Cybersecurity and IoT: Health Care and Well-Being in our Shared Spaces

Last updated: 07/07/2021

As the extraordinary situation of the COVID-19 crisis continues and more such supervirus incidents will occur, the benefits that IoT can provide will be even in more demand.  We are already seeing how IoT plays a significant role in modernising healthcare and disaster prevention, public safety and security, supply chain, and manufacturing and production.  

The Good We’ve Seen

In Hong Kong, the government has deployed smart wristbands to monitor city residents1 quarantined inside their homes.  Accelerating the timely discovery of outbreaks, these smart medical devices, powered with internet of things (IoT) technology, play an important role in containment of outbreaks like COVID-19 and prevent future pandemics.

Prior to COVID-19 pandemic, Japan was preparing for Tokyo 20202, the smartest Olympics ever with self-driving cabs to transport guests between sports venues, robotic guides, immersive virtual reality and crowd control directed by artificial intelligence.  Getting ready to welcome 11,000 athletes with 4 to 7 million on-site spectators from Japan and all over the world, this would have been a wonderful showcase of IoT tech and applications from a country that is already a technological leader in robotics and consumer electronics.  Unfortunately, the event is postponed 12 months, though the Olympic Committee resolves to have the games, it’s not clear how much of IoT tech applications will be used.

As public venues have been opening up in the past several weeks, there is a serious challenge of getting business going and the health and safety of people using the same facilities.  How can public toilets be kept safe and clean for everyone to use?  A common need at medical centres, restaurants, shopping malls, and any city where visitors would rely on public toilets. One new IoT company on the scene, Inferrix, has a solution for the “COVID Secure Washroom”, as described on their website: Inferrix wireless edge-intelligent sensors on the washroom doors show a red light to alert visitors if the washroom is unsafe to use. Any washroom can be installed in less than 1 hour.  We can easily imagine its application to be useful in office spaces near shared kitchen areas or study areas of public or university libraries as well.

When we reflect on the role that IoT played over the course of the pandemic, there are more notable instances. For example, telehealth consultations meant that there was a reduced risk of transmission that would otherwise have been prevalent with face to face consultations. Secondly, robot assistance is used to disinfect contaminated areas and objects, both protecting health carers and giving health carers more time to care for their patients. China was the first country to use Danish made UVD robots using IoT and help to disinfect treatment areas in nursing homes and clean patient rooms.

The Not So Good

In a 2019 study of security of IoT devices3, data revealed that more than twice the number of vulnerabilities were detected compared to six years earlier.  As covered in in our last blog post, cyber attacks from IoT risks have surged 300% and the UK and US are catching up on regulations to ensure companies safeguard devices. In March 2020 researchers found4 that more than half of all internet of things (IoT) devices are vulnerable to medium- or high-severity attacks, with 98% of all IoT device traffic being unencrypted.

As we’ve seen during the COVID-19 crisis, even when everyone else was rallying together, cyber criminals targeted vulnerable organizations in the health sector: data-stealing ransomware on US pharma company5 and Europe’s largest private hospital6, Czech republic hospital’s computer systems were attacked when their focus was on running coronavirus tests, and in the UK two construction companies building emergency hospitals were hacked7.

Such attacks can become more sophisticated and more dangerous to individuals using new health technology apps and devices used to provide medication or daily survival needs.

Bringing Tech Out for Good

Connected devices are available using cellular connectivity which are allowing doctors to rely on patients to use connected out-of-the-box devices for special readings to be sent directly to the doctor from the device (temperature, blood pressure, glucose meters).   Such technology is not limited to medical practitioners and is already available for anyone.  A user created a smart system to monitor his diabetic brother’s blood sugar8 (glucose) levels using an app, a data logging platform that processed data from his brother’s glucose sensor to make his own healthcare monitoring system.

Similarly, Australia saw its first ‘virtual hospital’9 open shortly before the COVID-19 pandemic hit through Royal Prince Alfred Hospital (RPA) in Sydney. Data from pulse oximeters used to measure oxygen saturation levels and heart rates along with armpit patches to track temperature were transmitted to the hospital. In addition, video-consultations allow coronavirus patients to receive the care they need without the risk of transmission. 

