{"title":"Balancing Patient Safety, Clinical Efficacy, and Cybersecurity with Clinician Partners.","authors":"Joseph Schneider, Axel Wirth","doi":"10.2345/0899-8205-55.1.21","DOIUrl":"https://doi.org/10.2345/0899-8205-55.1.21","url":null,"abstract":"Where We Stand Today Cybersecurity events affecting healthcare organizations are in the news with increasing frequency, indicating their growing impact and expanse. We have seen incidents ranging from breaches affecting millions of patient records to attacks shutting down hospitals across the country, with at least one of them tragically contributing to the death of a patient. Most recently, the Cybersecurity and Infrastructure Security Agency, Federal Bureau of Investigation, and Department of Health & Human Services (HHS) issued a joint warning about the healthcare industry being a target of expanding ransomware activity. Meanwhile, ransom financial demands are rising and adversaries are resorting to increasingly brazen methods, including exfiltrating data and extorting patients. COVID-19 has accelerated the trend toward connectivity in healthcare. We have added remote workers and remote patients using telehealth services and are placing devices in patients’ homes, offering a wide range of attack opportunities as critical data are transmitted across home and public networks. Healthcare is now taking place in a much more complex and highly accessible space, offering rich data and a growing attack surface. With the rapidly evolving, increasingly connected information technology (IT) infrastructure and growth of cyberthreats, healthcare is facing a perfect storm. The danger is exacerbated by the fact that we are no longer dealing solely with individual hackers but mainly with well-resourced cybercriminal organizations, as well as politically and economically motivated adversaries (e.g., nation-states, cyber terrorists). Global economic losses due to cyber incidents are estimated to be in the $3-trillion range and are expected to reach $6 trillion in 2021 and $10.5 trillion by 2025. Healthcare organizations are expected to spend $125 billion on cybersecurity over the next 5 years. It is imperative that healthcare improve its cyber defenses and “cyber culture.” This includes expanding our understanding of cyber risks, better defining what we must protect, learning how to protect it in ways that support efficient workflows and safety, and instilling good user cyber behavior. IT security and clinical engineering cannot do this alone. To develop a safe and effective path forward, we also need cyber-savvy clinicians working as partners to ensure that clinical needs are met in security decisions. This article proposes an approach and explores how we might achieve this.","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"55 1","pages":"21-28"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8641426/pdf/i0899-8205-55-1-21.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25335624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Naftalovich, S. Char, Andrew Iskander, D. Naftalovich
{"title":"Even the Simplest Devices May Malfunction: Split Septum Design Revisited.","authors":"R. Naftalovich, S. Char, Andrew Iskander, D. Naftalovich","doi":"10.2345/0890-8205-55.1.41","DOIUrl":"https://doi.org/10.2345/0890-8205-55.1.41","url":null,"abstract":"Split septum medical devices are used in tubing for intravenous (IV) fluid administration-an extremely common clinical task. These tubing caps contain a needleless, valveless system that allows fluid to flow directly through the lumen of the catheter but prevents backflow of fluid or blood when the tubing extension is not connected. We experienced complete failure of a needle-free connector extension set with a Luer-access split septum device in multiple patients due to the split septum remaining fused and essentially unsplit despite being connected on both ends. This led to an adverse event in a patient due to repeated unnecessary IV insertion attempts. This case shows how even the simplest of devices can malfunction and highlights the need for vigilance in clinical practice.","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"55 1 1","pages":"41-43"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43279393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rotem Naftalovich, Steven Char, Andrew J Iskander, Daniel Naftalovich
{"title":"Even the Simplest Devices May Malfunction: Split Septum Design Revisited.","authors":"Rotem Naftalovich, Steven Char, Andrew J Iskander, Daniel Naftalovich","doi":"10.2345/0899-8205-55.1.41","DOIUrl":"https://doi.org/10.2345/0899-8205-55.1.41","url":null,"abstract":"<p><p>Split septum medical devices are used in tubing for intravenous (IV) fluid administration-an extremely common clinical task. These tubing caps contain a needleless, valveless system that allows fluid to flow directly through the lumen of the catheter but prevents backflow of fluid or blood when the tubing extension is not connected. We experienced complete failure of a needle-free connector extension set with a Luer-access split septum device in multiple patients due to the split septum remaining fused and essentially unsplit despite being connected on both ends. This led to an adverse event in a patient due to repeated unnecessary IV insertion attempts. This case shows how even the simplest of devices can malfunction and highlights the need for vigilance in clinical practice.</p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"55 1","pages":"41-43"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8641422/pdf/i0899-8205-55-1-41.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25453724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bright Ideas: Picturing a Future for Diagnostic Imaging Apprentices.","authors":"Brian Stallard","doi":"10.2345/0899-8205-54.6.434","DOIUrl":"https://doi.org/10.2345/0899-8205-54.6.434","url":null,"abstract":"","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"54 6","pages":"434-437"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38730647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cyberinsights: A Good Companion.","authors":"Axel Wirth","doi":"10.2345/0899-8205-54.6.438","DOIUrl":"https://doi.org/10.2345/0899-8205-54.6.438","url":null,"abstract":"","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"54 6","pages":"438-440"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38730646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sterilization Central: COVID-19, Processing, and the Importance of Definitions: Focus on Face Masks.","authors":"Terra A Kremer, Gerald McDonnell","doi":"10.2345/0899-8205-54.6.444","DOIUrl":"https://doi.org/10.2345/0899-8205-54.6.444","url":null,"abstract":"","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"54 6","pages":"444-447"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38730651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joyce M Hansen, Scott Weiss, Terra A Kremer, Myrelis Aguilar, Gerald McDonnell
{"title":"Research: Dry Heat Processing of Single-Use Respirators and Surgical Masks.","authors":"Joyce M Hansen, Scott Weiss, Terra A Kremer, Myrelis Aguilar, Gerald McDonnell","doi":"10.2345/0899-8205-54.6.410","DOIUrl":"https://doi.org/10.2345/0899-8205-54.6.410","url":null,"abstract":"<p><p>The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged healthcare providers in maintaining the supply of critical personal protective equipment, including single-use respirators and surgical masks. Single-use respirators and surgical masks can reduce risks from the inhalation of airborne particles and microbial contamination. The recent high-volume demand for single-use respirators and surgical masks has resulted in many healthcare facilities considering processing to address critical shortages. The dry heat process of 80°C (176°F) for two hours (120 min) has been confirmed to be an appropriate method for single-use respirator and surgical mask processing.</p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"54 6","pages":"410-416"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38389829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gavin Stern, Amanda Benedict, Julian Goldman, Sandy Weininger, David Osborn, Andy Doering, Michael Jaffe
{"title":"Roundtable Discussion: How the AAMI COVID-19 Response Team Responded to Crisis.","authors":"Gavin Stern, Amanda Benedict, Julian Goldman, Sandy Weininger, David Osborn, Andy Doering, Michael Jaffe","doi":"10.2345/0899-8205-54.6.428","DOIUrl":"https://doi.org/10.2345/0899-8205-54.6.428","url":null,"abstract":"","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"54 6","pages":"428-433"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38389831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}