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Author(s):
Jeff Tully Jordan Selzer James P. Phillips Patrick O'Connor Christian Dameff
Journal
Mary Ann Liebert Inc
Abstract

As a result of the extensive integration of technology into the healthcare system, cybersecurity incidents have become an increasing challenge for the healthcare industry. Recent examples include WannaCry, a nontargeted ransomware attack on more than 150 countries worldwide that temporarily crippled parts of the National Health Service in the United Kingdom, and the 2016 ransomware attack on Los Angeles's Hollywood Presbyterian Medical Center. The attacks cost millions of dollars in lost revenue and fines, as well as significant reputational damage. Efforts are needed to devise tools that allow experts to more accurately quantify the actual impact of such events on both individual patients and healthcare systems as a whole. While the United States has robust disaster preparedness and response systems integrated throughout the healthcare and government sectors, the rapidly evolving cybersecurity threat against healthcare entities is outpacing existing countermeasures and challenges in the "all-hazards" disaster preparedness paradigm. Further epidemiologic research of clinical cybersecurity attacks and their effects on patient care and clinical outcomes is necessary to prevent and mitigate future attacks. © Copyright 2020, Mary Ann Liebert, Inc., publishers.

Concluding remarks
Public policy enacted to reduce the impacts of disasters have not adequately addressed the threats that arise from the growing dependence American healthcare has on connected technology. Limited resources, a complex and evolving organizational hierarchy, immature regulation, and a relatively unfamiliar threat model without a significant foundation of evidence-based research all combine to present a challenge for the individual healthcare delivery organization or public health system preparing for a cybersecurity-related incident. Additionally, appropriate tools to capture and attribute the true medical impacts of these events are still lacking. The current legal and regulatory landscape, including HIPAA and CMS regulations, provide a needed foundation, but recent incidents have demonstrated the importance of a more robust and evidence-based framework to combat healthcare cybercrime. Suggestions for future regulations to improve safety include improved event reporting and information sharing, improved tools for investigation and prosecution of cybercrimes, and federal training and response to cybersecurity events in ways similar to other disasters. The advances in disaster planning and management for conventional public health emergencies provide a roadmap for improving readiness in the cybersecurity arena. Additionally, prevention and risk reduction through various strategies, including end-user education, regular patching, and discontinued use of unsupported software and devices, are essential to improving healthcare cybersecurity. Thus, cybersecurity improvements will ultimately improve the health of patients. Further research should address the epidemiology of clinical cybersecurity incidents and characterize the effect they have on patient care capabilities and subsequent clinical outcomes. Best practices should be developed not only by information security professionals, but by multidisciplinary groups including clinicians, health system administrators, and policymakers.

Reference details

DOI
10.1089/hs.2019.0123
Resource type
Journal Article
Year of Publication
2020
ISSN Number
2326-5094
Date Published
2020-06-01

How to cite this reference:

Tully, J., Selzer, J., Phillips, J. P., O’Connor, P., & Dameff, C. (2020). Healthcare Challenges in the Era of Cybersecurity. Mary Ann Liebert Inc. https://doi.org/10.1089/hs.2019.0123 (Original work published)