Cybersecurity risks and gaps in hospital clinical care: Summary review (for the non-cyber professional) (Preprint)

2021 ◽  
Author(s):  
Liat Wasserman
Keyword(s):  
Medical Devices ◽  
Clinical Medicine ◽  
Clinical Care ◽  
Journal Articles ◽  
Policy Changes ◽  
Electronic Data ◽  
Pubmed Database ◽  
The Us ◽  
Security Incidents ◽  
Hospital Equipment

BACKGROUND Healthcare is facing a growing threat of cyberattacks. Myriad data sources illustrate the same trends that healthcare is one of the industries with the highest risk of cyber infiltration and is seeing the rate of security incidents surge within just a few years. The circumstances thus begged the question: are US hospitals prepared for the risks that accompany clinical medicine in cyberspace? OBJECTIVE This study aimed to identify the major topics and concerns present in today’s hospital cybersecurity field, intended for the non-cyber professionals audience in hospital settings. METHODS Via a structured literature search of the National Institutes of Health’s PubMed database (including the MEDLINE database) and Tel Aviv University’s DaTa database, 35 journal articles were identified to form the core of the study. 86 additional sources were examined to inform the study findings RESULTS The literature review revealed a basic landscape of hospital cybersecurity, including the top ten methods of attack, the primary reasons hospitals are frequent targets, and the consequences hospitals face following attacks. The cyber technologies common in clinical medicine, as well as their risks, were also examined, with the major categories highlighted being medical devices, telemedicine software, and electronic data. By infiltrating any of these three components of clinical care, cyber attackers can access a trove of valuable information and manipulate, steal, ransom, or otherwise compromise the records, or can use the access to catapult themselves to access other parts of a hospital’s network. Multiple secondary issues that can increase the cyber risks associated with devices, telemedicine, and electronic data were also identified. Finally, strategies that hospitals tend to employ to combat the cyber risks were explored and found to be subpar. There exist within hospitals’ cybersecurity measures serious vulnerabilities and gaps that many of today’s hospitals fail to address. The COVID-19 pandemic was used to further illustrate this issue. CONCLUSIONS Comparison of the risks, strategies, and gaps revealed that many hospitals in the US are unprepared for cybersecurity risks. The focus of their efforts are misdirected, with external - often governmental - efforts negligible. Policy changes, such as training employees in cyber protocols, adding advanced technical protections, and collaborating with a variety of experts, are necessary. Overall, hospitals must recognize that, in cyber incidents, the real victims are the patients. They are the ones at risk, physically and in information confidentiality, when medical devices, hospital equipment, or treatments are compromised.

Public health preparedness for maritime terrorist attacks on ports and coastal waters

2008 ◽  
Vol 3 (6) ◽  
pp. 377-384 ◽  
Author(s):  
John J. Wassel, MD
Keyword(s):  
Public Health ◽  
Natural Gas ◽  
Coastal Waters ◽  
Terrorist Attack ◽  
Terrorist Attacks ◽  
Mass Casualties ◽  
Journal Articles ◽  
Port Security ◽  
Pubmed Database ◽  
The Us

Objective: To assess the risk of mass casualties and necessary public health and provider preparation relating to maritime terrorist attacks on the US ports.Design: Articles were obtained by searching PubMed database, Google, and Google Scholar search engines using terms such as “maritime security,” “maritime terrorism,” “port security,” “terrorist attacks on the US ports,” “terrorist nuclear attacks,” “terrorist attacks on liquefied natural gas tankers,” and “terrorist attack on high occupancy ships.”Setting: US ports and coastal waters.Results: Seventy-six journal articles were reviewed.Conclusions: Morbidity and mortality high for nuclear terrorist attack; mortality low but morbidity potentially high for radiological attacks. It would be more difficult for terrorist attack on natural gas tankers to cause high mortality and/or morbidity.

