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Partners Universal Innovative Research Publication (PUIRP)
Volume: 01 Issue: 02 | November-December 2023 | www.puirp.com
© 2023, PUIRP | PU Publications | DOI: 10.5281/zenodo.10206563 Page | 93
The Emergence of Cybersecurity Medicine: Protecting Implanted Devices
from Cyber Threats
Dr.A.Shaji George1, A.S.Hovan George2
1,2 Independent Researcher, Chennai, Tamil Nadu, India.
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Abstract - With the increasing use of implanted medical devices like wearables, internet-connected
pacemakers, and neural implants, a new field is emerging at the intersection of healthcare and
cybersecurity. This paper explores the need for specialized cybersecurity doctors to protect these
vulnerable devices from cyberattacks. As medical implants become more interconnected, the risk
increases that hackers could access and manipulate them, endangering patient health and privacy.
Currently, the healthcare industry lacks professionals with expertise in both medical technology and
cybersecurity. This paper argues for the creation of cybersecurity medicine programs at universities to
train the next generation of doctors in protecting devices and patients from cyber threats. These
cybersecurity doctors would educate patients about data security, develop security strategies for medical
apps and devices, collaborate with developers to identify vulnerabilities, monitor cyber threats, and
respond quickly to incidents. Their specialized knowledge is essential to build security into medical devices
from the start and to institute best practices for developers. Cybersecurity doctors would also stay current
on the evolving threat landscape to devices and proactively address risks. With patient health data
increasingly held on connected devices prone to hacking, the paper emphasizes the vital role
cybersecurity doctors could play in safeguarding lives. The paper concludes that nurturing this emerging
field is crucial to protect patient trust in vital implanted technology as it becomes more pervasive. With
vigilance and expertise from cybersecurity medicine specialists, the lifesaving benefits of connected
devices can be harnessed while keeping confidential data safe.
Keywords: Cybersecurity medicine, medical cybersecurity, Healthcare data privacy, Clinical informatics
security, medical device security, Healthcare cyber threats, Digital healthcare risks, Patient data
protection, medical technology vulnerabilities, Connected care security.
1.INTRODUCTION
1.1 Brief Background on Implanted Devices Like Wearables, Chips, Etc. And Their Vulnerability
to Cyber Attacks
The integration of technology into healthcare has led to major advances in recent years, with implanted
medical devices like pacemakers, insulin pumps, and neural implants increasingly able to transmit data
and be controlled wirelessly. However, this connectivity also makes them vulnerable to potentially life-
threatening cyberattacks. There is growing recognition that cybersecurity needs to be a priority in the
design and deployment of implanted medical devices to keep patients safe.
Wearable fitness trackers have become ubiquitous in recent years for health and wellness monitoring. As
of 2022, over 40% of consumers own a wearable device, with smart watches leading the market. These
collect sensitive health metrics like heart rate, sleep patterns, activity levels, and location data. While
Partners Universal Innovative Research Publication (PUIRP)
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wearables have benefits, their wireless connectivity renders them susceptible to hacking, highlighted by a
2018 study that found popular consumer fitness trackers lacked even basic encryption. With fitness trackers
linked to smartphones and cloud accounts, a security breach could expose users’ personal information.
More serious risks come from implanted medical devices like insulin pumps, pacemakers, and
neurostimulators, which monitor and regulate critical bodily functions. Currently, over 160,000 pacemakers
are implanted in patients annually in the United States, with this number projected to grow substantially as
the population ages. These actively transmit patient vitals and can be adjusted wirelessly, but many
models have been found to contain security flaws allowing potential remote manipulation. A 2022
investigation of common insulin pumps again revealed vulnerabilities to hacking, including the ability to
override or block insulin delivery. The life-threatening implications of such interference are clear.
Neural implants that interface directly with the brain and nervous system also raise major cybersecurity
concerns. Cochlear implants to treat deafness and deep brain stimulation for movement disorders rely on
implanted electrodes controlled wirelessly. Researchers have demonstrated in lab settings that these
signals can be intercepted and altered to deliver unintended stimuli. As neural technology continues
advancing, experts warn its cyber risks are not being sufficiently considered. The healthcare industry is
behind other critical infrastructure sectors in prioritizing cybersecurity. Medical devices are not subject to
any specific security regulations, and manufacturers face limited incentives to overhaul legacy designs.
Hospitals utilizing connected devices often lack resources and expertise to implement cyber protections.
The result is systemic insecurity that leaves patients’ wellbeing vulnerable.