Recently, we have seen evidence of health providers recognise the risks surrounding IoT devices and the need to incorporate security standards to protect against malicious hackers. For example, University Hospitals of North Midlands NHS Trust has opted to trust Ordr with providing a systems control engine (SCE)10 which will locate and secure every connected device. This includes Internet of Medical Things (IoMT), Internet of Things (IoT) and Operational Technologies (OT) devices.

Security, safety, and data privacy considerations are important aspects of designing, building and maintaining such systems to protect the identity and well-being of the individual.  We’d hate to think about incidents where devices give wrong information due to a malicious actor – getting the wrong medication, dosage, or advice could have serious, even lethal consequences.  Having IoT devices and apps to create a safer world requires more scrutiny and protective measures designed as part of the solution.  As many of these solutions will be designed for one person’s use, customised to their medical needs or specific daily routines, it’s essential they are maintained, updated, and when no longer maintainable that they are properly turned off and disposed of.

Check out IoT For All Podcast with Christopher Schouten of Kudelski Group11.  He talks about necessary considerations to secure IoT projects, making sure they can scale as well as be practical in protecting what is valuable. 

Although the transformational journey to an IoT world seems daunting, the capabilities of IoT to bring high-tech care and consultancy out of the clinic and into homes and vulnerable communities across the world presents a thrilling opportunity.  Health care and IT experts, technicians, research scientists and security experts are collaborating, as are carers, policy makers and administrators.  Altogether, the confluence of tech and human intelligence will continue to evolve and strive to protect all that is worth protecting.  COVID-19 and cybercrime are making seismic shifts in worldwide health and safety, threatening our prosperity. Let’s defend the world, use technology for good and build the world we want.

If you are a developer or have a software development team using open source components, learn how  Meterian automates monitoring of software applications for open source risks and vulnerabilities.  Read about Meterian-X: Invisible Security for your Open Source Security Management in IoT systems and devices.

1 Doffman, Zak. “Coronavirus Police Surveillance Tags Are Now Here: Hong Kong First To Deploy.” Forbes, 17 March 2020, https: //www.forbes.com/sites/zakdoffman/2020/03/17/alarming-coronavirus-surveillance-bracelets-now-in-peoples-homes-heres-what-they-do/?sh=227b12984533

2 Hallet, Rebecca. “Tokyo on track for smartest Olympics ever”. Raconteur, 20 February 2020, https ://www.raconteur.net/technology/internet-of-things/iot-tokyo-2020/

3 Coble, Sarah. “Vulnerabilities in IoT Devices Have Doubled Since 2013”. Info Security, 17 September 2019, https ://www.infosecurity-magazine.com/news/vulnerabilities-in-iot-devices/.

4 O’Donnell, Lindsey. “More Than Half of IoT Devices Vulnerable to Severe Attacks”. threat post, 11 March 2020, https:// threatpost.com/ half-iot-devices-vulnerable-severe-attacks/153609/.

5 Whittaker, Zack. “Hackers publish ExecuPharm internal data after ransomware”. Tech Crunch, 27 April 2020, https: //techcrunch.com/2020/04/27/execupharm-clop-ransomware/.

6“Europe’s Largest Private Hospital Operator Fresenius Hit by Ransomware”. KrebsonSecurity, 6 May 2020, https: //krebsonsecurity.com/2020/05/europes-largest-private-hospital-operator-fresenius-hit-by-ransomware/.

7 “Coronavirus: Cyber-attacks hit hospital construction companies” BBC News, 13 May 2020, https: //www.bbc.co.uk/news/technology-52646808.

8 Anx, Quintessant. “Healthcare IoT: Monitoring Diabetes with Logz.io” Logz.io, 11 December 2018, https: //logz.io/blog/healthcare-iot-monitoring/.

9 Minion, Lynne. “‘Flattening the curve’ with virtual care in Australia'” Healthcare IT News, 30 June 2020,  https: //www.healthcareitnews.com/news/europe/flattening-curve-virtual-care-australia

10 Crouch, Hannah. “University Hospitals of North Midlands deploys Ordr cyber security solution”. digital health, 6 May 2021, https: //www.digitalhealth.net/2021/05/university-hospitals-of-north-midlands-ordr/

11 “Security Challenges in the IoT Landscape | Kudelski Group’s Christopher Schouten”. iot for all, 5 May 2020, https: //www.iotforall.com/podcasts/e064-iot-security-considerations.

