Healthcare is one of the sectors most exposed to cyberattacks this is partly because of the vulnerability of the systems, often running on legacy platforms. 4 Despite the number of reported cyberattacks on healthcare internationally, there has been no comprehensive assessment of the actual impact of any attack in terms of service disruption, financial impact, and harm to patients. 3 Most recently, the Singapore Health System reported a major breach of over 1 m patient records, including the prime minister’s record. 2Ĭyber security attacks are a growing threat to healthcare and there have been a number of significant cyber security incidents in healthcare globally, the biggest being at Anthem Blue Cross Insurance System in the U.S., where over 78 million (m) health records were stolen in 2015.
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1 Over the next week, the cyberattack resulted in significant disruption across the NHS for patients and healthcare staff, which included reverting to manual processes (e.g.: reporting blood results, paper notes) disruption to radiology services cancelled outpatient appointments, elective admissions, and day case procedures and for five infected acute trusts, emergency ambulances were diverted to other hospitals. 1 The attack was brought to a halt on the evening of the 12 of May by a cyber researcher who had activated a kill switch, which stops the spread of the malicious software, and prevented further devices from being infected. a major incident was declared as the scale of the problem became more apparent. The UK Department of Health and Social Care (DHSC) was alerted about the emerging events at 1 p.m. 1 Infected hospital trusts were locked out of their digital systems and medical devices, such as MRI scanners affected trusts were those that were not infected but reported disruption either through preventative action or sharing systems with infected organisations. 1 Over 600 organisations were affected this included 34 infected hospital trusts (NHS organisations that provide acute care, specialised medical services, mental healthcare, or ambulance services) and 46 affected hospital trusts. 1 Although not directly targeted, one of the biggest causalities of this attack was the National Health Service (NHS) in England. The global ransomware attack, WannaCry, took hold across multiple continents and organisations on Friday 12 May, 2017. Further work is needed to appreciate the impact of a cyberattack or IT failure on care delivery and patient safety. There was no increase in mortality reported, though this is a crude measure of patient harm. Among hospitals infected with WannaCry ransomware, there was a significant decrease in the number of attendances and admissions, which corresponded to £5.9 m in lost hospital activity. The total economic value of the lower activity at the infected trusts during this time was £5.9 m including £4 m in lost inpatient admissions, £0.6 m from lost A&E activity, and £1.3 m from cancelled outpatient appointments. Hospitals directly infected with the ransomware, however, had significantly fewer emergency and elective admissions: a decrease of about 6% in total admissions per infected hospital per day was observed, with 4% fewer emergency admissions and 9% fewer elective admissions. Trusts had 1% more emergency admissions and 1% fewer A&E attendances per day during the WannaCry week compared with baseline. Compared with the baseline, there was no significant difference in the total activity across all trusts during the week of the WannaCry attack. The main outcomes measured were : outpatient appointments cancelled, elective and emergency admissions to hospitals, accident and emergency (A&E) attendances, and deaths in A&E. A systematic analysis of Hospital Episodes Statistics (HES) data was done to determine the effects of the 2017 WannaCry attack on the National Health Service (NHS) by identifying the missed appointments, deaths, and fiscal costs attributable to the ransomware attack.
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