@inproceedings{GierlingDresenEichetal.2018,
  author    = {Gierling, Markus and Dresen, Christian and Eich, Hans and Mittman, Karin and Schinzel, Sebastian and Haverkamp, Uwe},
  title     = {Analysis and consequences of an imaging process concerning the cyber security of a networked computer tomography scanner},
  series = {STRAHLENTHERAPIE UND ONKOLOGIE},
  booktitle = {STRAHLENTHERAPIE UND ONKOLOGIE},
  pages     = {185 -- 186},
  year      = {2018},
  language  = {en}
}
@inproceedings{WillingDresenHaverkampetal.2020,
  author    = {Willing, Markus and Dresen, Christian and Haverkamp, Uwe and Schinzel, Sebastian},
  title     = {Analyzing medical device connectivity and its effect on cyber security in german hospitals},
  publisher = {BMC Medical Informatics and Decision Making volume},
  doi       = {10.1186/s12911-020-01259-y},
  year      = {2020},
  abstract  = {Background: Modern healthcare devices can be connected to computer networks and many western healthcareinstitutions run those devices in networks. At the same time, cyber attacks are on the rise and there is evidence thatcybercriminals do not spare critical infrastructure such as major hospitals, even if they endanger patients. Intuitively,the more and closer connected healthcare devices are to public networks, the higher the risk of getting attacked. Methods: To asses the current connectivity status of healthcare devices, we surveyed the field of German hospitalsand especially University Medical Center UMCs. Results: The results show a strong correlation between the networking degree and the number of medical devices.The average number of medical devices is 25.150, with a median of networked medical devices of 3.600. Actual keyusers of networked medical devices are the departments Radiology, Intensive Care, Radio-Oncology RO, NuclearMedicine NUC, and Anaesthesiology in the group of UMCs. In the next five years, the usage of networked medicaldevices will increase significantly in the departments of Surgery, Intensive Care, and Radiology. We detected a strongcorrelation between the degree of connectivity and the likelihood of being attacked.The survey answers regarding the cyber security status reveal a lack of security basics in some of the inquiredhospitals. We did discover successful attacks in hospitals with separated or subsidiary departments. A fusion ofcompetencies on an organizational level facilitates the right behavior here. Most hospitals rated themselvespredominantly positively in the self-assessment but also stated the usefulness of IT security insurance.Conclusions:Concluding our results, hospitals are already facing the consequences of omitted measures within theirgrowing pool of medical devices. Continuously relying on historically grown structures without adaption and trustingmanufactures to solve vectors is a critical behavior that could seriously endanger patients.},
  language  = {en}
}
@article{WillingDresenGerlitzetal.2021,
  author    = {Willing, Markus and Dresen, Christian and Gerlitz, Eva and Haering, Maximilian and Smith, Matthew and Binnewies, Carmen and Guess, Tim and Haverkamp, Uwe and Schinzel, Sebastian},
  title     = {Behavioral responses to a cyber attack in a hospital environment},
  series = {Nature -- Scientific Reports},
  journal   = {Nature -- Scientific Reports},
  doi       = {10.1038/s41598-021-98576-7},
  year      = {2021},
  abstract  = {Technical and organizational steps are necessary to mitigate cyber threats and reduce risks. Human behavior is the last line of defense for many hospitals and is considered as equally important as technical security. Medical staff must be properly trained to perform such procedures. This paper presents the first qualitative, interdisciplinary research on how members of an intermediate care unit react to a cyberattack against their patient monitoring equipment. We conducted a simulation in a hospital training environment with 20 intensive care nurses. By the end of the experiment, 12 of the 20 participants realized the monitors' incorrect behavior. We present a qualitative behavior analysis of high performing participants (HPP) and low performing participants (LPP). The HPP showed fewer signs of stress, were easier on their colleagues, and used analog systems more often than the LPP. With 40\% of our participants not recognizing the attack, we see room for improvements through the use of proper tools and provision of adequate training to prepare staff for potential attacks in the future.},
  language  = {en}
}