solutions.  The best thing you can do, is work with a managed IT provider who will secure your systems before you have a breach.
In closing below are a few simple short-term tips for each of you.  Beyond the short term, please build a plan for the long term.
Simple and Practical suggestions for all dental practices:

• Partner with a credible IT/Cyber Security company.  The DIA and its member companies take these matters seriously.
• Make Cybercrime and HIPAA a higher priority and invest resources in solutions
• Cyber Tips

o Allow the partners to deploy a credible firewall
o Allow the partners to deploy a credible back-up solution that includes Business Continuity
o Do not open email attachments!  Make sure the attachment is clean.  Clean can be because the email was sent via encryption, or just call the sender and verify they actually sent the email.

• HIPAA

o Build a comprehensive plan to address HIPAA in your organization
o Begin with a HIPAA risk assessment
o Train your staff
o Get Business Associate agreements in place
o Go back to your comprehensive plan

Most importantly, please work with a professional IT company. The Dental Integrators Association is an organization dedicated to educating IT professionals. To be sure you have cutting edge knowledge on your side you can find a professional at the Dental Integrators Association website www.dentalintegrators.org

 

sunset-p-jacobwithPatrick Jacobwith is the CEO of Sunset Dental Technologies a multi-state organization based in Minnesota.  Patrick is also the President of the Dental Integrators Association.  He believes in excellent service and building healthy and productive relationships.  Patrick’s core values are built on three words: Service, Humility and Love.

Patrick can be reached at patrick@sunsetdt.com

 

Selling Your Practice? Beware of This Scam

Selling Your Practice? Beware of This Scam

Amy Wood, ACS Technologies

I can’t believe I have to write this, but I’ve been told of this scam by several dentists as well as practice transition consultants.

 The scam is this:  A local doctor comes in looking to expand their patient database by purchasing your practice.  Seems legit, right?  They then ask for access to your computer or server to get an idea of your patient pool, or to run a report in your practice management program.  This is when they install a spyware program to secretly take your patient information to directly market to them.

Seriously?  As if we don’t have enough security threats to worry about, now we have to worry about your fellow dentists?

You can easily protect yourself by adhering to this simple rule: NO ONE gets access to your computers, server or network unless they are your staff or one of your HIPAA Business Associates.  If a potential buyer needs reports or information, you provide it to them.  This applies to consultants too.  They are not staff and they are not hired to interact with, create, receive, maintain or transmit Protected Health Information on your behalf, so they don’t get access to your systems.

 

 

 

 

Amy Wood is a HIPAA Data Breach Mitigator specializing in making dental practices compliant and secure.  She is president of ACS Technologies, LLC, a Northern California HIPAA Compliance & IT firm.  Amy has written many articles for various dental publications and spoken at dental associations, study clubs and private practices.  She runs ACS with her husband, Scott and lives in Santa Rosa, CA with their three daughters. 

Amy can be reached at hipaa@acsdt.com

HIPAA Compliance: More than Just Data Breaches

DIA Board Member, Amy Wood, recently wrote this article for Sally McKenzie.  It can be seen in whole on her site HERE

 

Amy Wood, ACS Technologies

HIPAA Compliance: More than Just Data Breaches

By Amy Wood, President of ACS Technologies, LLC

 

At this point we have all heard about the data breaches and million dollar fines, and how your HIPAA security alleviates these major concerns. But have you ever thought about all the other ways HIPAA compliance helps your practice?

Human Resources Issues
Imagine a problem employee. The one who casually browses the internet instead of working, even though you’ve told them not to. Worse yet, one who thinks they know enough about HIPAA and holds you hostage for the things you don’t yet have in place.

Proper Training is key to ensuring your staff actually knows and understands HIPAA regulation. Policies & Procedures are another component. Your entire staff should review and sign an acknowledgment of reading which includes privacy, security and technology policies. The most important one is a sanction policy which should outline what happens should the employee violate HIPAA or security in the practice – write up, termination or even jail depending on the violation or repeat violation.