Cola Beverages: Clinical Uses versus Adverse Effects

2019 ◽  
Vol 15 (2) ◽  
pp. 130-139
Author(s):  
Ehsan T. Moghaddam ◽  
Ali Tafazoli
Keyword(s):  
Adverse Effects ◽  
Health Risks ◽  
Feeding Tube ◽  
Evidence Based ◽  
Journal Articles ◽  
Healthcare Settings ◽  
Pubmed Database ◽  
Excessive Consumption ◽  
Points Of View ◽  
Medical Articles

Background: Excessive consumption of cola beverages is accompanied by numerous public health risks. But besides these well-known adverse effects, recently, several medical articles have been published that show some indications for cola beverages in clinical practice like resolution of gastrointestinal or feeding tube obstructions, increasing bioavailability and palatability of other medications, rehydration and other uses in healthcare settings. These approaches are not without shortcomings and complications. Methods: In this systematic review we tried to explore these new uses for practitioners and also reemphasize on the most evidence-based complications of cola consumption like bone loss and metabolic and cardiovascular adverse effects in cases of misuse and overuse from both clinical and nutritional points of view via searching the PubMed database. Results: We chose 145 journal articles from the most relevant ones plus 30 extra references and categorized their topics in two classes of medical uses and adverse effects. Conclusion: It could be stated that cola beverages have demonstrated interesting uses and benefits in medicine but their use should be regulated as strict as possible.

Regulating Medical Devices in the United States

2020 ◽  
Author(s):  
Patricia J. Zettler ◽  
Erika Lietzan
Keyword(s):  
United States ◽  
Medical Device ◽  
Medical Devices ◽  
Complete Information ◽  
The United States ◽  
Risk Level ◽  
Management Tools ◽  
Medical Technologies ◽  
The Us ◽  
Medical Device Regulation

This chapter assesses the regulation of medical devices in the United States. The goal of the US regulatory framework governing medical devices is the same as the goal of the framework governing medicines. US law aims to ensure that medical devices are safe and effective for their intended uses; that they become available for patients promptly; and that manufacturers provide truthful, non-misleading, and complete information about the products. US medical device law is different from US medicines law in many ways, however, perhaps most notably because most marketed devices do not require pre-market approval. The chapter explores how the US Food and Drug Administration (FDA) seeks to accomplish its mission with respect to medical devicecough its implementation of its medical device authorities. It starts by explaining what constitutes a medical device and how the FDA classifies medical devices by risk level. The chapter then discusses how medical devices reach the market, the FDA's risk management tools, and the rules and incentives for innovation and competition. It concludes by exploring case studies of innovative medical technologies that challenge the traditional US regulatory scheme to consider the future of medical device regulation.

Insulin Glargine and Risk of Cancer: A Meta-Analysis

2012 ◽  
Vol 27 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Xinli Du ◽  
Rihua Zhang ◽  
Yi Xue ◽  
Dong Li ◽  
Jinmei Cai ◽  
...  
Keyword(s):  
Insulin Glargine ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Long Term Effects ◽  
Open Label ◽  
Cancer Occurrence ◽  
Pubmed Database ◽  
Significant Difference ◽  
The Us ◽  
Risk Of Cancer

Aims Recently, more and more attention has been drawn on the long-term effects of insulin glargine. Here we strived to estimate the association of cancer occurrence with the use of insulin glargine. Methods We searched all the publications regarding the association between cancer occurrence and the use of insulin glargine using the US National Library of Medicine's PubMed database. Data were independently extracted and analyzed using random or fixed effects meta-analysis depending upon the degree of heterogeneity. Results Seven cohort studies were included in the meta-analysis. Cancer occurrence had no significant difference in glargine-treated patients compared to patients treated with other insulins (RR=0.86, 95% CI=0.69–1.07, p=0.17, Pheterogeneity <0.00001). In our subgroup analysis, glargine, compared to other insulins, did not increase the risk of breast cancer (RR=1.14, 95% CI=0.65–2.02, p=0.65, Pheterogeneity=0.002), prostate cancer (RR=1.00, 95% CI=0.79–1.26, p=0.99, Pheterogeneity=0.78), pancreatic cancer (RR=0.57, 95% CI=0.14–2.35, p=0.44, Pheterogeneity=0.0002) and gastrointestinal cancer (RR=0.80, heterogeneity 95% CI=0.62–1.02, p=0.07, Pheterogeneity=0.86). Conclusions This meta-analysis of open-label studies does not support an increased cancer risk in patients treated with insulin glargine. The result provides confidence for the development of insulin glargine, but needs confirmation by further clinical studies.

