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.

Vulnerabilidades de Segurança da Informação na Indústria 4.0: Proposição de Critérios para o uso de Análise Multicritério

“…Confidencialidade (Agrawal et al, 2020;Ankele et al, 2019;Butun et al, n.d., 2020;Dimitriadis et al, 2020;Kim et al, 2020;Lara et al, 2020;Liang et al, 2019;Luo et al, 2015;Murch et al, 2018;Ratasich et al, 2019;Samaila et al, 2020;Sun & Liu, 2012;Willing et al, 2020) Integridade (Agrawal et al, 2019;Ankele et al, 2019;Bolbot et al, 2020;Butun et al, n.d., 2020;Dimitriadis et al, 2020;Kim et al, 2020;Lara et al, 2020;Liang et al, 2019;Luo et al, 2015;Mohamed et al, 2020;Moraitis et al, 2020;Ratasich et al, 2019;Sun & Liu, 2012;Willing et al, 2020) Disponibilidade (Agrawal et al, 2019(Agrawal et al, , 2020Al-Mhiqani et al, 2018;Bolbot et al, 2020;Butun et al, n.d., 2020;Dimitriadis et al, 2020;Liang et al, 2019;Luo et al, 2015;Mohamed et al, 2020;Ratasich et al, 2019;Sun & Liu, 2012;Willing et al, 2020) Autenticação (Ankele et al, 2019;Bolbot et al, 2020;…”

“…K. Pandey & Alsolami, n.d.; Sun & Liu, 2012) Sensibilidade (Anuar et al, 2013;Luo et al, 2015;Yan et al, 2020) Similaridade e distribuição de alvo (Agrawal et al, 2020;Anuar et al, 2013;Luo et al, 2015;Sun & Liu, 2012) Frequência (Anuar et al, 2013) Riscos Avaliação de risco (Ani et al, 2019;Anuar et al, 2013;Bolbot et al, 2020;Dimitriadis et al, 2020;Kim et al, 2020;Mendonça Silva et al, 2016;Mohamed et al, 2020;Moraitis et al, 2020;Mourtzis et al, 2019;S. Pandey et al, 2020;Russo et al, 2019;Willing et al, 2020;Yan et al, 2020) Probabilid. de evento/ ameaça (Anuar et al, 2013;A.…”

“…K. Pandey & Alsolami, n.d.;Sun & Liu, 2012;Walker-Roberts et al, 2020) Gestão de risco (Anuar et al, 2013;Bolbot et al, 2020;Dimitriadis et al, 2020;Fekete & Rhyner, 2020;Kim et al, 2020;Mohamed et al, 2020;Prislan et al, 2020;Russo et al, 2019) Impacto do evento/ameaça (Anuar et al, 2013) Segurança de rede Cadeias de suprimento (Fekete & Rhyner, 2020;He et al, 2016;Moraitis et al, 2020;Murch et al, 2018) Sistemas de segurança (Ankele et al, 2019;Butun et al, 2020;Lara et al, 2020;Luo et al, 2015;Mohamed et al, 2020;A. K. Pandey & Alsolami, n.d.;Russo et al, 2019;Samaila et al, 2020) Interoperabilidade (Agrawal et al, 2019;Butun et al, 2020;Dimitriadis et al, 2020;Modarresi & Symons, 2020;Ratasich et al, 2019;Willing et al, 2020) Ameaças de segurança (Al-Mhiqani et al, 2018;Ankele et al, 2019;Bolbot et al, 2020;Butun et al, 2020;Dimitriadis et al, 2020;Fernández-Caramés & Fraga-Lamas, 2020b;He et al, 2016;Kim et al, 2020;Lara et al, 2020;Liang et al, 2019;…”

“…Aquisição de dados e privacidade (Butun et al, n.d., 2020;He et al, 2016;Lara et al, 2020;Liang et al, 2019;Mohamed et al, 2020;Mourtzis et al, 2019;Murch et al, 2018;Samaila et al, 2020;Yan et al, 2020) Comunicação (Ankele et al, 2019;Bolbot et al, 2020;Fernández-Caramés & Fraga-Lamas, 2020b;He al., 2016;Modarresi & Symons, 2020;Mohamed et al, 2020;Mourtzis et al, 2019;Ratasich et al, 2019) Sistemas de informação Sistemas de aprendizagem (Agrawal et al, 2019;Ankele et al, 2019;Fernández-Caramés & Fraga-Lamas, 2020a, 2020bLiang et al, 2019;Mohamed et al, 2020) Organização e gestão (Ani et al, 2019;Dimitriadis et al, 2020;Fernández-Caramés & Fraga-Lamas, 2020a, 2020bHe et al, 2016;Mendonça Silva et al, 2016;Mohamed et al, 2020;Prislan et al, 2020;Russo et al, 2019;Willing et al, 2020) Fonte: resultado da pesquisa.…”

Information Security Awareness and Behaviors of Health Care Professionals at Public Health Care Facilities

“…26 brings more risks of internal and external threats and exploitations of sensitive data. 15,27 Future studies should further investigate the characteristics (e.g., size, type, services provided, etc.) of the health care facility and their relationships with cybersecurity vulnerabilities.…”