Addressing the cyber-physical risks associated with connected medical devices will require a concerted
effort from stakeholders across healthcare, government, industry, and cybersecurity. Medical device
manufacturers need to embed security into their design process. Hospitals must improve network
protections and staff training to better identify and respond to threats. And regulators should implement
appropriate standards and reporting mechanisms for cyber incidents involving medical devices. Most
importantly, cybersecurity expertise needs to be integrated directly into healthcare practice. The emerging
field of cybersecurity medicine recognizes that securing networked medical technology is now
fundamental to patient care. As medical implants become more intertwined with cyberspace, specialized
doctors combining medical and technical knowledge will be essential to safeguard both patient health
and patient data. Cybersecurity medicine is the critical missing link to realize the benefits of connected
devices in healthcare while protecting patients in the modern threat environment.
1.2 The Need for Cybersecurity Expertise in the Medical Field to Protect These Devices
The healthcare industry has seen an explosion in connected medical devices and health apps
that collect, analyze, and transmit sensitive patient data. This connectivity has led to
groundbreaking innovations in patient monitoring, diagnosis, and treatment. However, it has
also exposed vulnerabilities that make medical data and devices prime targets for
cybercriminals. The potentially life-threatening implications of cyberattacks on hospitals and
patient health make securing medical technology imperative. This necessitates cybersecurity
expertise within the healthcare field to keep pace with emerging threats targeting networked
medical devices and information systems.
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Recent years have seen alarming growth in cyberattacks on hospitals and healthcare providers. Between
2016 and 2021, reported data breaches in healthcare surged by 50%. In 2021 alone, over 44 million healthcare
records were compromised in reported incidents. Medical data is highly valuable to cybercriminals since
health records contain a wealth of personally identifiable information. Breached health data sells for up to
$1,000 per record on the dark web. The impact of these breaches is far reaching, exposing patients to
identity theft, insurance fraud, and other forms of exploitation.
Beyond data theft, cybersecurity researchers have demonstrated the feasibility of remotely hacking and
manipulating connected medical devices like pacemakers, insulin pumps, and imaging technology. In 2017,
the FDA issued a warning after a pacemaker was shown to be vulnerable to hacking that could rapidly
deplete its battery or deliver incorrect pacing pulses. With lives directly at stake, lax cybersecurity on
medical devices is wholly unacceptable. However, healthcare has lagged behind other industries in
devoting resources to information and device security. Most hospitals still rely on legacy equipment and
lack personnel focused on cyber protections.
Bridging this expertise gap is imperative as medical technology grows more complex and interconnected.
Currently, cybersecurity is rarely part of medical school curriculums or physician training. But doctors on
the frontlines need awareness to recognize and respond to potential cyber threats introduced by
networked monitoring equipment, electronic health records, and web-enabled medical tools. Cyber
hygiene practices like strong passwords, encryption, and timely software updates need emphasis in clinical
settings. And specialized technical knowledge is required to vet the cyber risks of new treatment
technologies before their widespread adoption.
Integrating cybersecurity experts onto medical teams would significantly improve protections for patients
and providers. They could conduct security audits, institute access controls and system redundancies,
develop incident response plans, and ensure network traffic is monitored and analyzed for anomalies.
Cybersecurity personnel could also advise hospitals on selecting medical devices from manufacturers
prioritizing security in their design. With healthcare fast becoming digital, neglecting cybersecurity risks
puts patients in harm's way.
Cybersecurity medicine is an emerging interdisciplinary field seeking to bridge this knowledge gap at the
intersection of healthcare and information technology. Academic programs are beginning to produce
dual-trained cybersecurity doctors and medical technologists. Their cross-cutting skills combining patient
care and data protection are indispensable as technology transforms healthcare’s threat landscape.
Properly securing health data and devices will require making cybersecurity an integral part of patient care
and medical best practices.
2. THE ROLE OF THE CYBERSECURITY DOCTOR
2.1 Responsibilities of a Cybersecurity Doctor
2.1.1 Educating patients and public on data security
The emerging role of a cybersecurity doctor encapsulates a critical need in the healthcare industry for
professionals at the nexus of medical expertise and cybersecurity knowledge. As medical devices and
health data become increasingly digitized and interconnected, intentional attacks and unintended flaws
leave patients’ wellbeing and sensitive information vulnerable. Cybersecurity doctors would hold
responsibilities spanning clinical care, public education, and oversight of the complex medical technology
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infrastructure. Their multifaceted role is essential for realizing the benefits of healthcare digitization while
safeguarding patient safety.
A core duty of cybersecurity doctors is educating patients and the wider community on protecting health
data. With telemedicine and remote patient monitoring expanding, patients require awareness on securely
configuring devices and platforms introduced into their homes. Cybersecurity doctors should provide
guidance on steps individuals can take to reduce their risk, like using unique passwords, installing software
updates, and avoiding unsecured public WiFi networks for at-home medical devices. They can also debunk
misinformation on social media and other outlets around medical cybersecurity threats, providing expert
perspectives patients can trust.