scholarly journals Practical Negotiation for Medical Professionals

2018 ◽  
Vol 32 (04) ◽  
pp. 166-171 ◽  
Author(s):  
Bradley Eisemann ◽  
Ryan Wagner ◽  
Edward Reece
Keyword(s):  
Clinical Medicine ◽  
Clinical Care ◽  
Medical Knowledge ◽  
Medical Innovation ◽  
Medical Field ◽  
Residency Programs ◽  
Clinical Patient ◽  
Negotiation Strategies ◽  
Business Acumen ◽  
Time And Energy

AbstractDespite incredible advances in medical innovation and education, many students finish medical school, and physicians finish residency, without sound business acumen regarding the financial realities of the modern profession. The curriculum in medical schools and residency programs too often neglects teaching the business of medicine. This overview addresses how physicians can utilize effective negotiation strategies to help develop a medical practice or add value to an existing practice or institution. The authors applied the six foundations of effective negotiating, detailed by Richard Shell in his Bargaining for Advantage, to the medical field to demonstrate the processes involved in effective negotiating. They then outlined a strategy for physicians to adopt when negotiating and showed how this strategy can be used to add value. The six foundations include: developing a personal bargaining style, setting realistic goals, determining authoritative standards, establishing relationships, exploring the other party's interests, and gaining leverage. As physicians complete training, the ability to solely focus on medical knowledge and clinical patient care disappears. It is crucial that physicians invest the time and energy into preparing for the business aspects of this profession in much the same way they prepare for the clinical care of patients. This overview seeks to define the basics of negotiation, characterize the application of negotiation principles toward clinical medicine, and lay the foundation for further discussion and investigation.

scholarly journals Post QALY: Scientific Approaches to Real World Formulary Decision Making

2020 ◽  
Vol 11 (2) ◽  
pp. 19
Author(s):  
Paul Langley ◽  
Stephen McKenna
Keyword(s):  
Decision Making ◽  
Medical Devices ◽  
Evidence Base ◽  
Pharmaceutical Products ◽  
Normal Science ◽  
Value Assessment ◽  
Scientific Methods ◽  
Article Type ◽  
The Us ◽  
The Uk

The purpose of this anniversary supplement for Innovations in Pharmacy is to consider and / or propose modern, scientific methods for determining the evidence base for the fair pricing and accessibility of pharmaceutical products and medical devices. At present, such decisions are based on the construction of imaginary value assessment models that fail to meet the standards of normal science. Such a business model has been adopted by the Institute for Clinical and Economic Review (ICER) in the US, NICE in the UK and in a number of other countries.   Article Type: Call for Papers

scholarly journals Clinical and economic strategies in outpatient medical care during the COVID-19 pandemic

2020 ◽  
Vol 45 (8) ◽  
pp. 579-585 ◽  
Author(s):  
David Anthony Provenzano ◽  
B Todd Sitzman ◽  
Samuel Ambrose Florentino ◽  
Glenn A Buterbaugh
Keyword(s):  
Medical Care ◽  
Clinical Care ◽  
Economic Consequences ◽  
Financial Indicators ◽  
Medical Practices ◽  
Strategic Plans ◽  
Economic Strategies ◽  
The Us ◽  
Insight Into

