Evolving Threats in Cybersecurity and Radiation Oncology
Effect of the Cyberattack Targeting the Irish Health System in May 2021 on Radiation Treatment at St. Luke's Radiation Oncology Network
On May 14, 2021, the Health Service Executive (HSE) of Ireland experienced a major ransomware cyberattack. The HSE initially took down all of its information technology systems to protect its core systems. All Internet connections within the HSE were unavailable from 7 am for approximetely three weeks which had a major effect on the radiation oncology service nationally within the public service. St. Luke's Radiation Oncology Network (SLRON) is a complex, 3-center radiation oncology service, and it is the largest in the country; with 14 linear accelerators, it is one of the largest radiation centers in Europe.A National Cyberattack Affecting Radiation Therapy: The Irish Experience
On Friday, May 14, 2021, the Health Service Executive, the organization providing public health services in the Republic of Ireland, was the victim of a significant cyberattack on its information technology systems. All systems were subsequently shut down to prevent further damage and to allow cybersecurity experts to investigate the attack. As a result, oncology services were severely disrupted, with the cessation of radiation therapy treatments in all public radiation therapy departments. Ireland has 5 large public and 6 smaller private radiation therapy centers in total.Impact of and Response to Cyberattacks in Radiation Oncology
Cyberattacks on health care facilities are increasing and significantly affecting health care delivery throughout the world. The recent cyberattack on our hospital-based radiation facility exposed vulnerabilities of radiation oncology systems and highlighted the dependence of radiation treatment on integrated and complex radiation planning, delivery and verification systems. After the cyberattack on our health care facility, radiation oncology staff reconstructed patient information, schedules, and radiation plans from existing paper records and physicians developed a system to triage patients requiring immediate transfer of radiation treatment to nearby facilities.The Impact of a Cyberattack at a Radiation Oncology Department: Immediate Response and Future Preparedness
Cyberattacks are increasing year after year and many organizations, including hospitals, are becoming targets. Radiation oncology is especially vulnerable because of the reliance on computer and network capabilities to transfer relevant patient information for safe and effective patient treatment. In early 2019, our institution was hit by a ransomware attack that brought down our oncology information system (OIS). Although we were not fully prepared for such an attack, a total of 69 treatment fractions occurred without our OIS thanks to the quick development of a contingency plan and the ability to restore the patients’ records.Emerging Cybersecurity Threats in Radiation Oncology
Modern image guided radiation therapy is dependent on information technology and data storage applications that, like any other digital technology, are at risk from cyberattacks. Owing to a recent escalation in cyberattacks affecting radiation therapy treatments, the American Society for Radiation Oncology's Advances in Radiation Oncology is inaugurating a new special manuscript category devoted to cybersecurity issues.Development of Rapid Response Plan for Radiation Oncology in Response to Cyberattack
As a result of a cyberattack on the University of Vermont Health Network, access to all servers and clinical systems was immediately halted by our information technology infrastructure team on October 28, 2020. This resulted in all hospital electronic medical records and laboratory, pharmacy, pathology, radiology, and messaging systems becoming inaccessible. Only access to basic information, including demographic information; medical, surgical, family, and social history; most recent labs; medications; and last clinic note, was available.