In clinical settings, cybersecurity doctors should conduct assessments to identify vulnerabilities in medical
facilities’ device security, data handling policies, and network systems. They can then work collaboratively
with hospital IT staff and administrators to implement cyber hygiene best practices and training programs
for medical personnel. Conducting regular cybersecurity audits and preparedness exercises for healthcare
providers is also imperative.
For medical technology vendors and device manufacturers, cybersecurity doctors can provide critical
consultation on engineering security into products from the initial design phase. With expertise spanning
both clinical environments and solutions development, they are uniquely positioned to advise companies
on potential cyber risks to avert in medical system architectures and software. This security-by-design
approach for medical device engineering is essential to prevent dangerous oversights.
At the public health level, cybersecurity doctors should coordinate with government agencies to establish
policies and oversight mechanisms for cyber protections in healthcare. They can inform regulations around
medical device security standards, while also helping policymakers appreciate nuanced challenges
hospitals face in upgrading legacy systems. Promoting public-private partnerships and information
sharing on emerging cyber threats is another key role for cybersecurity doctors in strengthening healthcare
preparedness.
Within healthcare organizations, cybersecurity doctors can spearhead incident response teams and
processes for cyberattacks on medical data or devices. Their combined understanding of clinical
workflows, data sensitivity, and attack vectors allows rapid containment and remediation after a breach.
For organizations lacking resources to employ a full-time cybersecurity doctor, they can provide
outsourced guidance on policies and staff education to uplift preparedness across the care continuum.
As a research discipline, cybersecurity medicine is still in its nascence. Academic programs are charting
new curriculum at the cross-section of medicine and information security. Through publishing findings and
collaborating across sectors, cybersecurity doctors can continue advancing understanding of the field’s
intricacies. Their insured expertise will grow more crucial as medical technology evolves and new threats
emerge.
In all facets, the cybersecurity doctor’s role bridges healthcare and cybersecurity, harmonizing patient
wellbeing and data protection. Their holistic view of the clinical, technical, and human factors in play
provides an invaluable perspective. With lives increasingly dependent on secure medical devices and data,
educating, empowering and mobilizing cybersecurity doctors is imperative for healthcare’s future.
2.1.2 Developing security strategies for medical apps and devices
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Medical mobile applications and connected devices are transforming healthcare through remote patient
monitoring, telehealth, improved diagnostics, and streamlined care coordination. However, these tools also
introduce vulnerabilities that cybersecurity doctors are uniquely qualified to assess and address.
Developing robust security strategies for medical apps and devices will be a key responsibility of these
emerging professionals.
A core duty of a cybersecurity doctor is threat modeling new medical apps and devices while still in the
design phase. They can identify potential weak points across hardware security, software access controls,
data transmission protocols, patch management, and other facets of the system. By proactively finding
flaws early, developers can harden the app or device well before deployment. The cybersecurity doctor
also provides guidance on incorporating encryption, multifactor user authentication,
compartmentalization, and other security features into the technology.
For apps already launched and in clinical use, cybersecurity doctors perform penetration testing to uncover
any bugs or gaps in protections. Checking for unsecured data APIs, lack of input validation, and other
common programming oversights allows issues to be resolved quickly before exploitation. The
cybersecurity doctor can scan for vulnerabilities in both the app frontend and backend server
infrastructure. They further ensure medical apps have plans for automated security updates and
performance monitoring to catch any emerging issues.
At the organizational level, cybersecurity doctors develop information security blueprints encompassing
mobile apps, medical devices, electronic health records, and other connected systems. This includes
classifying all data by sensitivity level and establishing role-based access policies. Network segmentation,
intrusion detection, and monitoring systems should also be implemented to safeguard the entire IT
ecosystem. Plans for routine security audits and contingency protocols in case of a breach are critical
components of the cybersecurity strategy.
A key consideration for medical technology security is balancing usability for clinicians with rigorous
safeguards. Cybersecurity doctors collaborate closely with doctors, nurses, and other personnel to institute
protection policies that integrate smoothly into clinical workflows. Otherwise, burdensome security controls
risk being bypassed or ignored by time-pressured staff. The cybersecurity doctor becomes a vital
translator between clinical and technical teams to reach the optimal balance.
For medical devices specifically, cybersecurity doctors advocate for hardware-level protections to prevent
unauthorized access even if the device’s software is compromised. This includes physical locks, tamper-
proof firmware, and authentication chips in devices like pacemakers and insulin pumps to thwart
potentially fatal remote manipulation. As a longer-term goal, they promote security standardization across
device manufacturers to ensure every product meets minimum safeguards before approval.