Cybersecurity and IoT: Health Care and Well-Being in our Shared Spaces

Cyber Security and IoT

Last updated: 07/07/2021

How can we enjoy social gatherings in restaurants or busy spaces again?  This is possible with robots, devices, space partitions and humans occupying the same space.  With imagination, we will re-create the bustling spaces redefined with IoT technology.

What is IoT? 

If you’re new to IoT, see from Wikipedia: “The Internet of things (IoT) is a system of interrelated computing devices, mechanical and digital machines provided with unique identifiers (UIDs) and the ability to transfer data over a network without requiring human-to-human or human-to-computer interaction.”1  

Basically, an IoT device is one that has an internet connection, even though normally it wouldn’t.  Your smart boiler and smart thermostat are examples of IoT devices. You talk to them using an app on your smartphone. You tell the smart boiler to heat water so you can take a shower, and the smart thermostat to warm up the room to a cosy temperature by the time you arrive home.

In recent months, as the reach and severity of the COVID-19 pandemic increased, adopting IoT solutions started joining the frontline in many countries outside Asia in order to manage the crisis. With the boost in increased use of digital and remote technologies, videoconferencing has become the norm for office meetings, school lessons and exercise classes.  The capabilities of video conferencing, email and messaging technologies has shown just how productive remote work can really be, with studies showing that 65% of pandemic remote workers wished to continue working from home and only 2% wished to return to the office.2

These efforts are likely to take a step further with IoT.  Many countries have set up temperature measurement systems at the entrance of public places such as airports and train stations.  Restaurant managers are also recording the temperature of staff who are preparing food.  If this collected data (temperature) could be transferred and analysed in the cloud through an app, it could result in real-time analysis. 

To orchestrate such a system requires planning and a clear understanding of what is most valuable to protect and why.  There are many benefits and use cases of IoT.

Benefits of IoT

IoT, artificial intelligence, and the analysis of vast amounts of real-time data sets (aka Big Data) can be used to slow down proliferation of pandemics to avoid future global health crises.  Such real-time connected intelligence, dubbed “nowcasting”, could be gained from medical devices connecting over the internet.  Trend monitoring of wearable devices could analyse population-level influenza trends daily according to a recent study from Scripps Research scientists.3

As seen during COVID-19 isolation period, this preventive action to stop the virus spread combined with telehealth services lets health care providers advise patients without risking exposure.

Robot surveillance for social distance monitoring can alleviate the stress on police or community patrol since robots don’t get tired of doing repetitive tasks — observe, record, count, report and take action. 4


Key reasons for implementing IoT projects are summarized in Microsoft Azure’s IoT survey featured in their IoT Signals report, which highlight the top three reasons as improving Safety and security, Operations optimization, and Quality assurance.

 Source: 2019 Microsoft Azure IoT Signals

During COVID-19 crisis, we have seen that doctors and health care providers can maintain some employees’ productivity while social distancing and relying on the right connected devices and computing systems.  Logistics companies, supermarkets and the food supply chain can track the quality and quantity of goods and produce from shore to shop or farm to market with minimal manual effort.  Eventually, the click-pick-and-collect journey of groceries delivered by Ocado5 will be done entirely with robotics. Another instance in which IoT can act as a useful tool for retail stores is by tracking consumer and employee location data. Michele Pelino, senior analyst in infrastructure and operations research at Forrester said, “The idea is to use information about location: GPS capabilities in phones. Over time, there will be more opportunities to create location-based experiences to interact with a brand”. Possibilities for the next year include the ability for customers to use GPS to check in, allowing them to maintain distance by avoiding queues.

IoT Risks

As with all new technology, great progress comes with risks in uncharted fields.  

Since the explosion of the internet of things (IoT) across industries, companies providing products or services in any IoT ecosystem must carefully evaluate and examine possible threats of malicious intent.

We have been warned children’s toys6 and baby monitors’7 cameras have been hacked by strangers invading privacy and security of the home.  In the UK, regulations for IoT devices are gradually being introduced to catch up with the 300% surge in cyberattacks using IoT devices8, and similarly in the US9.

