Literature DB >> 34339260

Cancer Care in the Wake of a Cyberattack: How to Prepare and What to Expect.

Steven Ades1, Diego Adrianzen Herrera1, Tim Lahey2, Alissa A Thomas1, Sakshi Jasra1, Maura Barry1, Julian Sprague1, Kim Dittus3, Timothy B Plante2, Jamie Kelly1, Peter A Kaufman1, Farrah Khan1, Cory J Hammond3, Kelly Gernander3, Polly Parsons2, Chris Holmes1.   

Abstract

PURPOSE: Cyberattacks targeting health care organizations are becoming more frequent and affect all aspects of care delivery. Cancer care is particularly susceptible to major disruptions because of the potential of immediate and long-term consequences for patients who often rely on timely diagnostic testing and regular administration of systemic therapy in addition to other local treatment modalities to cure or control their diseases. On October 28, 2020, a cyberattack was launched on the University of Vermont Health Network with wide-ranging consequences for oncology, including loss of access to all network intranet servers, e-mail communications, and the electronic medical record (EMR).
METHODS: This review details the immediate challenges faced by hematology and oncology during the cyberattack. The impact and response on inpatient, outpatient, and special patient populations are described. Steps that other academic- and community-based oncology practices can take to lessen the brunt of such an assault are suggested.
RESULTS: The two areas of immediate impact after the cyberattack were communications and lack of EMR access. The oncology-specific impact included loss of the individualized EMR chemotherapy plan templates and electronic safeguards built into multistep treatment preparation and delivery. With loss of access to schedules, basic patient information, encrypted communications platforms and radiology, and laboratory and pharmacy services, clinical outpatient care delivery was reduced by 40%. The infusion visit volume dropped by 52% in the first week and new patients could not access necessary services for timely diagnostic evaluation, requiring the creation of command centers to oversee ethical and transparent triage and allocation of systemic therapies and address new patient referrals. This included appropriate transfer of patients to alternate sites to minimize delays. Inpatient care including transitions of care was particularly challenging and addressing patient populations whose survival might be affected by delays in care.
CONCLUSION: Oncology health care leaders and providers should be aware of the potential impact of a cyberattack on cancer care delivery and preventively develop processes to mitigate the impact.

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Year:  2021        PMID: 34339260      PMCID: PMC8758119          DOI: 10.1200/OP.21.00116

Source DB:  PubMed          Journal:  JCO Oncol Pract        ISSN: 2688-1527


  10 in total

1.  Electronic Chemotherapy Order Entry: A Major Cancer Center's Implementation.

Authors:  Nancy T Sklarin; Svetlana Granovsky; Eileen M O'Reilly; Andrew D Zelenetz
Journal:  J Oncol Pract       Date:  2011-07       Impact factor: 3.840

2.  Principles for allocation of scarce medical interventions.

Authors:  Govind Persad; Alan Wertheimer; Ezekiel J Emanuel
Journal:  Lancet       Date:  2009-01-31       Impact factor: 79.321

3.  A protocol and ethical framework for the distribution of rationed chemotherapy.

Authors:  Andrew Hantel
Journal:  J Clin Ethics       Date:  2014

4.  Ethical considerations for the clinical oncologist in an era of oncology drug shortages.

Authors:  Reshma Jagsi; Rebecca Spence; W Kimryn Rathmell; Angela Bradbury; Jeffrey Peppercorn; Stephen Grubbs; Beverly Moy
Journal:  Oncologist       Date:  2014-01-21

Review 5.  The organization of multidisciplinary care teams: modeling internal and external influences on cancer care quality.

Authors:  Mary L Fennell; Irene Prabhu Das; Steven Clauser; Nicholas Petrelli; Andrew Salner
Journal:  J Natl Cancer Inst Monogr       Date:  2010

6.  Fair Allocation of Scarce Medical Resources in the Time of Covid-19.

Authors:  Ezekiel J Emanuel; Govind Persad; Ross Upshur; Beatriz Thome; Michael Parker; Aaron Glickman; Cathy Zhang; Connor Boyle; Maxwell Smith; James P Phillips
Journal:  N Engl J Med       Date:  2020-03-23       Impact factor: 91.245

7.  The Toughest Triage - Allocating Ventilators in a Pandemic.

Authors:  Robert D Truog; Christine Mitchell; George Q Daley
Journal:  N Engl J Med       Date:  2020-03-23       Impact factor: 91.245

Review 8.  Impact of clinical pharmacists in outpatient oncology practices: A review.

Authors:  Justin Gatwood; Katie Gatwood; Ezra Gabre; Maurice Alexander
Journal:  Am J Health Syst Pharm       Date:  2017-10-01       Impact factor: 2.637

9.  Impact of clinical pharmacy services in a hematology/oncology inpatient setting.

Authors:  Amina Delpeuch; Dominique Leveque; Benedicte Gourieux; Raoul Herbrecht
Journal:  Anticancer Res       Date:  2015-01       Impact factor: 2.480

10.  Mortality due to cancer treatment delay: systematic review and meta-analysis.

Authors:  Timothy P Hanna; Will D King; Stephane Thibodeau; Matthew Jalink; Gregory A Paulin; Elizabeth Harvey-Jones; Dylan E O'Sullivan; Christopher M Booth; Richard Sullivan; Ajay Aggarwal
Journal:  BMJ       Date:  2020-11-04
  10 in total
  1 in total

1.  Impact of and Response to Cyberattacks in Radiation Oncology.

Authors:  Carl J Nelson; Emilie T Soisson; Puyao C Li; Nataniel H Lester-Coll; Havaleh Gagne; Matthew A Deeley; Christopher J Anker; Lori Ann Roy; H James Wallace
Journal:  Adv Radiat Oncol       Date:  2022-06-18
  1 in total

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