Current organ donation methods in need of a transplant
WRITTEN BY: Jonny Williamson
During the last century the world’s population experienced its biggest growth since records began. With the figure currently just over seven billion, the number is tipped to continue growing at an alarming rate during the current century. This coupled with the fact, at least for the western world, that in contemporary society people are living far longer lives, is putting immense strain on global healthcare services. Nowhere is this more evident than in the world’s demand for healthy organs, with almost every country’s’ requirements far outweighing the supply.
There are a surprisingly large amount of organs able to be donated and transplanted, including the heart, lungs, kidney, liver, pancreas and intestines, with tissues such as skin, heart valves, corneas and tendons also helping to save lives. Yet the combined amount of people waiting for organ transplant in just the UK and US alone equates to over 125,000 people, many of which have already been on the list for months and still face an uncertain future.
Long waiting lists and low organ stocks are not something that has happened overnight, the problem has been restraining healthcare providers for decades; but the seriousness of the situation is leading the world towards crisis point. Accordingly, 2012 has heralded the start of new debates on the subject, with experts, healthcare professionals, even the President of the United States, drawing attention to the problem, many of which are calling for traditional methods to be approached from a fresh perspective, with the entire system being rethought.
Healthcare Global considers the three biggest things happening to organ donation currently and how they are changing the way society views this problematic subject.
Though still needing to formally register with an official agency, Facebook’s decision earlier this year to give members the option to add that they are an organ donor to their profile, and subsequently share the information with friends and family through their timeline, has gone a long way to raise public awareness of the situation, especially with the younger demographic of society.
When questioned by the news programme Good Morning America as to the motives behind the sudden organ donation drive, the creator of Facebook, Mark Zuckerberg, replied that he had been impressed by the way communities had rallied together after recent events such as the tornados in Missouri and Japan by utilising the site to support and find family members.
Though initially only available in the US, the UK, Australia and the Netherlands, if the scheme goes on to become universally rolled out, Facebook’s organ donation drive has the potential to add an additional 900 million users to the global donor register.
Opt-In versus Opt-Out
The majority of countries make use of either an ‘opt-in’ or ‘opt-out’ policy when it comes to legislating organ donation. Opt-in is a method where individuals have to personally register their intent to become donors with official organisationsutilised by countries such as Germany, the UK and United States (though each State is responsible for its own stance).
Opt-out is the exact opposite, with every individual being considered a donor unless they specifically register as otherwise. Many countries within the EU have implemented an opt-out system, such as Sweden, Italy and France, as studies have shown that a great many people consider registering as donors but never get round to actually doing it, the opt-out policy eliminates this fundamental flaw. Though not without criticism, implementing an opt-out policy has the potential to increase the world’s donor pool three, even four fold.
Organ donation is a sensitive topic for many people, be that for religious, cultural or personal reasons, and the two examples described above have not been met with universal approval. Facebook’s organ drive has led many to complain that it is just yet another piece of personal information about us that will eventually be sold on to the highest bidder, with a large selection of society seeing a change to an opt-out scheme to be far too assuming. Debating the merits of both has generated considerable column inches, both online and in newspapers or magazines; and that is the most important thing currently happening regarding the topic of organ donation. Consistently discussing the issue openly, raising awareness and separating the fact from the fiction will prove to be the best possible way to address the present dilemma.
How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.