In the United States, FBI warned 10 the US private sector in February: “Software supply chain companies are believed to be targeted in order to gain access to the victim’s strategic partners and/or customers, including entities supporting Industrial Control Systems (ICS) for global energy generation, transmission, and distribution”. Recently we have seen this exact industry area targeted in oil pipeline system company Colonial Pipeline’s Ransomware attack. This led to the take down of the largest fuel pipeline in the U.S., and Colonial Pipeline paying out a huge $4.4m crypto currency ransome.

 In addition to attacks against supply chain software providers, the FBI said the same malware was also deployed in attacks against companies in the healthcare, energy, and financial sectors.

The Most popular supply chain attack is 2017’s NotPetya ransomware attack11. Due to a lack of patches to keep software in their Windows computer systems up to date, cyber criminals were able to gain access to computers and install a malware that spread through the networks of organizations like wildfire.  Multinational companies, AP Moller-Maersk, Reckitt Benckiser and FedEx, were crippled and they were not even the target of the state-sponsored attack.  Just collateral damage, and the estimated loss is $10 billion12.  

Gavin Ashton recently wrote in his personal blog about his insider view of the NotPetya experience, which cost Maersk $300 million: “you should put up a damn good fight to stop these attacks in the first case. … Staying with the home analogy; Yes, there’s security cameras and wizard cloud-connected ‘Internet of Things’ (IoT) devices and all kinds of expensive measures and widgets, but a lot of organisations fail simply on the basics. Lock the damn door.”13

The Value Security Adds to Systems

Such risks and misfortunate events are avoidable and can be mitigated.  

There is a range of use cases in which security indeed adds value to IoT systems.  For example:

  1. Need to prove authentic origin of products such as fresh produce or medications? Eliminate loss by tracking products with encrypted data.
  2. Need to guarantee the integrity of data?  Prevent tampering and fraud by ensuring systems have security controls for identification, authentication and authorization.
  3. Prevent cloning/faking/tampering of trackers or meters?
    • Ensure data of logistics/transport/utility/food services is confidential end-to-end
    • individual contact tracing. Ensure tracker data is confidential end-to-end
    • Prevent device/software tampering that could affect pricing and billing
  4. At home and with health care providers, 
    • Safeguard customer privacy by preventing intrusion into home systems
    • Comply with patient privacy regulations by protecting data at rest (stored on devices/systems)  and in motion (when sent from a device over the network to another device/system).

In the IoT ecosystem, it is crucial for organizations to have visibility into all connected devices and systems. As more employees use cloud apps and mobile devices for work, the traditional network security perimeter has lost relevance. This means more attention is needed on endpoint monitoring and protection, which includes not only employees’ devices to perform work, but also devices in the worker’s environment whether at home or at work. At work the environment may be an open plan of office desks, a clinician’s patient room, or on the assembly line of a manufacturing plant.  Each environment will have its unique characteristics.  For more on the role of IoT and the fight against COVID-19 in sensitive areas, read our blog: Cyber Security and IoT: Health Care and Well-Being in our Shared Spaces.

The user/actor in the environment may also vary and the device’s mobility would affect its position and environment.  IoT system design must take many of these factors into consideration and use secure-by-design principles to protect the value of the information that is being moved around the ecosystem.  There is no panacea to protect all aspects because in the IoT ecosystem the hardware, software, and services are provided by different vendors.   Each aspect will need to be secured to be fit for its purpose within the context of its environment and ecosystem.  Methods to update and/or remove devices are required to keep up with the pace of business and technological advancements.

Just as hardware devices come with basic security benefits that can be used and will need to be updated over time, the software of open source components used by IoT devices must also be maintained.  Continuous updates are essential.  New aspects of information and human security will need to be included.  In the context of autonomous vehicles, software must be resilient against both malicious actors as terrorists as well as unauthorised but friendly users, such as a child who could use a smartphone to direct the car to go to school, for example.

Look Out Ahead for CyberSecurity in IoT

The future is not promising to be better in terms of cybersecurity threats and malicious attacks.   Globally there were nearly 27.5 billion installed IoT devices number of installed IoT devices at the end of 2020, which is set to rise to 45.9 billion by 202514. So, with both of these figures growing, it is clear to see that IoT devices are the perfect vessel for cyber criminals to carry out attacks.

