Over 80% of Medical Imaging Devices Run on Outdated Operating Systems

The state of real-world IoT: Printers and cameras sitting on enterprise networks harbor the most vulnerabilities, misconfigurations, and compromises. In healthcare networks, some 70% of medical imaging devices are based on mostly old Windows versions that have either been retired by Microsoft or are under limited support.

A study of 1.2 million Internet of Things (IoT) devices in thousands of healthcare and other enterprises in the years 2018 and 2019 underscores the reality of the IoT as one of the weakest links in organizations. Palo Alto Networks, using data gathered from its Zingbox IoT inventory and management service, studied some 73.2 billion network sessions of more than 8,000 different types of IoT devices.

Microsoft's recent sunsetting of Windows 7 accounts for most of the older operating system data: Fifty-six percent of the imaging devices run on Win 7, which gets limited support and patching from Microsoft now, and another 27% of these devices run on the long-dead Windows XP, as well as old and decommissioned versions of Linux, Unix, Windows, and other embedded software.

Exacerbating the problem: Some 72% of virtual LANs contain a mix of IoT devices and other computing systems. "It's concerning that IoT medical devices - such as an infusion pump, medical imaging systems like MRIs or CAT scans or X-rays - if they are on the same network as a doctor clicking on a phishing email, that's a dangerous situation," says Ryan Olson, vice president of threat intelligence for PAN's Unit 42 research team. "That's an indicator to us that these networks are not being properly managed."

One positive sign is that the number of hospitals in the US that had more than 20 VLANs tripled from 2018 to 44% in 2019. "On the bright side, it's getting better," Olson says. The key is ensuring that IoT is on a separate VLAN than IT systems and that these devices don't have unnecessary network connections or access.

"A lot of IoT device management today is from a static inventory perspective," where the hospital or enterprise knows the device type and serial number, for example. "They are not tracking how long it's on the network, how they secure it, update it, nor is it managed through its life cycle."

That means knowing a device is retired or no longer needed and should then be removed from the network so it doesn't expose it, he says. As it is, the report shows that 98% of all IoT device traffic travels unencrypted, leaving potentially sensitive patient and other data exposed to attackers. In addition, some 57% of the IoT devices contained vulnerabilities or misconfigurations, and some 20% of healthcare organizations at one time or another had been infected with the old-school Conficker worm.

The stakes are high for the cross-contamination from IT systems to IoT. Some 72% of healthcare organizations say they have experienced an email-based cyberthreat in the past year that resulted in downtime, according to a new Mimecast and HIMSS Media study. The main losses for these victims were productivity (55%), data (34%), and financial.

And according to a new Enterprise Strategy Group report also released today, 77% of organizations say they don't have a full accounting or visibility into IoT devices on their networks. Less than half (47%) of organizations that have a strategy in place for getting a handle on this are confident about that initiative, according to the study, which was commissioned by asset management company Axonius.

A full-blown IT asset inventory of all computing, bring-your-own-devices (BYOD), and IoT devices can take more than two weeks, or some 89 person-hours of labor, and occur, on average, 19 times per year to stay on top of the ever-changing network population, according to the report.

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Outside of medical devices, the riskiest IoT devices in enterprises are (ironically) security cameras and printers, PAN data shows. While IP phones make up some 44% of all enterprise IoT devices, they only pose 5% of security issues, such as vulnerabilities, misconfigurations, default passwords, or compromises.

Security cameras, meanwhile, represent just 5% of the IoT devices in the study, but they harbor 33% of the security issues. "This is because many cameras are designed to be consumer-grade, focusing on simplicity of use and deployment over security," the report said.

Printers are the second-most risky, with 24% of security issues, mainly because they also come with less baked-in security and also can be abused via browser access. Print logs can contain sensitive and valuable information for an attacker, and the devices also can be abused like many other IoT devices - as a stepping-stone to other systems in the network.

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