May 17, 2020

OPINION: Analysing NHS System Integration & IT Services

medical IT
system integration
3 min
Clinical Software Needs To Be Employed Correctly
Written by Julian Osborne, IMS MAXIMS (a provider of electronic patient records to the NHS and private sector) The company has faced a turbulent time...

Written by Julian Osborne, IMS MAXIMS (a provider of electronic patient records to the NHS and private sector)


The company has faced a turbulent time over the last twelve months and there were indications of future trouble. Yet the signing of new deals with high profile NHS organisations made it look, at least on the surface, that 2e2 would pull through.

The biggest concern for those trusts using the company’s services, many who relied solely on them to support their entire IT infrastructure, will undoubtedly be around business continuity. How will they continue to provide the same level of service themselves?  How can they ensure that their IT applications, many of them now critical for the trust’s operations and more importantly to provide patient care, are not disrupted?

These are all valid and important questions that need answering but I wonder whether they would be asked if the NHS hadn’t chosen to outsource to a commercial company and instead it looked to other local trusts for support.

Several years ago, numerous NHS trusts desperately needed an external IT services provider to support their organisation, often they did not have the head count, capability nor the expertise in-house to ensure that they could implement, run and host the increasing systems that they needed.

Turn the clock forward to 2013 and I question whether, in today’s evolving and slightly more commercially focused NHS, trusts could pull on each other to do this themselves. Opportunities exist if trusts communicated in such a way where local NHS organisations understood each other's requirements, worked in partnership, shared IT services, drew on resources when required, and perhaps most importantly, provided back-up systems for each other and hosted each other’s data.

This doesn’t even need to happen with a trust’s next-door neighbour, services could be mirrored locally and even regionally, reducing duplication, cutting costs and potentially providing far greater stability ensuring that patient data is readily available and in turn accessible at the point of care.

On top of that it would help NHS organisations, many of which may now be reluctant to outsource to such IT providers, to de-risk the situation. Although recent months have seen trusts put into administration, it is highly unlikely that NHS organisations will experience the same type of issues as 2e2.

Traditionally, technology professionals used to join the NHS, gain experience and then head off to the private sector (often only to be re-employed as a commercial entity). This is happening less and less as talent appears to be far more greatly embedded in the NHS. Now the NHS needs to empower its champions to be more commercially minded and ambitious.

There are a number of organisations already pushing boundaries in this area, for example St Helen’s and Knowsley Hospitals NHS Foundation Trust is already working with IMS MAXIMS to host data from other healthcare organisations, not only within the NHS but also the private sector.

The trust is ready and willing to work with other like-minded organisations, public or private and better understand how it can cross-sell its IT systems and services into the NHS and private market.

Of course, there is a time and a place where organisations, such as 2e2 are of crucial importance to NHS organisations in need of their support and expertise; but my question is that in a risk averse NHS, is it simply less risky and more beneficial all around to invest in leveraging the knowledge and IT of our fellow NHS organisations?

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Jun 13, 2021

How healthcare can safeguard itself against cyberthreats

Jonathan Miles
6 min
Jonathan Miles, Head of Strategic Intelligence and Security Research at Mimecast, tells us how the healthcare sector can protect itself from attacks

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. 

Going digital 

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. 

Strengthening defences

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.

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