<story><title>Hospitals are a weak spot in U.S. cybersecurity</title><url>https://www.axios.com/hospitals-cybersecurity-medical-information-hacking-076cb826-fc69-4ba6-b3fd-57ce19ab00c6.html</url></story><parent_chain><item><author>rubatuga</author><text>People need to stop hating on fax. Hospitals still use fax because it is a much more punishable crime to tap phone lines which requires physical access, as opposed to a server that could be infected from a hacker halfway across the world.</text></item><item><author>burnte</author><text>Healthcare CIO here. This is true. Healthcare is still using paper fax. It has a 30 year old data interchange format that no one really supports because it&amp;#x27;s more profitable to lock in customers to your EMR. Healthcare is HORRIBLE about upgrading anything, at changing processes, and technological progress in general. Healthcare is VERY backwards from a tech standpoint.&lt;p&gt;Another problem is that EVERYTHING is custom, we use very, very few off the shelf solutions. Need an EMR? Let&amp;#x27;s build it in MUMPS, a 51 year old language that originated on the PDP7 and call it a state of the art system like Epic or GE Healthcare. Don&amp;#x27;t like the terminal interface? Let&amp;#x27;s slap a GUI on the front that still interacts via TTY on the back end. SQL? Nah. C, C++, or any more modern language with more robust features and way more programmers? Nope.&lt;p&gt;Now, there are some EMRs and other healthcare-centric apps that are better written, but they&amp;#x27;re also terrible. Healthcare is a relatively small market, you&amp;#x27;ll never sell a million units of your app, so you charge out the wazoo for it, get a few health systems on it, and allow they to go crazy with customization to help lock them in. And then you try to add on modern security features on to a system that&amp;#x27;s been growing for 50 years and it&amp;#x27;s a nightmare. It&amp;#x27;s INCREDIBLY common for nurses and doctors to need to have administrator access on their Windows desktops for various apps.&lt;p&gt;I was about to leave IT in general when a healthcare gig landed on me, and I&amp;#x27;m glad it did. I find it very refreshing to be in an industry where it&amp;#x27;s so far behind that there are mountains of problems to tackle, even if half of them are so stupid it makes me want to cry.</text></item></parent_chain><comment><author>keithnz</author><text>Fax is odd, it was a fantastic thing when it first came about, and it has some desirable properties.&lt;p&gt;- It&amp;#x27;s direct point to point communication (over a network)&lt;p&gt;- The transport network is dedicated and not open to anyone and covered by quite strong laws in many countries&lt;p&gt;- It&amp;#x27;s easy to see the history of communications&lt;p&gt;- It&amp;#x27;s easy to see if the other end successfully received something&lt;p&gt;- It&amp;#x27;s relatively standardized and ubiquitous ( in health )&lt;p&gt;Email would be the closest thing, but it doesn&amp;#x27;t have all the advantages, and the extra add ons that would make it better (like encryption, delivery receipt, digital signatures) are not standardized and&amp;#x2F;or ubiquitous ( and often hotly argued about )&lt;p&gt;So fax is the lowest common denominator, that, if it was proposed today, would not be accepted for many of its disadvantages, but it&amp;#x27;s now hard to find a way to replace it.</text></comment>
<story><title>Hospitals are a weak spot in U.S. cybersecurity</title><url>https://www.axios.com/hospitals-cybersecurity-medical-information-hacking-076cb826-fc69-4ba6-b3fd-57ce19ab00c6.html</url></story><parent_chain><item><author>rubatuga</author><text>People need to stop hating on fax. Hospitals still use fax because it is a much more punishable crime to tap phone lines which requires physical access, as opposed to a server that could be infected from a hacker halfway across the world.</text></item><item><author>burnte</author><text>Healthcare CIO here. This is true. Healthcare is still using paper fax. It has a 30 year old data interchange format that no one really supports because it&amp;#x27;s more profitable to lock in customers to your EMR. Healthcare is HORRIBLE about upgrading anything, at changing processes, and technological progress in general. Healthcare is VERY backwards from a tech standpoint.&lt;p&gt;Another problem is that EVERYTHING is custom, we use very, very few off the shelf solutions. Need an EMR? Let&amp;#x27;s build it in MUMPS, a 51 year old language that originated on the PDP7 and call it a state of the art system like Epic or GE Healthcare. Don&amp;#x27;t like the terminal interface? Let&amp;#x27;s slap a GUI on the front that still interacts via TTY on the back end. SQL? Nah. C, C++, or any more modern language with more robust features and way more programmers? Nope.&lt;p&gt;Now, there are some EMRs and other healthcare-centric apps that are better written, but they&amp;#x27;re also terrible. Healthcare is a relatively small market, you&amp;#x27;ll never sell a million units of your app, so you charge out the wazoo for it, get a few health systems on it, and allow they to go crazy with customization to help lock them in. And then you try to add on modern security features on to a system that&amp;#x27;s been growing for 50 years and it&amp;#x27;s a nightmare. It&amp;#x27;s INCREDIBLY common for nurses and doctors to need to have administrator access on their Windows desktops for various apps.&lt;p&gt;I was about to leave IT in general when a healthcare gig landed on me, and I&amp;#x27;m glad it did. I find it very refreshing to be in an industry where it&amp;#x27;s so far behind that there are mountains of problems to tackle, even if half of them are so stupid it makes me want to cry.</text></item></parent_chain><comment><author>pabs3</author><text>Fax machines are just as insecure as that server. Last year taking over a network using just a fax number was demonstrated:&lt;p&gt;&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;research.checkpoint.com&amp;#x2F;sending-fax-back-to-the-dark-ages&amp;#x2F;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;research.checkpoint.com&amp;#x2F;sending-fax-back-to-the-dark...&lt;/a&gt;</text></comment>