Through continuous monitoring of the threat landscape, cybersecurity doctors keep health organizations
apprised of emerging risks to medical apps and devices. Their proactive stance combines education and
action to adapt security strategies before threats become full-blown crises. With expertise spanning
technology and clinical environments, cybersecurity doctors provide the multilayered defense needed to
safely realize mobile health’s benefits.
2.1.3 Collaborating with developers to identify and fix vulnerabilities
As medical devices and health apps become ubiquitous, collaboration between cybersecurity experts and
software developers is essential to proactively identify and resolve vulnerabilities. Cybersecurity doctors
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can provide invaluable guidance in this capacity, leveraging their cross-disciplinary knowledge to bridge
the clinical and technical spheres.
Cybersecurity doctors should be involved in the full lifecycle of medical technology development, from
design conceptualization through post-market surveillance. During the initial planning stages, they can
advise on building comprehensive security into the architecture and code itself, rather than leaving it as
an afterthought. This “security by design” approach prevents oversights that are exponentially harder to
address once a flawed product has been implemented.
A key collaborative activity is threat modeling new medical software alongside its creators. Cybersecurity
doctors can methodically analyze each component and function of an application, anticipating ways bad
actors could compromise it. This structured process uncovers logical vulnerabilities that may be
overlooked by developers focused on core functionality. Cybersecurity doctors also provide input on
security testing plans to validate a system’s defenses.
Once medical software is ready for deployment, cybersecurity doctors assess its security posture through
simulated attacks known as penetration testing. By mimicking real-world intrusion techniques, they can
probe the app for any gaps that malicious hackers could exploit. The goal is to identify vulnerabilities and
have developers implement fixes prior to release.
For devices and software already in use, cybersecurity doctors help producers institute procedures for
ongoing patching and upgrades. They advise on monitoring digital interfaces to detect anomalies that
may indicate an attempted breach. Cybersecurity doctors additionally make manufacturers aware of any
newly discovered vulnerabilities in comparable products that should be proactively assessed.
Strong communication channels between cybersecurity doctors and technology vendors are critical for
rapid response when zero-day exploits emerge. Cybersecurity doctors can confirm if a newfound medical
device flaw applies to a manufacturer’s specific products. If the vulnerability is present, they swiftly notify
the company so its developers can release a patch before the weakness is maliciously leveraged.
At cybersecurity conferences, doctors have opportunities to directly collaborate with medical device
makers and health app developers on hardening their products. The free exchange of insights between
clinical experts and technical teams leads to better threat awareness and mitigation on both sides.
Regulatory bodies are also recognizing the need to loop cybersecurity doctors into the oversight process
for connected medical technologies. The FDA has signaled plans to consult cybersecurity professionals
when reviewing new device safety. Their input helps balance product security against patient need,
allowing truly life-saving innovation to proceed with appropriate safeguards.
As the bridge between clinical care and software engineering, cybersecurity doctors provide the cross-
disciplinary perspective necessary to make medical technology safe and effective. By collaborating
directly with developers, they institute security best practices at each stage of the product lifecycle.
2.1.4 Monitoring and responding to cyber threats
With medical devices and patient health data increasingly interconnected, vigilant monitoring for cyber
threats by specialized professionals is essential. Cybersecurity doctors will be at the forefront of threat
detection and rapid response in healthcare organizations to contain impacts and restore safe operations.
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Around-the-clock network monitoring is a core duty of a cybersecurity doctor. This involves deploying
intrusion detection sensors across medical systems to identify anomalous activity that may signal a
breach attempt. AI algorithms can supplement monitoring by learning normal usage patterns and alerting
to deviations that could indicate an attack. However, human oversight is still critical, as cybersecurity
doctors have the discernment to validate and investigate alerts.
For implantable devices specifically, cybersecurity doctors monitor wireless interfaces and traffic for any
unauthorized scanning or connection efforts. Any anomaly could signify an external party trying to access
and alter a patient’s implanted insulin pump, pacemaker or other critical device. Early warning allows
cybersecurity doctors to take steps to keep devices secure before a serious incident occurs.
Threat intelligence gathering is another responsibility essential for timely detection of emerging hazards.
Cybersecurity doctors should subscribe to information sharing platforms that aggregate warnings on new
attack vectors and device vulnerabilities circulating globally. They can then aggressively search medical
networks for indicators of similar threats that may have infiltrated silently.
