On Being Threatened

November 10, 2008

Express Scripts, one of the nations largest pharmacy benefit management companies, is being blackmailed with the release of private health information. The blackmailer proved that he/she has access to the data by providing information on 75 Express Scripts customers.The company has done a fine job of swallowing this bitter pill. They have done exactly the right thing by making a public announcement. This is not their fault and by choosing not to hide it they are demonstrating strong ethics in a tough situation.I would much rather have my PHI with a company that will tell me when something like this happens rather than one that makes me “feel safe” by telling me nothing. I am a big fan of “the devil that you know”.It bears mentioning that this is a real threat, rather than the dubious “lost laptop” problem. I have had a laptop with patient data stolen, but thanks to gpg, I have nothing to worry about. Laptops are easy to steal and easy to fence.

Thankfully, there is no way for the average criminal to even know that there is potentially valuable PHI on a laptop when they steal it out of the back of a car. It is much more likely that the operating system will be reinstalled from scratch by a fence to ensure that there is no way that the laptop can be traced back to the original owner.That means that when a laptop containing PHI is stolen, 99 times out of 100, there is nothing to worry about.The 1 out of 100 times is when the thief already knows the PHI is on the laptop. Which is to say that a healthcare organization is the subject of a focused attack.

Other security researchers are already guessing at how the blackmailer got the data. Here is my guess:65% chance this is an inside job. A rouge former or current employee is getting revenge.25% chance this is a foreign hacker. Siciliano (from the link about) correctly points out that only a foreigner would think that a US company would not go straight to the FBI after being blackmailed. A US hacker would have just sold the social security numbers to identity thieves.5% chance its a US hacker.3% chance it was a stolen laptop.2% chance something else happened.It will be interesting to see how this plays out. If they catch the blackmailer or otherwise discover the attack vector, it will be informative for people like me, who obsess over the best way to protect health information.If this happened because a laptop was stolen, I will eat my shorts.

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