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Cyberattacks on Telehealth Skyrocket, Privacy Concerns Hinder COVID Tracking-The HSB Blog 9/22/20

Targeted Cyberattacks on Telehealth Vendors Skyrocketed Along with Adoption, Report Finds &

Fewer than Half of Healthcare Institutions Met National Cybersecurity Standards Last Year

Event: (9/10 & 9/17) According to two recent reports, not only has the number of cyberattacks targeting popular telehealth applications risen 30% since the pandemic began, but healthcare institutions are slightly less prepared to deal with them in 2019 than they were in 2018 or 2017. First, based on the “Listening to Patient Data Security: Healthcare Industry & Telehealth Cybersecurity Risks” report by Security Scorecard and Dark Owl, there has been a dramatic increase in attacks on telehealth which saw the increase in security alerts noted above compared to the healthcare industry in general which saw an overall 77% decrease in security alerts. In addition, the CynergisTek 2020 Annual Report noted declines in four of five core security functions outlined in that National Institute of Standards and Technology’s cybersecurity framework with assisted living facilities scoring highest (96%) and physician groups scoring lowest (20%).

Description: Security Scorecard and DarkOwl compared security alerts sent to IT staff at 148 of the most popular telehealth applications for the period March through April of 2020 compared to the pre-COVID period of September 2019-February 2020. They found a 65% increase in patching cadence findings, a primary secret security approach to protect data and a parallel 56% increase in endpoint security attacks. They also found security issues were reported due to increased FTP attacks (which rose 42%) and RDP attacks (which rose 27%) both of which target increases in remote and virtual workers. The CynergisTek report showed that healthcare institutions compliance with IT security policies were sliding, scoring 44% in 2019, vs. 47% in 2018 and 45% in 2017. This included a decline in four of five core functions.

Implications: With the growth in remote work and the explosion of digital health due to the pandemic, the number of “digital endpoints” exposing healthcare institution’s to cyber risk has increased significantly. As a result healthcare institutions need to be even more vigilant and conscious of the risks to patient data and IT system integrity/security. Healthcare companies must work on greatly improving and patching their critical security tools enhancing endpoint protection, improving identity access management, and data loss prevention.

COVID-19 Tracking Tech – Weighing Personal and Public Health Benefits Against Privacy

Event: (9/18) A recent survey conducted by SecureAge Technology shows that 67% of consumers and 91% of IT professionals said they'd support a nationwide rollout of contact-tracing apps or other technologies despite the fact that the clear majority of these groups believe COVID contact-tracing technologies put individuals' personally identifiable information at risk. The report notes many have strayed away from using these resources, afraid that their personal information may be compromised as COVID has caused an increase in technologies used to educate, contact trace, and symptom report for those who may have been exposed to the virus.

Description: Public Health departments have begun rolling out applications to aid with contact tracing and educating individuals regarding COVID, but recent surveys are showing that there has been increased skepticism. Although these tools have been introduced to control virus transmission, the hesitation isn’t unfounded due to major technology firms like Google and Apple that have been facing scrutiny from the public and lawmakers over the collection and use of personal data for corporate gain. Additionally, published analyses suggest that many COVID apps made available for download make little effort to protect the data they are collecting. Despite the valuable aspects of these applications such as quarantine updates, healthcare contacts, location tracking, and educational tools, the cons have greatly overshadowed the pros.

Implication: COVID applications are valuable in helping users understand their risk, so they can adjust their behaviors and seek testing if necessary, but proper education is necessary to maximize the use and to save lives. The information stored in these applications are critical and need to be protected at all costs to create a safe space for use. Public health groups need to better inform the public about the benefits of these apps and ensure that the information is given with proper consent and handled responsibility, especially amongst higher risk populations that may have varying levels of literacy.

Why Digital Therapeutics are Flourishing Under COVID-19

Event: (9/17) A recent report in Mobihealthnews highlighted the growth in adoption and acceptance of digital therapeutics during the COVID pandemic. The article noted that not only has COVID removed some of the stigma around the conditions being treated (mental health, psychiatric conditions, etc.) and the ability to treat them digitally, digital therapeutics is not facing some of the issues in trial design and recruitment that traditional trials are experiencing. As a result, there has been increased access to evidence-based interventions which show reliability and personability to patients.

Description: Digital therapeutics are evidence-based therapeutic interventions driven by high quality software programs to prevent, manage, or treat a medical disorder or disease. As a result of COVID digital therapeutics executives and industry stakeholders have seen an increased demand for efficient and accessible treatments which can be done remotely without potentially exposing them to the virus and can be highly personalized. In addition, digital trials are decentralized, can be done from home and typically allow more flexibility in recruitment all of which have been advantageous vs. standard trial design during the pandemic.