When a cyberattack on medical systems is detected, cybersecurity doctors jump into response mode. They
coordinate with clinical teams to determine the attack’s scope and severity. For data breaches, they
identify affected records and types of information compromised to promptly notify patients and activate
response protocols. For device compromises, doctors disable wireless access and investigate the extent of
alteration.
Throughout the response, cybersecurity doctors prioritize restoring any disrupted medical services and
ensuring patient safety above all else. This may involve quarantining affected systems until security
patches or filters can be implemented. For implanted devices at risk, cybersecurity doctors work closely
with physicians and manufacturers on solutions, which could require surgically replacing compromised
equipment.
In parallel to hands-on response, cybersecurity doctors oversee communication and documentation of
the incident. They draft guidance to help clinical staff identify any related anomalous behaviors in devices
or patients under their care. Cybersecurity doctors also liaise with hospital leadership and public relations
to provide accurate cyberattack technical details and updates.
Post-incident, cybersecurity doctors lead forensic analysis of exactly how the breach or compromise
occurred in order to rapidly apply fixes across the organization. They correlate incident data with threat
intelligence to head off related vulnerabilities. The event is also used to refine policies, monitoring controls,
and staff training to improve readiness prior to the next attack.
With healthcare now on the frontlines of cyber warfare, specialized experts like cybersecurity doctors,
serving as 24/7 cyber threat monitoring and response cells, are indispensable. As medical technology
advances so too must institutional vigilance and defenses against those looking to wreak havoc through
healthcare systems. Cybersecurity doctors will be the linchpin safeguarding both patient wellbeing and
privacy.
2.2 Importance of Creating this New Specialty
As healthcare increasingly adopts connected technologies like internet-enabled medical devices, apps,
and electronic health records, the life-threatening risks posed by cyber vulnerabilities have become clear.
However, the traditional medical field lacks professionals dually trained in both patient care and
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cybersecurity. The emerging specialty of the cybersecurity doctor is intended to fill this dangerous gap at
the intersection of medicine and data protection. Instituting this new expert role and training pathway has
profound importance for healthcare’s future. Currently, frontline healthcare workers often lack awareness
of cyber hygiene best practices. A 2022 survey found 56% of nurses reported receiving no cybersecurity
training whatsoever from their employer. Without basic precautions, staff habitually introduce
vulnerabilities that hackers can exploit to infiltrate healthcare networks. The cybersecurity doctor’s in-depth
training allows them to educate caregivers on securing systems, identifying threats, and upholding data
privacy. Their leadership uplifts preparedness hospital-wide.
For healthcare administrators overseeing complex IT ecosystems, the scale of legacy technology and rapid
digital change makes cyber protections daunting. A dedicated cybersecurity doctor serves as their
strategic advisor and a resource for the rest of the C-suite. Conducting risk assessments, enacting policies,
selecting secure technologies, and contingency planning are all responsibilities of this new role being
created. As emerging disciplines, both medicine and cybersecurity are rapidly evolving. But siloed within
their own fields, breakthroughs are not translating between them. The cybersecurity doctor role exchanges
knowledge across specialties through multidisciplinary education and collaboration. They instill cyber
awareness during medical training and reciprocally provide medical insights to technologists. This cross-
pollination is desperately needed to secure healthcare innovation.
With lives directly at risk from potential device hacks or data theft, healthcare requires specially trained
cybersecurity leadership at a higher level than typical IT or technology staff. Cybersecurity doctors possess
patient care expertise beyond purely technical cybersecurity analysts. This enables them to evaluate risks
holistically and be equal partners with physicians on clinical decisions involving connected technologies.
Standardizing the cybersecurity doctor role creates a clear career pathway for those interested in this
cutting-edge specialty. Academic programs are emerging offering combined cybersecurity and medical
training to produce exactly the hybrid expertise healthcare organizations need. Students hear a calling to
serve patients through technology and data protections have a home in this new field. At the healthcare
policy level, the designation of cybersecurity doctor gives regulators and industry groups a specific
profession to consult on strengthening protections. Standards groups can write cybersecurity guidelines
tailored for this specialty’s duties. And government health agencies have seasoned experts to inform their
cyber policies and oversight. With healthcare understaffed and overwhelmed by the volume of cyber
threats, devoting resources to nurture the cybersecurity doctor specialty is imperative. Their specialized
skills, bridging clinical environments and data systems, are indispensable as technology transforms patient
care. Creating this role is an investment in the safety and trust of all who rely on healthcare.
3. EDUCATING THE NEXT GENERATION
3.1 Introduction of Cybersecurity Medicine Programs at Universities
As healthcare grapples with escalating cyber threats, universities are mobilizing to meet the need for
security-focused medical professionals through pioneering cybersecurity medicine programs. Blending
computer science and healthcare curriculums, these emerging degree tracks are training the first
generation of cybersecurity doctors and medical technologists. Their cross-disciplinary education equips
graduates to protect patient safety and data in increasingly networked health environments.
