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Analyzing medical device connectivity and its effect on cyber security in german hospitals

ABSTRACT: Background Modern healthcare devices can be connected to computer networks and many western healthcare institutions run those devices in networks. At the same time, cyber attacks are on the rise and there is evidence that cybercriminals do not spare critical infrastructure such as major hospitals, even if they endanger patients. Intuitively, the more and closer connected healthcare devices are to public networks, the higher the risk of getting attacked. Methods To asses the current connectivity status of healthcare devices, we surveyed the field of German hospitals and especially University Medical Center UMCs. Results The results show a strong correlation between the networking degree and the number of medical devices. The average number of medical devices is 25.150, with a median of networked medical devices of 3.600. Actual key users of networked medical devices are the departments Radiology, Intensive Care, Radio-Oncology RO, Nuclear Medicine NUC, and Anaesthesiology in the group of UMCs. In the next five years, the usage of networked medical devices will increase significantly in the departments of Surgery, Intensive Care, and Radiology. We detected a strong correlation between the degree of connectivity and the likelihood of being attacked.The survey answers regarding the cyber security status reveal a lack of security basics in some of the inquired hospitals. We did discover successful attacks in hospitals with separated or subsidiary departments. A fusion of competencies on an organizational level facilitates the right behavior here. Most hospitals rated themselves predominantly positively in the self-assessment but also stated the usefulness of IT security insurance. Conclusions Concluding our results, hospitals are already facing the consequences of omitted measures within their growing pool of medical devices. Continuously relying on historically grown structures without adaption and trusting manufactures to solve vectors is a critical behavior that could seriously endanger patients.

SUBMITTER: Willing M

PROVIDER: S-EPMC7526356 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Project description:A critical requirement for developing a cyber capable workforce is to understand how to challenge, assess, and rapidly develop human cyber skill-sets in realistic cyber operational environments. Fortunately, cyber team competitions make use of simulated operational environments with scoring criteria of task performance that objectively define overall team effectiveness, thus providing the means and context for observation and analysis of cyber teaming. Such competitions allow researchers to address the key determinants that make a cyber defense team more or less effective in responding to and mitigating cyber attacks. For this purpose, we analyzed data collected at the 12th annual Mid-Atlantic Collegiate Cyber Defense Competition (MACCDC, http://www.maccdc.org), where eight teams were evaluated along four independent scoring dimensions: maintaining services, incident response, scenario injects, and thwarting adversarial activities. Data collected from the 13-point OAT (Observational Assessment of Teamwork) instrument by embedded observers and a cyber teamwork survey completed by all participants were used to assess teamwork and leadership behaviors and team composition and work processes, respectively. The scores from the competition were used as an outcome measure in our analysis to extract key features of team process, structure, leadership, and skill-sets in relation to effective cyber defense. We used Bayesian regression to relate scored performance during the competition to team skill composition, team experience level, and an observational construct of team collaboration. Our results indicate that effective collaboration, experience, and functional role-specialization within the teams are important factors that determine the success of these teams in the competition and are important observational predictors of the timely detection and effective mitigation of ongoing cyber attacks. These results support theories of team maturation and the development of functional team cognition applied to mastering cybersecurity.

Project description:BackgroundThe use of mobile devices in hospital care constantly increases. However, smartphones and tablets have not yet widely become official working equipment in medical care. Meanwhile, the parallel use of private and official devices in hospitals is common. Medical staff use smartphones and tablets in a growing number of ways. This mixture of devices and how they can be used is a challenge to persons in charge of defining strategies and rules for the usage of mobile devices in hospital care.ObjectiveTherefore, we aimed to examine the status quo of physicians' mobile device usage and concrete requirements and their future expectations of how mobile devices can be used.MethodsWe performed a web-based survey among physicians in 8 German university hospitals from June to October 2019. The online survey was forwarded by hospital management personnel to physicians from all departments involved in patient care at the local sites.ResultsA total of 303 physicians from almost all medical fields and work experience levels completed the web-based survey. The majority regarded a tablet (211/303, 69.6%) and a smartphone (177/303, 58.4%) as the ideal devices for their operational area. In practice, physicians are still predominantly using desktop computers during their worktime (mean percentage of worktime spent on a desktop computer: 56.8%; smartphone: 12.8%; tablet: 3.6%). Today, physicians use mobile devices for basic tasks such as oral (171/303, 56.4%) and written (118/303, 38.9%) communication and to look up dosages, diagnoses, and guidelines (194/303, 64.0%). Respondents are also willing to use mobile devices for more advanced applications such as an early warning system (224/303, 73.9%) and mobile electronic health records (211/303, 69.6%). We found a significant association between the technical affinity and the preference of device in medical care (χs2=53.84, P<.001) showing that with increasing self-reported technical affinity, the preference for smartphones and tablets increases compared to desktop computers.ConclusionsPhysicians in German university hospitals have a high technical affinity and positive attitude toward the widespread implementation of mobile devices in clinical care. They are willing to use official mobile devices in clinical practice for basic and advanced mobile health uses. Thus, the reason for the low usage is not a lack of willingness of the potential users. Challenges that hinder the wider adoption of mobile devices might be regulatory, financial and organizational issues, and missing interoperability standards of clinical information systems, but also a shortage of areas of application in which workflows are adapted for (small) mobile devices.

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Analyzing medical device connectivity and its effect on cyber security in german hospitals

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