Monday, November 30, 2020

Healthcare on the Edge

 Perhaps you read about, or were directly impacted by, the massive, multi-hour Amazon Web Services (AWS) outage last week.  Ironically, AWS’s effort to add capacity triggered the outage, although apparently was not the root cause.  It’s no surprise that AWS sought to add capacity; it, like most cloud service vendors these days, has seen skyrocketing growth.  Even healthcare has jumped into the cloud in a big way.

But, as the outage reminds us, sometimes having core computing functions done in far-off data centers may not be always a great idea.  Still, we’re not about to go back to local mainframes or networked PCs.  The compromise may be edge computing. 


Definitions vary, and the concept is somewhat amorphous, but goal is to move as much computing to the “edge” of networks, primarily to reduce latency.  PwC predicts: “Now, with the rise of IoT, the centralised cloud is moving down and out, and edge computing is set to take on much of the grunt work.” 

 As they describe it:

With edge, instead of pushing data to the cloud to be computed, processing is done by devices ‘at the edge’ of your network. The grunt work is done closer to the user, at an edge gateway server and then select or relevant data is sent to the cloud for storage (or back to your devices).

 The oft-cited example is self-driving cars; you really don’t want the AI to wait a single millisecond longer than necessary to make a potentially life-saving decision.  An article in Nextgov pointed out:

Thus, a Tesla isn’t just a next-generation car; it’s an edge compute node. But even with Tesla, a relatively straightforward use case, building and deploying the edge node is just the beginning. In order to unlock the full promise of these technologies, an entire paradigm shift is required.

 If this sounds like techy “inside baseball” stuff, think again.  This is a big shift.  Analyst and fund manager Stephen McBride believes edge computing is the “next great tech revolution.”  He says:  

The key takeaway is that edge computing makes the “impossible” possible. Technologies like self-driving cars, IoT, AR, and the commercialization of 5G will never get off the ground without edge computing.

 It’s not just Mr. McBride who sees edge computing as a paradigm change.  The 2020 State of the Edge Report calls edge computing “the Third Act of the Internet."  Arpit Joshipura, the General Manager, Networking, Edge, and IOT for The Linux Foundation (which help create State of the Edge) proclaimed: “We stand on the precipice of a profound re-architecting of the Internet called edge computing, which will impact all areas of society.” 

 The press release warned:

Where we stand today is at the edge. Today's Internet struggles to support the newest use cases, particularly those that require real-time and low-latency interactions, not to mention handling connections with billions of devices generating petabytes of data. Only a radical restructuring of the Internet at the edge will solve for these emerging challenges, which will require thousands of companies to invest billions of dollars in new infrastructure.

The report estimates over $700b in capital infrastructure on edge infrastructure and data center facilities over the next decade, with healthcare identified as one of the leading industries that will adopt edge computing.  Mr. Joshipura believesedge computing will overtake cloud computing" by 2025, which is a pretty bold statement.

Credit: IDC

More recently, IDC forecast edge computing as being a $251b market by 2024, asserting: “
Edge products and services are powering the next wave of digital transformation.”  Healthcare is again cited as one of the impacted industries. 

There are plenty of hardware companies positioning for the edge computing movement, such as Akamai Technologies, Cloudflare, Fastly, or Telefónica, but also software vendors like Google, Microsoft or Red Hat. Earlier this year, Red Hat President and CEO Paul Cormier said:

We can look at the edge as the newest IT footprint, becoming an extension of the data center just like bare-metal, virtual environments, private cloud and public cloud.

The edge is open. The edge is hybrid. And the edge is powered by Red Hat.

Glenn O’Donnell, writing for Forrester in ZDNet, sees 2021 as an “inflection point for edge computing.  He predicts three key developments:

  • Data center marketplaces will emerge as a new edge hosting option – “We see a promising new option emerging that unites smaller, more local data centers in a cooperative marketplace model;”
  • Private 5G will push enterprises to the edgePrivate 5G is here now, and we expect it to fuel edge computing in 2021…2021 will be the inflection for 5G, but it will be private, not public.”  
  • New edge vendors will shave five points off public cloud growth As edge computing becomes a "cool" new platform for business computing, it will siphon some of the money that would otherwise have gone to cloud expansion.”

Internet of Bodies Credit: Rand Corp.