Business Insurance
It’s become commonplace for business insurance carriers to ask about basic security. Do you have business grade antivirus? Do you have a firewall? Do you use secure email? Do you have backups? The new trend in insurance is cyber-liability and data breach coverage, as most data breaches are happening in the digital data space. Their questions are even more comprehensive. Do you have the knowledge to answer these questions? If you are covered by a managed service IT provider, they can help you answer all of these.

Patient Insurance Audits
MACRA, the Medicare Access and CHIP Reauthorization Act which was enacted late last year, tied Medicare reimbursement rates to a practice’s level of security and thus, HIPAA compliance. Early in 2017, we started seeing major dental insurance carriers ask for proof of basic security practices as well as HIPAA risk assessments, other HIPAA related documentation and cyber-liability/data breach insurance. Failure to have these things results in lower reimbursement rates after the audit. These are basic business best practices anyway – protect those margins!

Patient Complaints
Over the years, I have fielded many patient complaints regarding HIPAA and security. One complaint asserted that the doctor, let’s call him Dr. Compliant, had sent multiple patient records to a single patient via unencrypted email. As it turned out, Dr. Compliant had used an encrypted secure email system to send several patient records to a second doctor, Dr. Not-So-Compliant, which was proved through the secure email program.

When the patient requested the x-rays by email, Dr. Not-So-Compliant forwarded the emails with all the files sent from Dr. Compliant on to the patient without checking the contents first, thus breaching the other patients. The patient demanded free treatment in exchange for silence. Thankfully, Dr. Compliant had embraced security and the use of encrypted secure email, and we were able to prove Dr. Compliant did not breach data.

PCI
Payment Card Industry (PCI) requires an annual questionnaire that asks numerous questions about paperwork and security, including your technology equipment and setup. Many of these requirements overlap with HIPAA requirements, which are, again, basic business best practices. Unfortunately, many doctors protect credit card data better than full PHI contained in their patient charts.

Summary
When we are talking about digital data security, there are simple ways to do it right and many ways to do it wrong. Talk to your IT provider to ensure you are using current standard of care for things like backups, anti-virus, firewall, secure email and patching. Most IT providers will provide you with a package of these services, as it is commonplace as well as expected by the Office for Civil Rights. Your provider doesn’t provide this? Find a healthcare specific IT provider at the Dental Integrators Association.

 

Amy Wood is a HIPAA Data Breach Mitigator specializing in making dental practices compliant and secure.  She is president of ACS Technologies, LLC, a Northern California HIPAA Compliance & IT firm.  Amy has written many articles for various dental publications and spoken at dental associations, study clubs and private practices.  She runs ACS with her husband, Scott and lives in Santa Rosa, CA with their three daughters. 

Amy can be reached at hipaa@acsdt.com

IT Security: What Every Doctor Needs to Know

DIA past-president and member, Bryan Currier, recently wrote this article for Sally McKenzie.  It can be seen in whole on her site HERE

 

Bryan Currier, Advantage Technologies

IT Security 101: What Every Doctor Needs to Know

 

What is IT Security?


Defining IT Security is a good starting point since it can have different meanings to different people.

According to Wikipedia,

IT Security is the process and mechanisms by which computer-based equipment, information and services are protected from unintended or unauthorized access, change, or destruction. It is of particular and growing importance in line with the increasing reliance on computer systems in most societies worldwide.

 

 

What does IT Security involve?
As you can see from the definition, IT Security encompasses certain things that most people don’t consider. For example, when you think of IT Security for your practice, what comes to mind? If you’re like most, you probably concern yourself with safe-guarding your system against hackers and crashes – which you should be doing.

However, notice the first words I emphasized – process and mechanisms. Process implies people, which has more to do with IT security than anything else. Additionally, you may have considered protection against unauthorized access and destruction. What about unauthorized change?

No one would dispute we are exponentially more reliant on computer systems now than we were just ten years ago. For instance, when I first started in dental IT a computer crash was nothing more than a minor inconvenience. But today? A crash can have major consequences and directly affect patient care – so protecting this information should be of paramount concern in any practice.

 

What is a high-level overview of the threats to IT Security? How can you mitigate those threats?

Viruses: The key here is complete anti-virus protection that you can prove is monitored, managed, and automatically updated. Additionally, you need a secure firewall with a gateway anti-virus.