Implications: Digital therapeutics are likely to yield improvements in self-care particularly for patients who are isolated due to COVID as well as reduce the social stigma around many of their conditions. With a number of digital therapeutics already approved and companies such as Big Health, Click Therapeutics, Akili, and others focused on using digital technologies to reduce development costs and increase accessibility to care for many conditions they are likely to redefine how care is delivered in many areas.

The Rise of Venture Capital Investing in Mental Health

Event: (9/16) On September 16th JAMA published an opinion piece about the increase in venture capital (VC) investment in mental health noting that the sector was ripe for innovation with fewer than ⅓ of the people in need of care receiving treatment and only a subset of those actually getting adequate care. The article went on to note that while VC investment has grown almost 23x since 2013 it was important to look at potential concerns and benefits associated with the influx of money.

Description: The private sector is using health and wellness as an investment opportunity after realizing there is a supply/demand imbalance mismatch for those in need of mental health treatment. However, VC supported companies often rely on the ability to grow quickly and serve a large population to maximize their return on investment which could be at odds with medicine’s evidence-based approach and the one-on-one nature of mental health treatment. In addition, there have been concerns around the security of data, privacy of client information, the lack of informed consent and broad-based nature of the apps (vs. the need for personalized treatments).

Implications: The rise in venture capital investment in mental health care offers an opportunity to scale treatments that work to address mental illness. However, while VC supported mental health companies can provide improvements in transparency with diagnosis, treatment process, and costs, concerns around developing evidence based treatment, appropriate quality controls, improved privacy safeguards and the continued need for solutions to treat severe mental illness, all need to be addressed further.

Telemedicine Projected to Account for 20% of Medical Visits in 2020, Report Says

Event: (9/16) Telemedicine projected to account for 20% of medical visits in 2020 according to a new Doximity Report. The new report, published last week by the Doximity physician network, is based on a randomized survey of 2,000 American adults. Doximity network data reflects "physician adoption insights," and data from the Medical Expenditure Panel Survey and commercial insurance claims to gauge the telemedicine market.

Description: The COVID pandemic has spurred widespread adoption of telemedicine along several fronts at health systems, hospitals, and physician practices—primarily over concern about the spread of the novel coronavirus in healthcare settings. Telemedicine visits for nonemergency care also have been shown to be efficient and effective from both the healthcare provider and patient perspectives. This has resulted in an overall increase in telemedicine visits. Since the Coronavirus pandemic began, the number of Americans participating in at least one telemedicine visit has increased 57%, according to the report.

Implications: Although COVID numbers have recently appeared to improve, given concerns about an impending second wave and the successful increase in application during the pandemic the market for digital health and increased ways to apply it will continue to grow. COVID has accelerated the rate of deployment, overcome physician reluctance to apply its use and rapidly increased consumer acceptance. As a result. more than a quarter of survey respondents reported feeling telemedicine visits have the same or better quality versus in-person visits with Doximity predicting telemedicine will account for $106B of medical services by 2023 (up from $29B of medical services in 2020).

U.S. HealthCare System on Life Support, Say Test Results from New Study

Event: (9/14) A recent report from The Commonwealth Fund, entitled a 2020 Scorecard on State Health System Performance, which looked at 49 indicators of health care system performance was not encouraging. According to the report, the state of healthcare issues in the U.S. such as access to, and the cost of basic medical care and minority health outcomes have significantly worsened, especially during the recent pandemic. Also, resources linked to mental health treatment have lost funding, causing an increase in drug/alcohol abuse and suicide all over the nation.

Description: The report, which drew primarily from 2018 data, and some preliminary 2019 data noted, among other things there is a nationwide crisis when it comes to overall health outcomes. The Black and Latinx populations are suffering the most as well as those residing in states that chose not to expand Medicaid services. The four main conclusions made from the data reviewed: 1) Americans are living shorter lives than in 2014, with Blacks twice as likely to die from treatable conditions than whites, 2) healthcare coverage gains have stalled with both out-of- pocket costs and insurance costs worsening, 3) increased healthcare prices have driven healthcare spending growth and the rise in consumer healthcare costs, and, 4) public health dollars are already being stretched while having to contend with unprecedented challenges due to the pandemic.

Implications: The current state of the U.S. healthcare system highlights the need to combat extreme deficiencies to promote better healthcare outcomes. The global pandemic has brought to light the extent of the healthcare gap and lack of access to resources that has negatively impacted the nation, especially amongst minorities. If new solutions do not emerge, Americans will continue to see a downturn in overall health, especially as COVID-19 continues to spread throughout the world.


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