Ransomware Attack Associated With Disruptions at Adjacent Emergency Departments in the US

Area of Science:

• Health Informatics
• Cybersecurity in Healthcare
• Emergency Medicine

Background:

• Cyberattacks, particularly ransomware, are increasingly sophisticated and frequent in healthcare.
• Previous research has not detailed the regional impact of these attacks on neighboring hospitals.
• Understanding these effects is crucial for preparedness and response strategies.

Purpose of the Study:

• To investigate the impact of a ransomware attack on a healthcare organization on the emergency department (ED) patient volume and stroke care metrics of a geographically proximate, but separate, institution.
• To quantify changes in ED census, patient throughput, and critical care indicators during and after the cyberattack.

Main Methods:

• A before-and-after cohort study design was employed, comparing data from two US urban academic EDs.
• Data were collected in the four weeks prior to, during, and four weeks after a month-long ransomware attack on a neighboring hospital system.
• Key metrics included ED encounter volumes, emergency medical services (EMS) arrivals, patient wait times, length of stay, and stroke care indicators.

Main Results:

• During the ransomware attack, the unaffected ED experienced significant increases in daily mean ED census, EMS arrivals, admissions, and patients leaving without being seen.
• Median waiting room times and total ED length of stay for admitted patients also significantly increased.
• There was a notable rise in stroke code activations and confirmed stroke cases during the attack period compared to the pre-attack phase.

Conclusions:

• Hospitals adjacent to facilities experiencing ransomware attacks may face increased patient volumes and resource strain, impacting time-sensitive care.
• Targeted cyberattacks can disrupt healthcare delivery regionally, affecting non-targeted hospitals within the same community.
• These cyber incidents should be recognized as regional disasters requiring coordinated community-wide response plans.