Medical Apps and the Gray Zone in the COVID-19 Era: Between Evidence and New Needs for Cybersecurity Expansion

Ten Years of TeleHealth and Digital Healthcare: Where Are We?

Due to the development of the technological innovation of devices, availability of increasingly performing networks, improvement of the digitization processes, and the push to greater diffusion determined by the COVID-19 pandemic, Digital Healthcare (DH), also referred to as Digital Health [...]

Hospital cybersecurity risks and gaps: Review (for the non-cyber professional)

Background

Healthcare is facing a growing threat of cyberattacks. Myriad data sources illustrate the same trends that healthcare is one of the industries with the highest risk of cyber infiltration and is seeing a surge in security incidents within just a few years. The circumstances thus begged the question: are US hospitals prepared for the risks that accompany clinical medicine in cyberspace?

Objective

The study aimed to identify the major topics and concerns present in today's hospital cybersecurity field, intended for non-cyber professionals working in hospital settings.

Methods

Via structured literature searches of the National Institutes of Health's PubMed and Tel Aviv University's DaTa databases, 35 journal articles were identified to form the core of the study. Databases were chosen for accessibility and academic rigor. Eighty-seven additional sources were examined to supplement the findings.

Results

The review revealed a basic landscape of hospital cybersecurity, including primary reasons hospitals are frequent targets, top attack methods, and consequences hospitals face following attacks. Cyber technologies common in healthcare and their risks were examined, including medical devices, telemedicine software, and electronic data. By infiltrating any of these components of clinical care, attackers can access mounds of information and manipulate, steal, ransom, or otherwise compromise the records, or can use the access to catapult themselves to deeper parts of a hospital's network. Issues that can increase healthcare cyber risks, like interoperability and constant accessibility, were also identified. Finally, strategies that hospitals tend to employ to combat these risks, including technical, financial, and regulatory, were explored and found to be weak. There exist serious vulnerabilities within hospitals' technologies that many hospitals presently fail to address. The COVID-19 pandemic was used to further illustrate this issue.

Conclusions

Comparison of the risks, strategies, and gaps revealed that many US hospitals are unprepared for cyberattacks. Efforts are largely misdirected, with external-often governmental-efforts negligible. Policy changes, e.g., training employees in cyber protocols, adding advanced technical protections, and collaborating with several experts, are necessary. Overall, hospitals must recognize that, in cyber incidents, the real victims are the patients. They are at risk physically and digitally when medical devices or treatments are compromised.

Preparing for hybrid warfare and cyber-attacks on health services' digital infrastructure: what nurse managers need to know

AIM

This article aims to outline the key concepts in hybrid warfare and cyber-attack to better inform nurses managers in their strategic contribution to the defence of critical digital infrastructure.

BACKGROUND

Hybrid warfare often targets a nation's critical digital infrastructure including health services. Hybrid warfare against national health services, primarily through cyber-attack, is likely to increase in a more destabilised and conflictual international environment.

EVALUATION

Key literature, reports and assessments on hybrid warfare, advanced persistent threats and cyber-attack referenced to health services were analysed.

KEY ISSUE

Health services are a key element of a nation's critical infrastructure and as such are a key target in hybrid war strategies. Cyber-attack through exploiting clinicians', such as nurses', online susceptibilities, is a key route of attack. Nurse managers, to be effective planners, need to be fully informed on both the context for and specific nature of cyber-attack.

CONCLUSION(S)

Articles that deal with the relationship of hybrid warfare and cyber-attack on health services are rarely aimed at nurses and nurse managers.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers need to be fully informed about the the geo-political nature of cyber-attacks if they are to be fully consulted and listened to in response planning.

Information Security in Medical Robotics: A Survey on the Level of Training, Awareness and Use of the Physiotherapist

Cybersecurity is becoming an increasingly important aspect to investigate for the adoption and use of care robots, in term of both patients' safety, and the availability, integrity and privacy of their data. This study focuses on opinions about cybersecurity relevance and related skills for physiotherapists involved in rehabilitation and assistance thanks to the aid of robotics. The goal was to investigate the awareness among insiders about some facets of cybersecurity concerning human-robot interactions. We designed an electronic questionnaire and submitted it to a relevant sample of physiotherapists. The questionnaire allowed us to collect data related to: (i) use of robots and its relationship with cybersecurity in the context of physiotherapy; (ii) training in cybersecurity and robotics for the insiders; (iii) insiders' self-assessment on cybersecurity and robotics in some usage scenarios, and (iv) their experiences of cyber-attacks in this area and proposals for improvement. Besides contributing some specific statistics, the study highlights the importance of both acculturation processes in this field and monitoring initiatives based on surveys. The study exposes direct suggestions for continuation of these types of investigations in the context of scientific societies operating in the rehabilitation and assistance robotics. The study also shows the need to stimulate similar initiatives in other sectors of medical robotics (robotic surgery, care and socially assistive robots, rehabilitation systems, training for health and care workers) involving insiders.