Health care is going to be impacted in a big way.  Most forecasts about the healthcare system of even the near future expect more real-time patient monitoring – the so-called Internet of Bodies (Iob) that includes
an expanding array of devices that combine software, hardware, and communication capabilities to track personal health data, provide vital medical treatment, or enhance bodily comfort, function, health, or well-being.”

We’re not going to get that without edge computing.  As PwC predicts: “5G and edge computing will enable the low-latency, real-time guaranteed conditions necessary to use IoT devices for patient monitoring and at-home care. For rural patients unable to access the care provided in larger metropolitan facilities, this could be a game-changer.

 The future of healthcare is on the edge.

I’m not smart enough to know exactly what edge computing will look like, in healthcare or anywhere else, much less how it works (then, again, don’t ask me how cloud computing or even PCs work!), but I’m smart enough to predict that this is a trend that no industry, especially healthcare, can overlook. 

As the 2020 State of the Edge report warned –not specifically about health care, but definitely including it: Edge computing is crucial for many industries that currently find themselves in the midst of the digital revolution…It is crucial that industry players respond to these demands—if they don’t they will be substituted for players who can and will.”

Ignore it at your own risk.

Monday, November 23, 2020

What, Us Worry?

 2020 has been an awful year.  Hurricanes, wildfires, murder hornets, unjustified shootings, a divisive Presidential election, and, of course, a pandemic.  Most of us are spending unprecedented amounts of time sheltering in place, millions have lost their jobs, the economy is sputtering, and over a quarter million of us didn’t survive to Thanksgiving.  If you haven’t been depressed at some point, you haven’t been paying enough attention.

Within the last two weeks, though, there has finally been some cause for hope.  Whether you want to credit Operation Warp Speed or just science doing what it does, we are on the cusp of having vaccines to battle COVID-19.  First Pfizer/BioNTech, then Moderna, and most recently, AstraZenica, announced vaccines that appear to be highly effective. 

We’re having our Paul Revere moment, only this time with good news.  The vaccines are coming!  The vaccines are coming!


It strikes me, though, that our enthusiasm about these vaccines says a lot about why the U.S. has had such a hard time with the pandemic; indeed, it tells us a lot about why our healthcare system is in the state it is. We’re suckers for the quick fix, the medical intervention that will bring us health.

Unless you were alive when Woodrow Wilson was President, COVID-19 has been the worst public health crisis of our lifetime.  It took some time for us to fully realize how bad it was going to be, and, even then, most of us underestimated exactly how bad that would be.  We may still be underestimating how bad these next few months will be.

We knew, of course, that we didn’t have any vaccine for this new virus, and that, at best, it would take some time to develop one.  We didn’t initially know what to expect when someone became infected, didn’t know the right treatments, didn’t know which therapeutics might help.  We weren’t even really sure how COVID-19 spread.  There have been many hard-won lessons. 

What we did know, though, was that we needed to take precautions.  Physical distancing, limiting social gatherings, wearing masks, contact tracing; we knew these things would help.  They wouldn’t prevent COVID-19 from spreading, they certainly wouldn’t cure it once infected, but they would mitigate. 

We couldn’t even do those right.

Mask wearing became a political issue.  It is not a coincidence that some of the areas with the lowest percent of people wearing masks are among the hottest spots for spread of COVID-19, such as North Dakota, which has the highest COVID-10 death rate in the world right now. 

While overall mask wearing has improved from the spring, to the point as many as 90% of Americans claim they usually wear a mask in public, it varies widely, as illustrated below:

Similarly, business shutdowns and stay-at-home orders have faced great resistance, again more along political lines than to intensity of COVID-19 cases.  There are no doubt grave economic impacts to them, as we’ve seen, but whatever such measures we tried in the spring are now seen as a price we are no longer willing to pay. 

Of course, if we had quicker and more widespread testing, and better contact tracing, we might not need such extreme measures, but we’re not very good at them.  We don’t have enough tests,  they take too long for accurate results, and a sizeable number of Americans view contact tracing with suspicion. 

The CDC pleaded with us to celebrate Thanksgiving at home with only the people we live with.  Do we listen?  Of course not; nearly 40% of us plan to attend large gatherings.  Over a million Americans flocked to the airport yesterday – the highest daily number since mid-March – with millions more expected to travel between now and Thanksgiving.  That is admittedly down from previous years, but at a time we are regularly breaking daily records for cases, hospitalizations, and deaths, it seems rather foolhardy. 

Why should we worry?  There’s a vaccine coming. 

