LAUSR

OBJECTIVE We investigated the progression of healthcare cybersecurity over 2014-2019 as measured by external risk ratings. We further examined the relationship between hospital data breaches and cybersecurity ratings. MATERIALS AND METHODS Using Fortune 1000 firms as a benchmark, time trends in hospital cybersecurity ratings were compared using linear regression. Further, the relationship between hospital data breaches and cybersecurity ratings was modeled using logistic regression. Hospital breach data were collected from US HHS, and cybersecurity ratings were provided by BitSight. The resulting study sample yielded 3528 hospital-year observations. RESULTS In aggregate, we found that hospitals had significantly lower cybersecurity ratings than Fortune 1000 firms, however, hospitals have closed the gap in recent years. We also found that hospitals with the low security ratings were associated with significant risk of a data breach, with the probability of a breach in a given year ranging from 14% to 33%. DISCUSSION Recent cyber-attacks in healthcare continue to illustrate the need to better secure information systems. While hospitals have reduced cyber risk over the past decade, they remain statistically more vulnerable than the Fortune 1000 firms against botnets, spam, and malware. CONCLUSION Policy makers should continue encouraging acute-care hospitals to proactively invest in security controls that reduce cyber risk. Best practices from other sectors like the financial services sector could provide useful guides and benchmarks for improvement.