Malware: An anti-malware system is a must – think CryptoWall and CryptoLocker. In addition, you need content filtering as part of a sound firewall strategy.

Hacking: Your primary defense against hacking is a solid firewall that is continually updated, monitored, and managed. Also, you should only be utilizing secure remote access. Using free tools to remotely access patient information from home or an iPad is simply a recipe for a data breach.

User Error: Often overlooked, user error represents one of the most common causes of unauthorized data change and loss. Staff training is your best bet to mitigate this risk. A great starting point is finding the answers to such questions as:

When was my team last trained on how to effectively use the practice management system? How much turnover have we had since the last training?

Are new staff members correctly trained in the current version of the software? How many bad habits are being picked up because someone at the front desk is just “showing them how to do it”?

Plus, you need to check their access credentials. Not everyone in the practice needs full administration rights to your management system, so take time to audit that.

Phishing: The key here is telling staff members to not check personal email at work. When you do check email of any kind, be extremely careful what links you click on. Not 100% sure? Simply don’t click on them. Another great defense against phishing is content filtering at your firewall.

System Crash: What’s the best prevention against a crash? First, you need to be using servers and workstations with business class pedigree and warranties — think Dell and HP systems.

Second, and more importantly, you need to have a managed IT service. This is a provider that is managing your system – servers, workstations, firewalls, anti-virus, etc. – on a continual basis. Someone essentially acting as your IT department. The Dental Integrators Association is a great resource to help you find local, independent IT companies that will work with you and on your behalf to help reach your goals.

Natural Disasters: This once again emphasizes the importance of having a dedicated IT provider that is supporting you with a solid backup and recovery plan. In addition, they should be providing you with a clearly defined contingency plan in the case of a disaster.

 

What are 5 practical steps to take into my practice?

1. Implement an acceptable use policy – what they can and can’t do on your computers.

2. Use ‘need-to-know’ access. This means auditing all user names in your practice management system. For example, Susie the hygienist cannot make changes in a patient’s ledger balance.

3. Protect your key data by ensuring your IT provider sets up a secure, backup, and disaster recovery strategy that is HIPAA compliant.

4. Make sure you’re only using secure remote access.

5. Confirm your IT provider offers a working knowledge of HIPAA, HITECH, PCI, and any other regulations that you may be subject to. It is extremely important that they have a solid understanding and are designing systems that work for you.

Again, a great resource to get you started in the right direction is the Dental Integrators Association. Their sole job is to provide a system which educates IT providers to a manner in which raises them above the norm.

 

Bryan Currier is the President of Advantage Technologies, an IT company that focuses on dental and dental specialties. It serves as the leader in utilizing cutting-edge technology to keep its customers in the forefront of dental technology. In the last 15 years, he and his team have worked with more than 1,000 practices, helping them effectively integrate computers and digital technology. Bryan has spoken at numerous conferences throughout the country, and has served on the Microsoft Partner Advisory Council and published articles in the Doctor of Dentistry magazine and The Journal of American Association of Oral and Maxillofacial Surgeons. 

Bryan has a bachelor’s degree in Business Leadership as well as various dental and technological certifications. He lives in Nashville, TN with his wife and four children. He can be reached via email at: Bryan@adv-tech.com

You can find Advantage Technologies online at www.adv-tech.com and the Dental Integrators Association can be found at www.dentalintegrators.org

IT Nation 2017

it-nation

it_nation-pic

 

 

 

Have you heard about it?

Have you attended?

How much did you learn?

 

IT Nation, hosted by ConnectWise a long time partner of the DIA, is the premier conference for technology solution providers and the largest event of its kind – offering a world-class experience for attendees.

Here at the DIA, we are constantly trying to advise the public and remind other dental IT providers that the DIA is here as a resource for them, both of them. IT Nation was just another example of this, eight DIA member companies (18 individuals) attended this conference. Our association, was able to provide a ‘home base’ for these attendees in a sea of more than 3,000!

