Pandemic boosts advances in medical technology and increase in cyber attacks

As the COVID-19 pandemic shows no signs of disappearing, global standards developing organizations work closer than ever together to develop countermeasures to prevent it spreading further.

The UVD autonomous robot can eliminate viruses and bacteria in infected rooms with UV-C light (Photo: Blue Ocean Robotics)
The UVD autonomous robot can eliminate viruses and bacteria in infected rooms with UV-C light (Photo: Blue Ocean Robotics)

The COVID-19 pandemic will be remembered for a very long time, first of all for its devastating human toll, killing millions; for the record, as of 1 February 2021, after one year, the US had lost more lives to COVID-19 than to combat-related deaths in both world wars, the Korean and the Vietnam wars combined...

Like wars before, the pandemic will be remembered as a driver of advances in the medical domain.

However, this time these advances will extend well beyond drugs, such as antibiotics and sulphonamides that were used to successfully treat infections in WW2.

It will indeed be remembered for the rapid development of certain vaccines, but also, for a number of major advances in the field of equipment, much of it electrical, used in the medical environment, and for the introduction of new applications and technologies, such as artificial intelligence (AI), machine learning, and advances in other domains, such as robotics and the development of remote diagnosis and treatment through telemedicine. This was obvious at the latest (virtual) Consumer Electronics Show 2021 where it was one of the topics generating the most interest.

COVID-19 being highly contagious people have been forced to stay home, forcing the healthcare sector to roll out innovative ways to diagnose, advise and even treat patients remotely.

Video-based consultations have their limits, a promising approach is that offered by special devices such as the MedWand system for tablet and smartphones, a remote monitoring device, which can assess and monitor patients for hundreds of medical conditions and connect them securely with their doctors.

Breaking down silos is central to better healthcare, convergence

What is new is an unprecedented and closer cooperation between the three Geneva-based global standards developing organizations (SDOs): the IEC, the International Telecommunication Union (ITU) and the International Organization for Standardization (ISO). A series of meetings on "effective coordination among IEC, ISO, and ITU-T technical standardization activities" is scheduled between March and June of this year. COVID-19-related activities are likely to figure prominently on their agenda.

The reasons for this closer collaboration between these organizations, which already work together in many domains where their competences overlap, is the fact that more than ever before the interoperability of equipment, devices and processes being introduced, many essential to the medical environment and to address COVID-19-related issues, is not possible without the integration of standards developed by the three organizations.

Non-exhaustive examples of these include:

  • The use of robots in the medical and care environment, which undoubtedly increased in the past year to deal with a number of issues linked to the pandemic, such as remote monitoring of patients, the treatment of patients by delivering drugs and protecting medical staff, as previously reported in e-tech. 

    They are also used to allow the interaction between patients and medical staff even when the former are not in medical facilities, and are even carrying out what are normally labour-intensive and hazardous tasks such as disinfection and cleaning work of medical facilities.

    Robots, which integrate a range of equipment and devices, such as batteries, sensors, and electronic components rely on the work of many IEC TCs, such as IEC TC 47, Semiconductor devices, IEC TC 21, Secondary cells and batteries. Robots used to monitor and interact with patients may also include screens as well as multimedia systems and components, international standards for these are developed by IEC TC 100,  Audio, video and multimedia systems and equipment and IEC TC 110, electronic displays.  
  • Applications in the AI area, for which the IEC and ISO set up in 2017 ISO/IEC JTC 1/SC 42, a subcommittee of their ISO/IEC JTC 1 Joint Technical Committee, will be central in countless domains, not least in healthcare for the development of antiviral drugs, for customized diagnosis and treatment equipment and many other uses.
  • Telemedicine, which depends on the transmission of data and information, including imagery, between patients and medical professionals, or between medical establishments for interpretation, relies for the transmission of data, on standards for data connection and transmission which are primarily developed by ITU.

Standards and conformity assessment

International standards for electrical equipment in medical practice are developed by IEC TC 62 and its subcommittees, which have over 300 publications.

IECEE, the IEC System of Conformity Assessment Schemes for Electrotechnical Equipment and Components offers testing and certification for the safety, quality, efficiency and overall performance to IEC International Standards for 22 categories of products, including electrical equipment for medical use. To do so, it established an Expert Task Force, (ETF) 3 "MEAS, MED", to cover measurement, control and laboratory equipment (MEAS) and electrical equipment for medical use (MED), as detailed in e-tech (November 2020).

Mitigating cyber security risks in the COVID era and beyond

There's growing awareness regarding the need to protect confidentiality of patients' records, data integrity and access to healthcare facilities, research institutes and laboratories.

This comes in the wake of cyberattacks against many facilities and security breaches. These are carried out by state or non-state actors (sometimes on behalf of states) and criminals. They may take the form of intrusion by bad actors trying to bypass long and costly research efforts to obtain information on COVID-19 vaccines and therapeutics.

Or they may be aimed at using ransomware to lock up medical facilities, including hospitals systems for days, encrypting data and decrypting it (or not) against payment. This is particularly serious at a time when hospitals are on the front lines of combating the COVID-19 pandemic and can have fatal consequences.

The human factor is the weakest link

The introduction of different working practices, such as teleworking, following the pandemic outbreak, have contributed to an increase in cyberattacks.

An October joint cyber security advisory on ransomware activity targeting the US healthcare and public health sector, reported that "hospitals and healthcare organizations had been targeted by a rising wave of ransomware attacks."

The multinational Check Point Software company announced on 5 January that there had been an increase of over 45 per cent in the number of attacks against healthcare organizations globally since 1 November 2020, compared to an average 22 per cent increase in attacks against other industry sectors. "Canada experienced the most dramatic increase with over a 250 per cent uptick in attacks, followed by Germany with a 220 per cent increase and Spain saw a doubling in attacks," Check Point Software reported.

In addition to costs, these attacks can result in death, as happened in Germany in September 2020 when a woman died after she couldn't be admitted to a hospital that had come under cyberattack.

Too often and for too long cybersecurity took a backseat in healthcare facilities as these relied on insecure medical devices and kept using outdated legacy equipment and software.

Cyber security firms emphasize the importance of awareness, the need to educate staff against malicious tools and to patch systems, or if this is impossible to use an intrusion prevention system with virtual patching capability to prevent attempts to exploit weaknesses in vulnerable systems or application.

The other central issue is to ensure that medical devices manufacturers design and maintain cyber secure products.

It remains to be seen if measures adopted to deal with this global pandemic will help prevent or mitigate future ones.