Of course, no vaccine has yet been approved, none is in full production, there are tremendous production and logistical issues to overcome.  It will take many months to have enough supply to vaccinate enough people to make an impact on COVID-19’s spread. 

Equally troubling, experts estimate that, even with a vaccine that is over 90% effective,  over 70% of people have to get vaccinated.  That may be a problem; fewer than 60% of Americans say that would be willing – and that’s up from earlier in the year.  Even healthcare workers, who are expected to be first in line when vaccines become available, are not yet convinced they’ll take it.

There may be a light at the end of this particular tunnel, but it’s a long tunnel. 

We’ve all got pandemic fatigue, we all want COVID-19 gone, we all want to go back to our “normal lives,” but we don’t seem quite able to bring ourselves to do the things we should in order to help bring those about.  Somehow, we assume, doctors and scientists will fix things for us.  It’s par for the course.

We don’t do enough about our diet and exercise; it’s easier to just take pills for our high blood pressure and bad cholesterol.  We don’t eat enough fruits and vegetables, so we take supplements to get the necessary vitamins and minerals.  We don’t stay active enough, so we end up with hip and knee replacements.  We claim to worry about the safety of vaccines, but give processed food manufacturers carte blanche to tailor their products to maximize our consumption. 

 We debate the need for universal coverage, but don’t spend nearly enough time talking about food or housing insecurity.  We not only can’t persuade ourselves to take climate change seriously, we don’t even care to ensure that our water and atmosphere are safe now.

It’s easier to trust health care to protect our health than to take responsibility ourselves, even though medical care is estimated to only account for 10-20% of our health.  So why wear a mask?  Why social distance?  Why stay in our family bubble?  Soon there will be a vaccine. 

We need to stop acting like the proverbial damsel in distress waiting to be rescued, and start taking more responsibility for our own health – for COVID-19 and all the health issues we face.  


Monday, November 16, 2020

Healthcare's Bridge Fire

We had a bridge fire here in Cincinnati last week.  Two semis collided in the overnight hours.  The collision ignited a blaze that burned at up to 1500 degrees Fahrenheit and took hours to quell.  Fortunately, no one was killed or injured, but the bridge remains closed while investigators determine how much damage was done.  It is expected to remain closed for at least another month.

Credit: WLWT

Unfortunately, the bridge in question is the Brent Spence Bridge, which is the focal point for I-71 and I-75 between Ohio and Kentucky.   It normally carries over 160,000 vehicles daily, and is one of the busiest trucking routes in the U.S. Over $1 billion of freight crosses each day.  There are other bridges nearby, but each requires significant detouring, and none were designed for that traffic load.

What makes this all so galling is that it has been recognized for over 25 years that the bridge has been, to quote the Federal Highway Administration, “functionally obsolete” – yet no action was taken to replace it.  This most recent disaster was a disaster hiding in plain sight.    

Just like, as the coronavirus pandemic has illustrated, we have in health care.

Brent Spence Bridge traffic. 
Credit: Build Our New Bridge Now
The Brent Spence Bridge was opened in 1963, intended to carry a maximum of 80,000 vehicles daily.  That had been surpassed by the 1990’s, causing calls to replace it with a newer, bigger bridge.  At one time, Rep. John Boehner, from the Cincinnati area, was Speaker of the House and Kentucky’s Mitch McConnell was Senate Majority leader, yet were not able to obtain funding for the replacement, despite strong support from then President Obama and, in turn, President Trump.   

Money is the problem, of course.  The federal gasoline tax, intended to fund interstate highways and bridges hasn’t been raised since 1993.  There was talk about funding a new bridge via tolls, but neither Kentucky nor Ohio politicians were keen to impose them; in 2016, the Kentucky legislature prohibited using tolls for such a replacement.  This short-sighted parsimony isn’t limited to the Brent Spence Bridge, of course; the American Society of Civil Engineers gives America’s infrastructure a D+. 

We know there is a problem, but we choose to ignore it, letting future generations deal with it, and we certainly don’t opt to fund addressing it.  Just like we are doing with climate change -- and just like we have done with our healthcare system.

Epidemiologists had long warned of a global pandemic.  The Obama Administration prepared a detailed “playbook” for such a pandemic, but, nonetheless, the Trump Administration was caught flat-footed when COVID-19 hit.  It’s easy to blame it for our lack of timely and comprehensive response, but not many state or local governments have covered themselves in glory for their responses either, not after years of public health cuts. 