One of the first undergraduate cybersecurity medicine initiatives launched at the University of Rhode Island.
Recognizing the vulnerability of connected medical devices, the program combines courses in networks,
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programming, data privacy, and healthcare systems. Students gain hands-on cybersecurity experience
through analyzing medical device vulnerabilities in the university’s cyber range. The curriculum was
collaboratively designed by the College of Engineering and College of Health Sciences to synthesize their
complementary expertise. In the graduate sphere, Carnegie Mellon University introduced a master’s degree
in medical cybersecurity. Alongside core computer security courses, it incorporates applied learning like
detecting anomalies in medical data that could indicate a breach. The program aims to build skills for roles
like Chief Information Security Officer at hospitals, where technical cybersecurity and clinical knowledge
are required. Graduates are also prepared for consulting positions securing electronic health records
systems and medical device software.
The Mayo Clinic has similarly launched an advanced studies program in healthcare security, aiming to
groom healthcare technology leaders versed in both patient care and data protection. Enrollees already
working in healthcare can complete the part-time program remotely while remaining in their current roles.
This nurtures precisely the professional hybridization needed to drive cultural change around cybersecurity
in clinical environments. In partnering with medical schools, existing cybersecurity programs are adapting
joint concentrations for students pursuing clinical degrees like the MD. For example, New York University
offers a cybersecurity specialization track within its medical school curriculum. Students undertake core
computer security courses and complete healthcare-related projects applying security concepts. This
allows aspiring physicians to enter practice equipped to evaluate and strengthen cyber defenses around
patient care technologies.
To maximize reach, some programs are offered in flexible online formats with modules integrating
cybersecurity and healthcare topics. This accessibility opens the field to current medical professionals
seeking to build cyber readiness and make career shifts into healthcare security leadership roles.
Cybersecurity certifications are also growing more tailored for the medical domain, assessing
competencies like secure electronic health records management and medical device risk evaluation.
Obtaining niche certifications enables clinicians to validate expertise that elevates cyber maturity across
health systems. Propelling these academic initiatives are multisector partnerships between technology
leaders, medical centers, government agencies, and cybersecurity organizations. Their combined
perspectives and resources ensure emerging cybersecurity medicine programs align with healthcare’s
most urgent digital challenges. This thoughtful foundation will empower graduates to meet needs in
securing patient safety and trust.
3.2 Multidisciplinary Curriculum Covering Both Medical and Cybersecurity Topics
Bridging the knowledge gaps between clinical medicine and cybersecurity is imperative to prepare the
next generation of healthcare professionals that can protect patient wellbeing in increasingly networked
care environments. Cybersecurity medicine academic programs aim to achieve this through innovative
multidisciplinary curriculums fusing together subjects from the two spheres. By organically integrating
medical and technical coursework, students build robust understanding of healthcare delivery and data
systems along with skills to secure them against emerging threats.
Foundational classes in cybersecurity medicine cover core computer science and programming, including
operating systems, networks, and databases. Crucially, projects and examples used in these courses
feature medical contexts to illuminate how fundamental concepts apply. For instance, students may code
healthcare data classification algorithms or simulate medical device communications.
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Introductory medical courses focus on topics like health systems operations, clinical workflows, medical
terminology, and basics of common devices and technologies utilized in care settings. This grounding helps
students appreciate challenges clinicians face and the sensitive nature of patient medical data that cyber
protections aim to safeguard. Specialized courses allow students to synthesize their developing medical
and technical knowledge. In Medical Device Security, students assess real commercial devices for
vulnerabilities, while contemplating associated patient safety risks. Other tailored courses cover securing
electronic health records, clinical decision support systems, mobile health apps, and emerging
technologies like IoT sensors and telemedicine platforms.
Multidisciplinary capstone projects bring together cumulative learning across subjects in an applied
setting. Groups may be tasked with performing penetration testing on a medical simulation system,
designing a secure healthcare network architecture, or formulating an organizational cyber response plan.
These complex assignments mirror the blend of skills demanded in healthcare cybersecurity roles. Some
programs immerse students directly in clinical environments, such as assignments shadowing IT staff at
hospitals or clinics to observe cybersecurity practices firsthand. Insights gained from professionals in the
field highlight practical considerations beyond textbook concepts.
