CGM Cybersecurity Assessment Dashboard

Review each criterion and determine the cybersecurity performance of your CGM.

Forward Writing

Criteria A

Cybersecurity Vulnerability: Glucose data can be overwritten or altered during transmission to CGM reader (forward writing).

Risk to Patient: Inaccurate glucose values can lead to inappropriate treatment decisions in real time.

Evidence: Demonstrate that transmitted data does not match data stored locally on device.

Has an attack been demonstrated in which glucose data was overwritten or altered during transmission to data receiver (forward writing)?

Backward Writing

Criteria B

Cybersecurity Vulnerability: Glucose data can be overwritten or altered locally on the device (backward writing).

Risk to Patient: Inaccurate glucose values can lead to inappropriate treatment decisions in real time or on retrospective data review.

Evidence: Demonstrate that the glucose data stored locally on the device is altered, by recording the data immediately before and after the attack.

Has an attack been demonstrated in which glucose data was overwritten or altered locally on the device (backward writing)?

Device Metadata

Criteria C

Cybersecurity Vulnerability: Device information (serial number, device identifying information, or other) can be modified.

Risk to Patient: Alteration of device serial number or identifying information may be used to inform calibration settings. Changing them may lead to inaccurate CGM calibration and thus inaccurate glucose readings.

Evidence: Demonstrate a single device reporting different device information before and after simulated attack.

Has an attack been demonstrated in which device information was altered?

Criteria C(i) Was the device activation or stage-of-life altered?

Criteria C(ii) Was any other device information altered?

Privacy / Local Data

Criteria D

Cybersecurity Vulnerability: Unauthorized access to device (authorization given without authentication)

Risk to Patient: Breach of sensitive patient data.

Evidence: Demonstrate that data (glucose values, plain text, encrypted data, or other) stored on the local device can be read by an unauthenticated device.

Has data on the local device been read by an unauthenticated user or device?

Criteria D(i) Has a third-party application demonstrated the ability to report a glucose value from this CGM sensor?

Criteria D(ii) Has local device data been read by an unauthenticated user or device in any other way?

Additional Scenario

Optional

Would you like to evaluate a scenario which is not covered in the pre-defined scenarios?

Scenario: For vulnerabilities or exploits which do not fall under the predefined scenarios. User will be prompted with all questions from MITRE framework.

Attack Vector

Can the attacker utilize some type of network or communication protocol to exploit this vulnerability?

Attack Complexity

Can the attacker attempt to exploit the vulnerability at will, i.e., without requiring any special circumstances, configurations, or use of other vulnerabilities or attacks before attacking this vulnerability?

Privileges Required

Does the device/component use an authorization model that supports login for multiple different users or roles with different privilege levels?

User Interaction

To successfully exploit the vulnerability, must the attacker depend on another user or victim to perform an action or otherwise interact with the system?

Scope

Can the attacker affect a component whose authority ("authorization scope") is different than that of the vulnerable component?

Confidentiality, Integrity, Availability Impact

For each type of data or functionality, indicate whether exploitation enables the attacker to read, modify/delete, or prevent access to it.

For Personally Identifiable Information (PII) or Protected Health Information (PHI) data: Can this data or functionality be read/exposed? Can this data or functionality be modified/deleted? Can this data or functionality be rendered inaccessible?

For any data or functionality related to diagnosis or monitoring: Can this data or functionality be read/exposed? Can this data or functionality be modified/deleted? Can this data or functionality be rendered inaccessible?

For any data or functionality related to the delivery of therapy: Can this data or functionality be read/exposed? Can this data or functionality be modified/deleted? Can this data or functionality be rendered inaccessible?

For any data or functionality related to clinical workflow: Can this data or functionality be read/exposed? Can this data or functionality be modified/deleted? Can this data or functionality be rendered inaccessible?

For any data or functionality related to private system or system-user data, e.g. passwords or private keys: Can this data or functionality be read/exposed? Can this data or functionality be modified/deleted? Can this data or functionality be rendered inaccessible?

For any other kind of critical sensitive data or functionality: Can this data or functionality be read/exposed? Can this data or functionality be modified/deleted? Can this data or functionality be rendered inaccessible?

Exploit Code Maturity

Is there exploit code that works in every situation; is actively being utilized by malware such as a worm or virus; has been integrated into a reliable automated tool; and/or can be manually triggered using detailed instructions that have been made widely available?

Remediation Level

Is there an official fix available?

Report Confidence

Has the vendor confirmed that the vulnerability exists?

CGM Cybersecurity Assessment Dashboard

Forward Writing

Not Assessed

Backward Writing

Not Assessed

Device Metadata

Not Assessed

Privacy / Local Data

Not Assessed

Additional Scenario

Attack Vector

Attack Complexity

Privileges Required

User Interaction

Scope

Confidentiality, Integrity, Availability Impact

Exploit Code Maturity

Remediation Level

Report Confidence