Our global, just-in-time systems for supplies was found severely wanting in the case of an exponentially spreading global pandemic, leaving healthcare workers short of essential protective gear and equipment like ventilators. 

Similarly, our testing efforts were botched from the beginning.  Even today accurate, rapid tests remain a pipe dream, making it hard to determine when someone has COVID-19, where they were infected, or who they might have given it to.    

As we’ve learned, COVID-19 hits people with comorbidities hardest; as we’ve long known, the U.S. leads in world in people with chronic conditions. It has also disproportionately impacted people of color – reflected, in part, their increased likelihood of being essential workers who cannot work from home, and underlying health disparities.    

Just within the past week, we’ve received promising news on vaccines from Pfizer and Moderna.  Unfortunately, vaccine development has become politicized.  Only half of Americans say they are willing to get a COVID-19 vaccine, a figure that dropped twenty percentage points from May to September.  We should not be surprised; American’s trust in vaccines generally had been dropping even before COVID-19, as evidenced by the anti-vax movement.

Credit: Jeff Dean/AFP via Getty Images

We’ve thrown trillions of dollars at COVID-19 relief, including large amounts to the healthcare system, yet hospitals claim they are losing hundreds of billions of dollars, and our already weakened system of primary care is on the verge of collapse.  Burnout among healthcare workers was already a problem, but the pandemic has caused it to reach new levels, especially when many people shun basic precautionary measures like masks or social distancing. 

It’s embarrassing that in the richest country in the world, 11% of the non-elderly lack health coverage.  It is disturbing that 25% of Americans report that they or a family member have put off treatment for a serious medical condition in the past year due to cost – and that was before the pandemic.  It is tragic that our morbidity and mortality rates are, at best, middle-of-the-pack despite our extravagant health care spending.  And it is shameful that, for measures like maternal health or infant mortality, our results are third-world, especially for persons of color. 

All of which is to say, the pandemic is a bridge fire, all right, but it is taking place on a healthcare bridge that we’ve long known is “functionally obsolete.” 

We can’t entirely avoid bridge fires, but we can design the bridges to minimize their likelihood and can ensure they are structurally sound enough to withstand them.  Similarly, we can’t preclude the possibility of a pandemic, but we can have the public heath infrastructure in place for one, and a healthcare system that is robust enough to cope with one. 

What we can’t do – or, rather, what we shouldn’t do – is to wait for disasters to happen and only then try to figure out what to do. 

In the case of a bridge fire, that might mean millions of hours of traffic delays and probably higher prices for many goods.  In the case of a pandemic, though, that means hundreds of thousands of “excess deaths” and crippling economic impacts. It’s no way to run a highway system and it’s most certainly no way to run a healthcare system. 

The pandemic may be healthcare’s bridge fire, but it didn’t cause our healthcare system’s shortcomings; it only helped expose them.  The question is, will it spur us to do something about them? 

Monday, November 9, 2020

In Praise of Unsung Heroes

Even in this extraordinary year, this has been an extraordinary week.  Last Tuesday we had what many believe to have been the most important Presidential election in recent times, maybe ever.  The week also found the coronavirus pandemic reaching new heights.  That was the week that was.

What struck me, though, is how both our election systems and our healthcare system rely on “ordinary” people to keep them going.  They’ve never been more extraordinary than this year.

Ballot Counting in Maricopa County.  Credit: Fox 10 Phoenix

The pandemic first impacted voting earlier in the year, during primary season.  Going to the polls suddenly seemed like potentially a life-threatening choice, and working at them practically suicidal.  Dates of primaries were moved, many polling stations were closed, new voting procedures were put into place, and absentee ballots found a new popularity.  And yet people turned out in droves to vote, often standing in line for hours.

President Trump upped the ante by constantly railing against absentee ballots and warning about voter fraud.  Despite this, or perhaps because of it, record numbers of people voted early, in person or by mail.  Several states had surpassed 2016 numbers of voters before Election Day.   Tens of millions more showed up on Election Day.  And, amazingly, Election Day passed with relatively few incidents.

Then the counting started. 

We’re a week in and races in several states have yet to be called, and have lack of agreement from most Republicans about some of the ones that have been called.  We have an apparent President-elect but no concession from the current President or other Republican “leaders.”  Instead, they utter the bromide that we should count the legal votes, not count the illegal votes, and let the judicial process play out.

As is always true, but especially during the pandemic, the election would not have been possible without poll workers.  With older people both being more at risk for COVID-19 and being the majority of the election workforce, it wasn’t initially clear there would be enough workers.  