To foster exchange between disciplines, cybersecurity medicine programs often integrate computer
science and health sciences faculty. Both teach core courses tailored to their specialization, while co-
developing blended curriculum to unify participant perspectives. Programs also enlist guest lecturers from
healthcare providers, medical device manufacturers, regulators, and other stakeholders to reinforce real-
world relevance. Dual degree options enabling students to concurrently pursue degrees in both
cybersecurity and healthcare disciplines are increasingly offered as well. This allows truly customized
curriculums integrating the two spheres based on learners’ interests and career goals. With lives on the
line, designing cybersecurity specifically for the healthcare context is vital. Thoughtfully blending medical
and technical curriculum within emerging cybersecurity medicine programs prepares graduates to meet
this immense responsibility at the intersection of patient care and data protection.
3.3 How These Programs Will Train Future Cybersecurity Doctors
The pioneers of cybersecurity medicine programs recognize that didactic courses alone are insufficient to
produce proficient cybersecurity doctors. Their curriculums leverage immersive simulations, hands-on
projects, and clinical rotations to provide contextual training that instills the judgment and experience
graduates need to thrive in healthcare's complex digital landscape.
Many programs operate cybersecurity labs or "cyber-ranges" where students can apply concepts in safe
virtual environments modeling real healthcare systems. For example, they may be tasked with scanning
for vulnerabilities in a simulated hospital network containing medical devices, servers, cloud applications
and electronic health record systems. Identifying and mitigating flaws in this mimicked ecosystem
develops critical skills in risk assessment, system hardening, monitoring, and incident response.
Through cybersecurity challenges, students are presented with hacker threats and anomalies within their
simulated healthcare organization. As the scenario evolves, they must make decisions on containing the
attack, eradicating malware, restoring services and notifying patients. This exercises the quick, precise
judgement needed during crises. Discussing missteps and optimal responses helps learners internalize
approaches for managing high-stakes healthcare cyber incidents.
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Hands-on medical device security testing teaches the nitty-gritty of identifying and responsibly disclosing
technology vulnerabilities. Students pentest devices like infusion pumps, wearables and connected
imaging tools using tactics from network sniffing to reverse engineering. Immersing in adversarial thinking
grows intuition on where clinical environments are most susceptible to compromise by bad actors.
Rotations shadowing IT security analysts at actual healthcare facilities provide invaluable observations of
challenges and considerations. Students witness issues like legacy system constraints, tight budgets, and
the need to balance usability, productivity and security for clinicians. The human and institutional factors
at play in real healthcare cybersecurity decision-making become tangible. Some programs facilitate
students pursuing cybersecurity certifications, like CompTIA Healthcare IT Technician and ISC2 Healthcare
Cybersecurity, that validate IT and data security skills tailored for clinical environments. Pursuing niche
credentials exhibits dedication to apply learned cyber-medical knowledge.
Through collaborative course projects, future cybersecurity doctors and healthcare technologists work
together. Mirroring the real-world need for alignment between security and clinical teams, these joint
assignments build mutual understanding of the two spheres. Shared vocabulary and appreciation for
diverse perspectives emerges. Assignments also look beyond technology to test communication,
leadership and other essential soft skills. Students may draft educational materials on medical cyber
hygiene for patients and caregivers. They formulate advice for hospital leadership on threat prevention
and securing funding for initiatives. These exercises sharpen abilities to relay cybersecurity’s importance
across healthcare roles.
Finally, an immersive clinical rotation, collaborating on risk assessments and incident response plans
alongside hospital IT and security staff, reinforces practical integration of learning. This test run for serving
as future healthcare organization cybersecurity leaders is invaluable preparation. With human lives riding
on decisions they'll make, cybersecurity medicine programs aim to graduate doctors and technologists
who are not just knowledgeable but truly work-ready. Blending theory with simulations, projects and on-
site learning cultivates the judgement, technical expertise and leadership required in this emerging
specialty safeguarding healthcare’s digital transformation.
4. SECURE MEDICAL APP DEVELOPMENT
4.1 Best Practices for Developers Creating Apps for Medical Devices
The integration of mobile apps with medical devices like glucose monitors, pacemakers and EEGs has
enormous potential to improve patient care and outcomes. However, without proper security built in, these
apps pose significant risks, as a flawed app could allow malicious actors access to modify device functions
or steal sensitive health data. That is why following cybersecurity best practices during medical app
development is so crucial. Threat modeling should be conducted early when planning a medical app to
analyze the types of vulnerabilities that could arise within the app, device, network communications and
associated cloud components. Identifying potential weaknesses in the conceptual phase allows preventive
measures to be incorporated into the foundational design.
Developers should conduct a privacy impact assessment to minimize the PHI collected and transmitted by
the medical app, only gathering essential data. Transmitted data should be encrypted end-to-end using
approved standards like AES-256 to prevent interception by unauthorized parties. Medical apps and
associated device firmware should be developed using secure coding practices like input validation,
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sanitization and fuzz testing that expose flaws in how the software handles anomalous or malicious data.
