Flaw in VA’s Vista Medical Records Platform May Put Patients at Risk

Although the United States The United States Department of Veterans Affairs runs some interesting technology programs, it’s not known for being a flexible and nimble organization. And when it comes to electronic medical records management, the VA has had a slow but high-stakes drama for years.

The department’s registration platform, VistA, first instituted in the late 1970s, is hailed as efficient, reliable and even innovative, but decades of underinvestment have eroded the platform. On several occasions throughout the 2010s, the VA has stated that it will replace VistA (short for Veterans Information Systems and Technology Architecture) with a commercial product, and the latest iteration of this effort is currently underway. In the meantime, however, safety researchers are uncovering real safety issues in VistA that could affect patient care. They want to disclose them to the VA and fix the issues, but they haven’t found a way to do that because Vista is on death row.

At the DefCon security conference in Las Vegas on Saturday, Zachary Minneker, a security researcher with a background in health informatics, presents findings on a concerning weakness in the way VistA encrypts internal credentials. Without an additional layer of network encryption (like TLS, which is now ubiquitous on the web), Minneker discovered that the in-house encryption developed for VistA in the 1990s to protect the connection between the network server and individual computers can be easily defeated. . In practice, this could allow an attacker on a hospital network to impersonate a healthcare provider within VistA, and potentially modify patient records, submit diagnoses, or even theoretically prescribe medication.

“If you were adjacent on the network without TLS, you could break passwords, replace packets, make database changes. Worst-case scenario, you could essentially impersonate a doctor,” Minneker told WIRED. “It’s just not a good access control mechanism for an electronic medical record system in the modern age.”

Minneker, who is a security engineer at software company Security Innovation, only briefly discussed the findings at his DefCon conference, which was mostly focused on a broader evaluation of Vista’s security and the language. programming of database MUMPS which underlies it. He’s been trying to share the discovery with the VA since January through the department’s vulnerability disclosure program and Bugcrowd’s third-party disclosure option. But Vista is out of reach for both programs.

This may be because the VA is currently attempting to phase our VistA using a new medical records system designed by Cerner Corporation. In June, the VA announced that it would delay the general rollout of the $10 billion Cerner system until 2023, as pilot rollouts have been plagued with outages and potentially resulted in nearly 150 instances of consumer harm. patients.

The VA did not return WIRED’s multiple requests for comment on Minneker’s findings or the broader Vista vulnerability disclosure situation. In the meantime, however, VistA isn’t just being deployed in the VA healthcare system, it’s also being used elsewhere.

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