Calls went out for young people to become poll workers – and they responded.  Organizations like Power the Polls and Poll Hero Project recruited over 650,000 new workers, most of them under 65 and many of them students.

“I just felt that I had to do something,” one student worker told The New York Times.   Another told The Christian Science Monitor:

There are a lot of stereotypes about my generation: We’re lazier, not connecting to the real world. We’re zombies to social media and our phones and stuff.  But this has truly shown me that is just not at all true. There are so many people my age who are just looking for any opportunity to get involved.

Election Assistance Commission chairman Ben Hovland told Time: “Poll workers are really the unsung heroes of our democracy.” He’s right.

But, of course, once all those votes are cast they have to get counted, and that leads to a second group of unsung heroes of democracy.  Those are the people sitting in those drab offices and warehouse deciding which ballots are valid and ensuring they get properly counted.  They’re set up as bipartisan teams, usually with election observers watching the process. 

AZ Ballot counting protests.  Credit: Reuters
In 2020, unfortunately, they’re the ones also risking catching CIVID-19 in the close quarters and getting threats of physical violence, even death threats.  The President and his allies are constantly questioning their motives, challenging their tallies and gathering outside counting spots to protest. They’re demeaning the hard work and long hours the workers have been putting in. 

One nonpartisan poll watcher saw partisan observers harassing election workers, telling WaPo:

That was the most heartbreaking part.  I felt for those workers. I could only imagine what it would feel like, trying to do your job, having these people hover and sneer at you and yell at you and make something so simple, something that’s supposed to be so patriotic, so hard.

Despite all that, the Registrar in Clark County (NV) spoke for all his compatriots, insisting to WaPo: “We’re going to be okay.  We’re going to continue to count. We will not allow anyone to stop us from doing what our duty is.”

“It’s a risky thing to do, but it’s essential work,” one such worker proudly told NYT. 

Meanwhile, the U.S. is nearing 10 million COVID-19 cases and a quarter of a million deaths, setting new daily records for cases and hospitalizations, both nationally and in a majority of states.  ICU beds are in short supply, as is PPE.  As bad as the spring was in the northeast, the fall is proving to be just as frightening, and the winter threatens to be even worse.

Speaking of unsung heroes, the last count – well over a month ago -- for health care worker deaths from COVID-19 topped 1,700 in the U.S. alone. 

Getty Images
Health systems are again resorting to recruiting contract health care workers, often from other states USA Today reports: “Hospitals in nearly every state are recruiting contract nurses to fill shifts,” often paying “crisis rates.”  One emergency room physician added: "Pretty much every nurse who wants a job right now in the United States has a job."

These are the workers whom President Trump accused of falsely inflating COVID-19 counts in order to get paid more.  It’s not clear if he was including the Walter Reed staff who saved his life when he contracted COVID-19.   

“Trump has insulted our integrity and allowed for more than seven months of chaos and excessive deaths (due) to COVID,” one ER physician told CNBC.  Another lamented that so many still voted for President Trump: “I really thought that our experiences in the trenches would impact people’s voting decisions.” 

The poll workers showed up to work.  The ballot counters showed up to work.  The nurses, medical technicians, aides, doctors, pharmacists, and other healthcare workers showed up for work.  It isn’t always, or even usually, glamorous, and, for most of them, it’s not even particularly well paid. But they do it anyway, despite the risk of COVID, despite the criticisms, despite even the threats,

The least we could do is to be grateful, and not make their jobs even harder.  Let’s make them unsung no more. 

Monday, November 2, 2020

It's (Cyber)Criminal

One of the redeeming aspects of crises is that, amidst all the confusion, suffering, and loss, there are usually moments of grace, of humans showing their best nature.  With COVID-19, we’ve seen health care workers working long hours in dangerous conditions.  We’ve seen other essential workers -- including not just first responders but also grocery workers, meatpackers, trash collectors, and countless others -- putting their own safety at risk so that our lives can go on.  There are heroes all around.

Unfortunately, crises also tend to bring out the worst of our natures.  With the pandemic, those trillions of dollars in play have brought out not just those seeking to profit, but also those looking to profit by breaking the law.   We’ve seen people stealing or counterfeiting stimulus payments, defrauding COVID unemployment payments, getting fraudulent PPP loans, and stealing PPE. 


And then there are the cyberattacks. 