The DIA is more than just comradery, it’s about education and advancement of your businesses. We are proud to announce that, our president, Patrick Jacobwith of Sunset Dental and Christina Archer of Dental PC were asked to sit on the Partner Panel of How to Create Lasting Change & Make Your Business Model Changes Stick. This session was detailed:

 

To stay competitive and profitable, top MSPs are on a continual march of evolution. If you want those changes to stick, you’ve got to excel in a few critical areas. In the partner panel, Paul Dippell will dive into the key places your organization should focus to make your business model changes stick. Partners who have successfully implemented the as-a-service model will share the lessons learned and challenges they overcame to make lasting changes in their organization.

IT Nation Education Panal

We are proud of our DIA Members and thrilled that the dental community sees their worth as well! If you would like to learn more about the DIA and how to become a member yourself, please email michelle@dentalintegrators.org or https://dentalintegrators.org/join-dia/

DIA President & CW CEO

 

Arnie Bellini, Connectwise CEO

Patrick Jacobwith, Sunset Dental CEO & DIA President

IT Nation 2017, Orlando FL

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Did you know that your data can be compromised?

ransomware

By Patrick Jacobwith, Sunset Dental

President, DIA

Guest Writer for Sally McKenzie

 

 

Hackers have become more sophisticated, and technology has advanced resulting in an increased level of vulnerability to your network.

  • Did you know more than 400,000 new viruses were written in 2015?
  • Did you know there is a daily “black market price” for personal information?
  • Did you know that healthcare companies are a target of hackers due to the wide scope of information stored for each person?
  • A successful hack can result in a data breach that is costly, may add HIPAA compliance issues and could result in a loss of business?

 

 What can you do in the face of this new and growing threat? Outlined below is a recent customer case study involving an infection.

 

Case Study

At approximately 3:15am a clinic’s system was infected with a ransomware virus. This particular infection not only encrypted files on the server, but also spread to every computer on their network. The hackers hold the data “ransom” and for a fee from the clinic. To obtain the decryption key from the hackers, the clinic must pay the ransom.

In less than one hour the virus infected all 16 workstations plus the server. Once the files are infected they are encrypted and unusable by the clinic staff. By 9am, a plan was created with a goal to have the office fully functioning by the next morning.

Resources/Team (IT)

  • First response team
  • Engineering
  • Command Center
  • Team lead

 

The team now set in motion a path to allow the clinic to see its business information as soon as possible. In simplified terms the server and the workstations required immediate attention. The clinic kept paper records during the day.

Server

  • A loaner server deployed that had VMware ESXi installed.
  • It was essential to get new/replacement equipment on-site and in use.
  • Engineering restored a backup file to a virtual machine on the ESXi.
  • The new/replacement equipment was populated with a recent back up file to allow the clinic to see its schedule and continue operations.
  • As the backup exported to a virtual machine format, the server then started up in its virtual format seamlessly.

 

A conventional process would take several days; this process allowed the team to get the server up and running within 5 hours.

 

Workstations

The team re-imaged all of the computers. To expedite the imaging process, a pre-configured image was deployed on an imaging server. This allowed the team to reimage all 16 workstations in approximately 30-35 minutes each. The conventional process would have taken at least two to five hours per computer.

Once the server was up, the team connected the computers to the domain and moved forward with installing and configuring software. Prior to leaving the site at 5pm, all computers were able to access the practice management software and peripherals. In the evening, the team spent several hours configuring the software to get the workstations as close to their original state, prior to the infection, as possible.

The team spent the following morning at the clinic working with the staff to address any questions and make any changes necessary. The clinic staff entered the previous day’s appointments in to the practice management software.

 

Recovery Timeline

Item Case study time to respond/recover “Market” time to respond/recover
Phone call Immediate One day
Diagnosis Less than 1 hour Up to one week
Server repaired and back online 5 hours Up to one week
16 Workstations repaired and back online 8-9 hours Up to one week
Resources Pre-defined team Support Techs
Media Message to customers to prevent a disaster from spreading Unknown

 

Impact Assessment

Daily average production for this clinic                             $15,000

Saved days (Case Study vs Conventional)                           7 Days

Ransom Fees Avoided                                                            $5,000

Estimated Dollar Savings                                                     $110,000           

In addition:

  • the clinic continued to see patients even during the virus containment
  • a possible HIPAA breach was averted
  • the staff only needed to re-enter one day of patient activity

Unfortunately, as hackers become more sophisticated, these situations will increase. Below are a few key suggestions to minimize your risk:

  • Monitor the health of your network
  • Continuously monitor and manage your server and workstations
  • Schedule reviews to discuss changes in technology and security
  • Implement a disaster recovery plan
  • Obtain adequate insurance coverage

 

Most importantly, please work with a professional IT company. The Dental Integrators Association is an organization dedicated to educating IT professionals. To be sure you have cutting edge knowledge on your side you can find a professional at the Dental Integrators Association website.