The COVID-19 pandemic has resulted in significant clinical and economic consequences for medical practices of all specialties across the nation. Although the clinical implications are of the utmost importance, the economic consequences have also been serious and resulted in substantial damage to the US healthcare system, including pain practices. Outpatient pain practices have had to significantly change their clinical care pathways, including the incorporation of telemedicine. Elective medical and interventional care has been postponed. For the most part, ambulatory surgical centers have had to cease operations. As patient volumes have decreased for non-emergent elective care, the financial indicators have deteriorated. This review article will provide insight into solutions to mitigate the clinical and economic challenges induced by COVID-19. Undoubtedly, the COVID-19 pandemic will have short-term and long-term implications for all medical practices and facilities. In order to survive, medical practices will need dynamic, operational, and creative strategic plans to mitigate the disruption in medical care and pathways for successful reintegration of clinical and surgical practice.

Digital Library Structure and Software

2005 ◽  
pp. 193-198
Author(s):  
Cavan McCarthy
Keyword(s):  
Digital Library ◽  
Digital Libraries ◽  
Digital Systems ◽  
The Internet ◽  
Journal Articles ◽  
Electronic Journals ◽  
The Us ◽  
The Uk ◽  
Area Of Study

Digital libraries (DL) can be characterized as the “high end” of the Internet, digital systems which offer significant quantities of organized, selected materials of the type traditionally found in libraries, such as books, journal articles, photographs and similar documents (Schwartz, 2000). They normally offer quality resources based on the collections of well-known institutions, such as major libraries, archives, historical and cultural associations (Love & Feather, 1998). The field of digital libraries is now firmly established as an area of study, with textbooks (Arms, 2000; Chowdhury & Chowdhury, 2003; Lesk, 1997); electronic journals from the US (D-Lib Magazine: http://www.dlib.org/) and the UK (Ariadne: http://www.ariadne.ac.uk/); even encyclopedia articles (McCarthy, 2004).

scholarly journals Making headlines: an analysis of US government-funded cancer research mentioned in online media

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e025783 ◽  
Author(s):  
Lauren A Maggio ◽  
Chelsea L Ratcliff ◽  
Melinda Krakow ◽  
Laura L Moorhead ◽  
Asura Enkhbayar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Control ◽  
Online Media ◽  
Cancer Type ◽  
Journal Articles ◽  
Funded Research ◽  
Media Attention ◽  
The Us ◽  
Us Government ◽  
The Subject

ObjectiveTo characterise how online media coverage of journal articles on cancer funded by the US government varies by cancer type and stage of the cancer control continuum and to compare the disease prevalence rates with the amount of funded research published for each cancer type and with the amount of media attention each receives.DesignA cross-sectional study.SettingThe United States.ParticipantsThe subject of analysis was 11 436 journal articles on cancer funded by the US government published in 2016. These articles were identified via PubMed and characterised as receiving online media attention based on data provided by Altmetric.Results16.8% (n=1925) of articles published on US government-funded research were covered in the media. Published journal articles addressed all common cancers. Frequency of journal articles differed substantially across the common cancers, with breast cancer (n=1284), lung cancer (n=630) and prostate cancer (n=586) being the subject of the most journal articles. Roughly one-fifth to one-fourth of journal articles within each cancer category received online media attention. Media mentions were disproportionate to actual burden of each cancer type (ie, incidence and mortality), with breast cancer articles receiving the most media mentions. Scientific articles also covered the stages of the cancer continuum to varying degrees. Across the 13 most common cancer types, 4.4% (n=206) of articles focused on prevention and control, 11.7% (n=550) on diagnosis and 10.7% (n=502) on therapy.ConclusionsFindings revealed a mismatch between prevalent cancers and cancers highlighted in online media. Further, journal articles on cancer control and prevention received less media attention than other cancer continuum stages. Media mentions were not proportional to actual public cancer burden nor volume of scientific publications in each cancer category. Results highlight a need for continued research on the role of media, especially online media, in research dissemination.

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