On March 8, 2019, JAMA published a study analyzing the effects of simulated phishing emails at U.S. health care organizations. Concluding that the click rates for the simulated phishing emails present a big cybersecurity risk for health care organizations, the study provides helpful insight into how to prepare an organization’s workforce to detect harmful emails.
Phishing emails are deceptive communications intended to trick recipients into disclosing their security credentials or otherwise sharing sensitive information. Oftentimes, a sender’s identity is spoofed, tricking the recipient into thinking that the email originated from within their organization or that it was sent by a colleague or superior. Hospitals and other health care organizations are attractive targets of cyberattacks, as they have high-value personal and health data.
The study analyzed six health care organizations across the United States as they participated in simulated phishing emails between August 1, 2011 and April 10, 2018. The phishing emails fell into three categories: office-related, personal, and information technology-related. The emails were sent to employees in all types of roles. In total, approximately 2.9 million simulated phishing emails were sent, and recipients clicked on approximately 422,000 of them (approximately 14%). This means that the employees from the studied health care organizations clicked on an average of almost one in seven of the simulated phishing emails.
The study showed that the median click rates were higher for the information technology-related simulated phishing emails (18.6%) than the office-related emails (12.2%).
The study noted that repeated phishing simulations decreased the odds of an individual clicking on a simulated phishing email, which highlights the importance of the phishing simulation process and other forms of personnel training on these types of attacks.
As hospitals and other health care organizations face financial and care-related consequences from cyberattacks, this study emphasizes the need for health care organizations to train their workforces on cybersecurity best practices, including through simulated phishing emails. As the study noted, it only takes one successful phishing incident to paralyze a system that is critical to the patient care provided by a health care organization. The study cited to several elements that may make a health care organization more vulnerable to a cyberattack, including a continuous stream of new employees, the use of a large number of information technology systems, and devices and systems that are highly interdependent. It also discussed other techniques that health care facilities can use to prevent or limit personnel from clicking on phishing emails, including using technology to try to filter suspicious emails and indicate on emails when they are sent by a person outside of the organization.
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