 

sunset-p-jacobwithPatrick Jacobwith is the CEO of Sunset Dental Technologies a multi-state organization based in Minnesota.  Patrick is also the President of the Dental Integrators Association.  He believes in excellent service and building healthy and productive relationships.  Patrick’s core values are built on three words: Service, Humility and Love.

Patrick can be reached at patrick@sunsetdt.com

 

Do your Dental Patients Witness you Violating HIPAA?

HIPAA CompliantDentistry IQ Article: August 29, 2016

By Amy Wood

 

HIPAA has been around for 20 years now, yet many dental practices have barely started their HIPAA compliance journey. Despite two decades of regulation, I see multiple violations before even passing the front desk in many offices. As a HIPAA Risk Assessor, I’m trained to look for these things. But have you considered how many of your patients also see these risks?

An office manager at the office of one of my clients had just completed the annual HIPAA class a few days before taking her mother to her primary care physician. The front desk person in that office printed her mother’s information on the wrong form and instead of shredding it, she crumpled it up and tossed it in the garbage. “Wait, you’re going to shred that, right?” she asked.  “Of course I am,” the front desk person said with a meek laugh as she smoothed the paper and put it in the shredder. Her mother’s information might have been compromised had my client’s office manager not known what to look for.

Being told that you’re doing something wrong is never fun, but what about the people who notice your violations and say anything to you? A friend of mine moved and a few months later asked me about a few things she’d noticed that “weren’t quite right” with her new dentist. Instead of notifying the office about her concerns, she left the practice. The practice is still not secure with patient information.

Another example is from one of my employees. Shortly after starting with us, she visited her dentist who her family had been seeing for years. While sitting in the waiting area, the front desk person shouted across the waiting room, asking waiting patients about family members’ treatment, payment, insurance information, and medical issues. Our employee told us she was afraid to go back to that office knowing how blatantly they were ignoring basic.

Unfortunately, these stories are not uncommon. Your patients are watching. In states like California that have Private Right of Action laws, patients can sue if their information is compromised in your care.

What things are not compliant that patients are seeing? Anytime I walk into an office, these are the top violations I see in almost every practice.

  • Conversations, especially within earshot of other people. You never know who is listening. 
  • Outdated notice of privacy practices (NPP). Many practices have NPPs from 2003, or they use something they found on the internet and didn’t update for their office. One time I saw a notice that was supposed to be for a dental practice, but it contained an optometrist’s contact information. The Department of Health and Human Services created colorful, easy-to-ready NPPs for download on their website because they want people to easily access compliance.
  • Printed schedule or computer screen. Most current practice management systems have settings to limit what information you see on a schedule. You can have no name, first name, last name, or initials. While it may appease the staff to see who is coming in next, you don’t want patients to see others on your schedule, or what their procedure is.
  • Open Wifi. I know more about 90% of the offices I walk into by accessing their wifi before I even speak with the doctor. I have a free app on my phone that runs a quick scan once I have access to the practice’s wireless. I can see all devices, cell phones of patients and staff, office computers, printers, tablets, laptops, and the server. If I can do that with a free app, a thief or even a bored 14-year-old with a laptop can siphon patient information and an office would never know about it. “But I have a password” is the response I hear. “The password you just gave me and the last four patients?” A colleague recently did a Twitter search for “Hacked Dentist Wifi” and came up with a list of patients who had publicly posted on Twitter that they had accessed their dentist’s network and could see everything.