80% of data breaches can be prevented with basic actions, such as vulnerability assessments, patching, and proper configurations.  Getting basic cyber hygiene right is critical to help prevent cyber attacks.  There are always those who destroy unity and stifle positive progress.  Cyber criminals unfortunately will continue to innovate with artificial intelligence to increase their attacks at machine speed from anywhere in the world and on a scale comparable to that of a pandemic.

How a Software Bill Of Materials can help prevent cyber attacks

The National Telecommunications and Information Administration (NTIA) defines a Software Bill Of Materials (SBOM) as “a complete, formally structured list of components, libraries, and modules that are required to build (i.e. compile and link) a given piece of software and the supply chain relationships between them. These components can be open source or proprietary, free or paid, and widely available or restricted access.” A bill of materials such as this acts as a comprehensive compilation of all internal parts of the software, including third party contributions. This would facilitate the tracking of individual components such as libraries or source code within software programs. With a complete and traceable inventory, companies can see and manage the risks associated with open source libraries by identifying vulnerable systems as early as possible. Furthermore, it allows developers to monitor what components they use by vetting the code in their projects. Finally, this level of transparency would allow for a more informed purchasing experience for consumers. President Biden recently formalized the importance of SBOMs through the Executive Order on Improving the Nation’s Cybersecurity15, in which it was made mandatory that all software used by the US government came with its own SBOM— so as to prevent from SolarWinds type hacks in the future.

If you are interested in automated auditing of your software applications for open source compliance risks and security vulnerabilities, get in touch.

1 Wikipedia, https ://en.wikipedia.org/wiki/Internet_of_things

2 Mlitz, Kimberly. “Work from home & remote work- Statistics and Facts”. Statistica, 30 March 2021, https: //www.statista.com/topics/6565/work-from-home-and-remote-work/.

3 “Fitness wearables may improve real-time tracking of seasonal influenza outbreaks.” Scripps Research, 16 January 2020, https ://www.scripps.edu/news-and-events/press-room/2020/20200116-wearable-flu.html.

4 Stieg, Cory. “This $75,000 Boston Dynamics robot ‘dog’ is for sale—take a look”. Make it, 22 June 2020, https ://www.cnbc.com/2020/06/22/75000-boston-dynamics-robot-dog-for-sale-take-a-look.html.

5 Banks, Martin. “Google Solving Together – Ocado Technology readies clients for more changes to online retail’s ‘new normal”. 15 June 2020, https ://diginomica.com/google-solving-together-ocado-technology-readies-clients-more-changes-online-retails-new-normal

6 “What did she say?! Talking doll Cayla is hacked”. 30 January 2015, https ://www.bbc.co.uk/news/av/technology-31059893 .

7 “Smart camera and baby monitor warning given by UK’s cyber-defender”. BBC News, 3 March 2020, https ://www.bbc.co.uk/news/technology-51706631.

8 Kelly Early. “What do the UK’s newly proposed IoT laws look like?”. Silicone Republic, 28 January 2020, https ://www.siliconrepublic.com/enterprise/uk-iot-internet-of-things-regulation-laws.

9 https ://www.nist.gov/internet-things-iot

11 Cimpanu, Catalin. “FBI warns about ongoing attacks against software supply chain companies”. ZD Net, 10 February 2020, https ://www.zdnet.com/article/fbi-warns-about-ongoing-attacks-against-software-supply-chain-companies/

12 Hall, Kat. “Largest advertising company in the world still wincing after NotPetya punch”. The Register, 7 July 2017, https ://www.theregister.com/2017/07/07/ad_giant_recovering_from_notpetya/.

13 Ashton, Gavin. GVNSHTN, Maersk, me & notPetya, 21 June 2020, https ://gvnshtn.com/maersk-me-notpetya/.

14 Belton, Padraig. “In 2021, as you work from home hackers eye your IoT”. Light Reading, 1 April 2021, https ://www.lightreading.com/iot/in-2021-as-you-work-from-home-hackers-eye-your-iot/d/d-id/766350

15 “Executive Order on Improving the Nation’s Cybersecurity”. The White House, 12 May 2021, https ://www.whitehouse.gov/briefing-room/presidential-actions/2021/05/12/executive-order-on-improving-the-nations-cybersecurity/.

Cyber Security and IoT