Last week the federal Cybersecurity & Infrastructure Security Agency, the FBI, and HHS issued a joint alert Ransomware Activity Targeting the Healthcare and Public Health Sector, warning that they have “credible information of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers.”  I’ll spare you the technical details of the expected attack strategies or suggested mitigation efforts, but I will note that they warned: “CISA, FBI, and HHS do not recommend paying ransom.”

Hospitals could ask Universal Health Services (UHS) about that.  UHS took some three weeks to resume “normal services” after a ransomware attack that hit their 250 U.S. hospitals in late September.  UHS claims thatWhile our information technology applications were offline, patient care was delivered safely and effectively at our facilities across the country utilizing established back-up processes, including offline documentation methods.   E.g., paper records.

Or they could ask the family of the woman in Germany who died as the result of having to be diverted to another city for her medical emergency because the closer facility had suffered a ransomware attack.  One suspects there may have been other deaths, and other adverse outcomes, due to cyberattacks, and that we can expect there to be more.

The expected attacks have already started.  The Wall Street Journal reports attacks on hospitals in New York, Oregon, and Vermont, while The Washington Post cited hospitals in California, New York, and Oregon.  Security firm Check Point found that October saw a 71% increase in ransomware attacks against the healthcare sector. 

“I think we’re at the beginning of this story, Mike Murray, CEO of Scope Security, told MIT Technology Review.  Similarly, cyber strategist John Ford warned:

The seemingly crazy predictions of the past around the cost of ransomware attacks on the healthcare industry stand to be proven true in 2021. We've seen a substantial rise in ransomware since the onset of COVID, and as the space race 2.0 continues, so will the prevalence of attacks.

There’s never a “good” time for a ransomware attack when it comes to hospitals, but this could possibly be one of the worst.  “Right now resources are very stretched for a lot of health centers,” Mitch Parker, the chief information security officer with Indiana University Health Inc, told WSJ. “With this resurgence of COVID, a lot of people’s attention is focused on staying operational.”

Cyber attacks include not just ransomware, where thieves try to extort money in return for return of control of impacted systems, but also theft of patient and other clinical data, and potential manipulation of data.  We’ve already seen pharma companies in India and in Japan working on a COVID-19 vaccine get hit with cyberattacks, with other attacks impacting clinical trials.  Germany’s Robert Koch Institute for infectious disease control was hit with a cyberattack last week. 

Charles Carmakal, CTO of cybersecurity firm Mandiant, told NPR:

We are experiencing the most significant cybersecurity threat we've ever seen in the United States…Most threat actors aren't willing to deploy ransomware and cause destruction to hospitals right now during the pandemic because they're worried about impacting lives," he said. But in this case, the attacker is deliberately targeting hospitals "and has no real fear of potential human impact, and is just looking to make money.”

“We expect panic,” the hackers reportedly predicted. 

If we think attacks on hospitals and other healthcare organizations are the worst case scenario, think again.  Rand has a new report out on the “Internet of Bodies,” which includes not just wearables but also an array of implantable devices. Rand warns:

Vulnerabilities could allow unauthorized parties to leak private information, tamper with data, or lock users out of their accounts.

In the case of some implanted medical devices, hackers could potentially manipulate the devices to cause physical injury or even death.

It is, the report says, a threat to national security, and Alex Berezow Ph.D., of Geopolitical Futures, agrees.  He warns that such attacks are not just a threat to public health but also to national security; “undermining a nation’s ability to respond to infectious disease outbreaks or other natural disasters may allow some countries to achieve geopolitical objectives.”

“We are outnumbered—the people that are doing bad things, whether it’s a nation-state type of activity or cybercrime—the good guys and gals were vastly outnumbered prior to the pandemic,” David Shearer, CEO of (ISC)2, lamented to CNBC.  It is particularly a problem for health care, which is often viewed by security experts as not having the appropriate infrastructure or personnel to combat such attacks, despite being responsible for life-critical technology and extremely personal information.  And the hackers know it.

Healthcare is still patting itself on the back for going digital, despite not doing that well (think EHRs’ poor usability and interoperability).  But it needs to recognize that we live in a scary digital world; there are bad actors out there looking for vulnerabilities.  Cybersecurity may now be as important to our health as clinicians, and healthcare better invest accordingly.

It’s bad enough that our lives are under attack by an actual virus, but it’s another thing altogether if/when are lives can be put at risk due to a cybervirus.  Whether we like it or not, whether we’re ready for it or not, cyber-criminals are coming for healthcare.