These are the easily identifiable vulnerabilities patients can see within a few minutes of visiting your practice. When you dig a little deeper, there are all kinds of risks that haven’t been considered. Doing a thorough risk assessment will identify your vulnerabilities and allow you to address them. The government doesn’t expect you to be Fort Knox, but they do expect you to have basics in place. In fact, there is a lot of leniency if you are up front about your risks and are able to offset those risks until a permanent solution can be implemented.

Technology and HIPAA: Where are the risks? The risks on the tech side of your business are ever evolving. Five years ago the biggest threat was backup failure from a portable backup drive. Now we’re dealing with encryption, cybersecurity, ransomware, hacking, and IT people that don’t support your needs. The threat landscape certainly has changed since HIPAA was enacted 20 years ago.

Shadow IT/Multi IT Verizon does an annual study that repeatedly shows that Shadow IT, or multiple people making IT choices and decisions, is the top cause for data breaches. My own panoramic films were involved in a data breach due to Shadow IT. An employee thought she was “helping” by making an unauthorized backup of data to a thumb drive, and lost it. The IT staff had a secure protocol for that and the employee breached thousands of records that contained my name, birthdate, last four digits of my social security number, and my entire medical record number—in other words, enough to steal my identity.

When it comes to IT, it’s not about cleaning up messes; it’s about proactive security. The only way it can be done is to have one vendor that is ultimately responsible for making technology decisions. Multiple vendors having unattended access and making changes will increase your chance of causing a data breach.

Inadequate/Incomplete risk assessment A lot of practices want HIPAA to be quick and cheap. It isn’t. A thorough risk assessment and risk management plan is the single most important thing you can do for your practice in regards to HIPAA. I tell people that if it’s not intrusive and uncomfortable, then they aren’t doing it right. Not only is it required under HIPAA, but it allows you to identify risks and do something about them. Inadequate or incomplete risk assessments are the top reason for penalties in breach investigations.

There are a lot of options out there when it comes to risk assessments, but I advise practices to look for one of two types of Risk Assessors: a privacy and security expert, or a privacy expert that works with your IT (if they’re doing what they’re supposed to do for your practice).

Secure your server Think about the information you have in a single patient record—name, birthdate, social security number, insurance information—a virtual treasure trove for an identity thief. With full medical records demanding around $500 per record on the black market, you have a very large asset in your office. The average American dentist has roughly 2,500 active charts in addition to 10 years of stored inactive charts. With conservative numbers hovering around 4,000 charts, dentists are looking at around $2 million to a thief. What would you reasonably do to protect $2 million?

Fortunately, there are easy and affordable solutions for dental practices. With servers, we’re looking at physical theft or loss. This is addressed by locking it or encrypting it. But having encryption is not the end all and be all. You have to prove it was in place, document its configuration, and show evidence of testing it. In addition, there are many considerations with encryption. The safest place to encrypt data is where the data is created.

Properly vet business associates Are your business associates insured? Do they take responsibility in their Business Associate Agreement? Do they have documented risky behavior? I see more business associates in the dental vertical that are doing risky things to their customers than in any other health-care space. It’s worth it to ask them difficult questions, or better yet, have an experienced risk assessor ask questions.

Choose a good IT partner Everyone has an IT “guy” they love, but is the person doing all that is legally required for your dental practice? The Omnibus Final Rule of 2013 placed regulation on IT providers. With Omnibus, IT providers are expected to know and identify any security deficiencies in your practice and offer you paid solutions. If they don’t, they can be held liable for any breaches. If you have to ask for something security related, such as backups, updates, secure email, or a firewall, then chances are the IT person isn’t doing any of the things you and the federal government expect of an IT professional in the health-care space.

It can take years to establish a trust relationship with an IT company. Regardless of your current relationship, you have to ask yourself if your current IT is doing what’s best for your practice and your patient information. If not, you should seriously consider switching. A good place to look for quality, HIPAA-trained IT providers is the Dental Integrators Association.

 

ACS - A. Wood

Amy Wood is a HIPAA Risk Assessor who specializes in making dental practices compliant. She is president of ACS Technologies LLC, a HIPAA and IT firm based out of Santa Rosa, California. Amy maintains multiple certifications in HIPAA, is an active member of the FBI’s Infragard, and she speaks to private practices, study clubs, and dental societies.