"99.9% of clinicians wouldn’t expect a device to fail”: Insights from a clinically orientated workshop on healthcare cybersecurity and medical technology (Preprint)

Abstract

Healthcare professionals receive little training on the digital technologies that their patients rely on. Consequently, practitioners may face significant barriers when providing care to patients suffering from digitally-mediated harms (e.g., device failures, medical cybersecurity exploits). Here, we explore the impact of technological failures in clinical terms.

Our study explored the key challenges faced by frontline healthcare workers during digital events, identified gaps in clinical training and guidance, and proposes a set of recommendation for improving digital clinical practice.

A qualitative study involving a one-day workshop of fifty-two participants, internationally attended, with multi-stakeholder participation. Participants engaged in table-top exercises and group discussions focused on medical scenarios complicated by technology (e.g., malfunctioning ventilators, malicious hacks on healthcare apps). Extensive notes from five scribes were retrospectively analysed and a thematic analysis was performed to extract and synthesise data.

Clinicians reported novel forms of harm related to technology (e.g., geofencing in domestic violence, errors related to interconnected foetal monitoring systems) and barriers impeding adverse event reporting (e.g., time constraints, post-mortem device disposal). Challenges to providing effective patient care included a lack of clinical suspicion for device failures, unfamiliarity with equipment, and an absence of digitally tailored clinical protocols. Participants agreed that cyberattacks should be classed as Major Incidents, with the repurposing of existing crisis resources. Treatment of patients was determined by the role technology played in clinical management, such that those reliant on potentially compromised laboratory or radiological facilities were prioritised.

Here, we have framed digital events through a clinical lens, described in terms of their end-point impact on the patient. In doing so, we have developed a series of recommendations for ensuring responses to digital events are tailored to clinical needs and centre patient care.

N/A