[ziddoap]

>I'm observing that the litany of "this should be air-gapped" complaints isn't productive, because things are not going to be air-gapped.

So, how would one be productive about it?

Your post seems to say, and please correct me if I am wrong, that because things aren't currently happening and there are some barriers to making it happen, we should all give up on pushing for it? To me, that seems like a rather fatalist attitude to have. Do we apply this line of thinking to everything? Or just air-gapping?

[tptacek]

Well, I guess I'm going to say something challenging here: give up on air-gapping, since it's not going to happen. Revise your premises to assume technology that can be connected will be connected, and proceed accordingly.

I am not, by the way, happy about this, but I've also spent essentially a lifetime (minus maybe 13-14 years at the beginning) having all the surprise on this particular issue knocked out of me.

[hackinthebochs]

Sure, companies won't air gap willingly. But legislation can fix that. I see no reason why this world (or this country) is one where such legislation necessarily cannot happen.

[ziddoap]

It's really a shame that a (relatively easy to implement) solution exists to a problem, that could potentially save lives in this case, should be left to the wayside and a new solution needs to be invented. Which, that solution may also not be implemented.

I guess I have a little bit of surprise left in me on this issue.

[closeparen]

It's not a solution, it's a layer. Vulnerabilities still matter behind an airgap. A hospital is a large, semi-public facility. Patients are left alone in their rooms with network drops. There are legitimate business needs to transfer records in from and out to other institutions; who's to say they can't contain exploit payloads? There are contractors, vendors, and high-turnover low-skilled staff circulating every day. And even if there weren't, if you've been thinking of the airgap as a "solution" and not keeping up with patches, the first person to cross will have a ridiculously easy time with whatever's inside.

It's good to raise the bar from drive-by internet strangers to people and organizations willing to take mild physical risks, but it's not a panacea.

[ziddoap]

I suppose I could have been more precise in my wording, and clarified that I see it as a solution to a piece of the puzzle. Indeed, you do word it better in saying it is a layer. I agree. It is a solution to facet of a problem which exists at a certain layer.

I don't quite know how my comment led you to believe that I think airgapping is a pancea which solves all the existing computer woes in the world.

I certainly don't think, and didn't intend to imply, that airgapping removes the risk from contractors or a reason to not keep up on patches. Again, I'm confused how you reached that conclusion based on my comment.

[aptwebapps]

Unless the person you're replying to thinks you are personally currently maintaining such equipment, that's a general 'you'.

"And even if there weren't, if you've been thinking of the airgap as a "solution" and not keeping up with patches, ..."

Nobody here is going to say airgap and done, but out in the wild they will certainly deprioritize updates on airgapped equipment.

[ziddoap]

Well I mean, I said it's a solution. They said it is not a solution, a direct response to what I specifically had said, and followed by directly responding to the rest of my statement. The entire comment seems to be directed at what I said, hinging off my use of "solution".

Perhaps the 'you' was intended to be generalized. I interpreted as directed at me, since the entirety of the comment is directed at me. Maybe I'm mistaken.

The joys of trying to have meaningful conversations over text.

[closeparen]

If it’s a solution, legislation should just require it. If it’s one of many possible security controls that will each help a bit, we might need more nuanced and local decision making.

[Spooky23]

Think beyond your scope. IT is a tool.

The risks of compromise of an anesthesia machine are scary. It’s also scary that without EMR integration, a dosage might be misreported or an allergy missed.

It’s possible to securely segment a network to defend against these types of risks. The bigger problem here is that the professional practice of IT is such a garbage fire, it’s assumed that the LAN is compromised and airgapping is the responsible choice.

[Kalium]

> So, how would one be productive about it?

One might start by observing that there are reasons these things aren't air-gapped. A person could go on to note which of these reasons continue to apply and are considered compelling by those who make the relevant decisions, and thus that air-gapping is likely to persist.

[ziddoap]

I wasn't being facetious with my question, it was made in good faith. As I'm not familiar with hospital infrastructure, nor hospital equipment, could you explain to me what reason (other than updates, which is being debated here) an anesthesia machine should not be air-gapped?

[Kalium]

Updates, remote monitoring and remote management all come to mind. Further, integration with other instruments is something that is sometimes considered valuable and difficult to do when everything is airgapped from everything else.

[jacquesm]

Updates should not happen while a patient is under treatment using the machine. Remote monitoring can be done through an airgap (one way optical bridge) that does not have the ability to influence the machine. Remote management while a patient is being treated sounds wildly irresponsible.

So maybe the system could be connected to the network except for when it is treating a patient. A big red slider with 'On Air/Isolated' could be present which would lock out the patient treating options as soon as the machine is networked. Now, this would still leave some gaps: an update could be faulty, a malicious actor could install something that triggers only after a while or when the machine is used to treat a patient. But it would remove a lot of the concern I have with equipment like this being online all the time.