efforts to secure medical devices will continue to be warranted
among device manufacturers, medical researchers, medical
providers, and computer security experts. HIM professionals
involved in information governance are well positioned to bring
attention to these risks among their healthcare colleagues.
One of the first steps HIM professionals can take with regard
to medical devices is to ensure all devices have default passwords changed. Default passwords assigned by manufacturers
of devices are published online and easily obtained by hackers.
The Internet of Things (Io T) provides opportunities for hackers
to exploit vulnerabilities in those organizations that have not
changed default passwords. HIM professionals should also educate colleagues about these threats.
What to Know about Blockchain
Since one of the objectives of Bitcoin was to avoid traditional
banking infrastructure, the creators had to develop their own
highly reliable and secure system for tracking transactions. Bitcoin introduced an innovative supporting technology called
blockchain to manage its own distributed financial ledger using
decentralized computing resources. 28 It turns out the way blockchain works to secure financial transactions may also be useful
for securely maintaining and sharing electronic health records.
Timing and sequencing of transactions are critical to finance. For
example, funds must first be deposited into an account before being transferred out. One of blockchain’s strengths is maintaining
integrity and sequence of transactions to avoid fraud.
Electronic health records have a similar need for integrity and
time sensitivity. One way to think about the longitudinal continuum of care for an individual patient is a series of transactions
including birth, diagnoses, laboratory tests, administration of
medicine, clinical procedures, etc. Maintaining a secure and
accurate history of transactions is precisely what blockchain
was designed to do. It seems natural to explore how blockchain
could be used as a platform for storage and exchange of electronic health records. In fact, HHS saw sufficient potential that
it sponsored a blockchain challenge competition in 2016 to encourage vendors to propose ways to apply blockchain for health
IT and health research. The competition resulted in fifteen winners with some very promising proposals. 29 HIM professionals
should continue to explore blockchain.
Dark Web Creates and Solves Risk
The Dark Web refers to regions of the Internet which are not illuminated by mapping or indexing, and therefore are not exposed
by traditional search engines. These regions contain a variety
of information services and tools used by people on both sides
of the law desiring to maintain privacy. While the Dark Web remains a source of high risk for patients and HIM professionals,
it has also provided innovations and tools that may be useful
to HIM professionals working to enable secure storage and exchange of electronic health records. Blockchain is a prime example as it has strong potential application for healthcare and
deserves deeper understanding by HIM professionals. Knowing
the potential the Dark Web holds to potentially hurt HIM is the
first step in being proactive to protect against it. ¢
1. Reeves, Mary. “Create a Learning Environment for Information Governance.” Journal of AHIMA website. July 28,
2. Bergman, Michael K. “White Paper: The Deep Web: Surfacing Hidden Value.” The Journal of Electronic Publishing
7, no. 1 (2001): 1-35.
3. He, Bin; Mitesh Patel; Zhen Zhang; and Kevin Chen-Ch-uan Chang. “Accessing the Deep Web.” Communications of
the ACM 50, no. 5 (2007): 94-101.
4. Bergman, Michael K. “White Paper: The Deep Web...”
5. Weimann, Gabriel. “Going Dark: Terrorism on the Dark
Web.” Studies in Conflict and Terrorism 39, no. 3 (2016):
6. Weimann, Gabriel. “Terrorist Migration to the Dark Web.”
Perspectives on Terrorism 10, no. 3 (2016): 40-44.
8. Van Hout, Marie Claire and Tim Bingham. “‘Silk Road’ , the
Virtual Drug Marketplace: A Single Case Study of User Experiences.” International Journal of Drug Policy 24, no. 5
9. Chaudhry, Peggy E. “The Looming Shadow of Illicit Trade
on the Internet.” Business Horizons 60, no. 1 (2017): 77-89.
10. Weimann, Gabriel. “Terrorist Migration to the Dark Web.”
11. The Tor Project. “Tor.” www.torproject.org/projects/tor-browser.html.en.
12. Carmona, Anais. “The Bitcoin: The Currency of the Future,
Fuel of Terror.” Evolution of Cyber Technologies and Operations to 2035. Switzerland: Springer, 2015: 127-135.
13. Bohannon, John. “Why Criminals Can’t Hide Behind
Bitcoin.” Science. March 9, 2016. www.sciencemag.
14. Barratt, Monica J.; Simon Lenton; and Matthew Allen. “
Internet Content Regulation, Public Drug Websites and the
Growth in Hidden Internet Services.” Drugs: education,
prevention and policy 20, no. 3 (2013): 195-202.
15. Reeves, Mary. “Create a Learning Environment for Information Governance.”
16. Dyer, Owen. “Medical Data of 655,000 Americans Put Up
for Sale by Hacker.” BMJ: British Medical Journal 353, no. 1
17. Goedert, Joseph. “Active Market for Healthcare Records
Looms as Newest Cyber Threat.” Information Management. July 12, 2016. www.information-management.
18. Solander, Adam C.; Adam S. Forman; and Nathaniel M.
Glasser. “Ransomware—Give Me Back My Files!”
Employee Relations Law Journal 42, no. 2 (2016): 53-55.
19. Department of Health and Human Services. Fact Sheet:
Ransomware and HIPAA. 2016. www.hhs.gov/sites/de-fault/files/RansomwareFactSheet.pdf.
Beware the Internet’s Dark Side
Continued on page 52