Clinical Cybersecurity Training Through Novel High Fidelity Simulations (Preprint)

Abstract

Background: Cybersecurity risks in healthcare systems have traditionally been measured in data breaches of protected health information but compromised medical devices and critical medical infrastructure raises questions about the risks of disrupted patient care. The increasing prevalence of these connected medical devices and systems implies that these risks are growing.Objective: This paper details the development and execution of three novel high fidelity clinical simulations designed to teach clinicians to recognize, treat, and prevent patient harm from vulnerable medical devices. Methods: Clinical simulations were developed which incorporated patient care scenarios with hacked medical devices based on previously researched security vulnerabilities. Results: Clinician participants universally failed to recognize the etiology of their patient's pathology as being the result of a compromised device. Conclusions: Simulation can be a useful tool in educating clinicians in this new, critically important patient safety space. IntroductionThe increasing development of and reliance on technical systems is an inescapable reality for humanity. Inherent cyber vulnerabilities in these systems are ubiquitous spanning all sectors of the global economy. From damaging breaches of private consumer data such as the Equifax hack that exposed half of the US population to the threat of identity theft [1], to active cyber warfare between nation states[2], the potential for harm caused by the exploitation of such vulnerable systems is profound.