Adhering to secure coding guidelines specific to the programming language prevents common oversights.
Access controls within the app are needed to restrict access to device functionality and patient data only
to properly authenticated users. This includes password protection, two-factor or biometric authentication,
and role-based permission levels for app features. Device access permissions should be revocable by
patients at any time within the app. Updates and patches need to be expediently provided when new
vulnerabilities are uncovered in the app or medical device’s software. Automated monitoring should scan
for any anomalous app behavior that could signal issues. Apps should also have functionality to remotely
logout users in case of detected compromise.
Developers should ensure the app properly interfaces with the medical device by validating all inputs and
outputs to prevent unauthorized commands being executed. The app should have configurable safety
constraints on device settings to catch potentially harmful changes. Extensive functionality, reliability and
cybersecurity testing must be conducted on medical apps and associated firmware updates before
deployment to end-users. Pentesting should be performed to probe the app for vulnerabilities in its
frontend, backend APIs and device connectivity.
Cloud services linked to medical apps likewise require hardened configurations and layered defenses
against DDoS attacks or other threats that could cause service outages. Recovery plans need to provide
for failover data centers and backups to avoid health-threatening disruptions. Transparency and training
are essential for users to employ medical apps securely. Details of encryption, access controls and other
protections should be provided alongside clear guidelines for secure use and cyber hygiene. By
intentionally incorporating security throughout the software development lifecycle, adhering to app
cybersecurity best practices, and validating with rigorous testing, medical app creators can fulfill their
ethical obligation to deliver products safe enough for this highly sensitive use case.
4.2 Encryption, Authentication, Secure Coding Principles
Medical mobile applications handle highly sensitive patient health data like vital signs, lab results, medical
history and real-time telemetry from connected devices. Robust security protections for these apps are
imperative to safeguard patient privacy and prevent potentially dangerous manipulation. Three
foundational security techniques—encryption, authentication, and secure coding principles—should be
baked into every medical app from the start.
Encryption protects sensitive data in transit and at rest by encoding it so that only authorized parties can
interpret the information. Medical apps should implement end-to-end encryption using industry standards
like AES-256 for all data transmission channels. Server databases storing app data should be encrypted,
as well as local storage on user devices. Proper key management procedures must be instituted to secure
the encryption keys themselves against compromise.
Multi-factor authentication should be required for users accessing medical apps to verify their identity.
Beyond just usernames and passwords, an extra authentication factor like biometrics, security keys, or one-
time verification codes helps validate access attempts. Role-based access controls then restrict
authenticated users’ app permissions to only necessary functions based on their role. Together, these
measures prevent unauthorized parties from illicitly accessing app functions or data.
Adhering to secure coding principles when developing medical apps significantly reduces vulnerabilities
open to exploitation. Input validation techniques should be used to sanitize and verify any data entered
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into the app, preventing injection of malicious scripts or commands. Proper handling of errors and
exceptions helps avoid leakage of sensitive technical details. Code reviews and testing tools like static
analysis identify common security bugs before the app is deployed. For the transmission of data within the
app and to/from backend servers, secure communications protocols like Transport Layer Security (TLS)
encrypt connections and validate server identity to prevent man-in-the-middle attacks. Only TLS version
1.2 or higher should be permitted, using the most secure cipher suites available.
Access control policies enforced in the app codebase restrict access to sensitive data processing functions
and API routes only to authorized administrative or medical personnel. Role-based permissions levels
prevent exposure of functions to all app users. To secure underlying app runtime environments, all third-
party libraries, dependencies, operating systems, and firmware should be kept up-to-date with the latest
patches. Commonly exploited components then have reduced vulnerabilities to be targeted.
Throughout development, dynamic application security testing actively probes the medical app for any
vulnerabilities in its codebase or backend connections. Identified weaknesses can then be remediated to
strengthen defenses prior to deployment. Following secure software development practices, medical app
creators can minimize risks to patient privacy and safety. Defense-in-depth with encryption, rigorous
authentication, and secure coding principles help fulfill developers’ ethical obligations when handling such
sensitive data.
4.3 Importance of Patching and Updates
The connectivity and complexity of medical mobile applications make them prime targets for cyber threats
constantly evolving to exploit new vulnerabilities. Keeping medical apps updated through regular software
patching and version upgrades is essential to stay ahead of these shifting risks. However, many healthcare
organizations neglect this critical process, exposing patients to preventable privacy breaches or possible
device hacking. Statistics show that unpatched software vulnerabilities are involved in over 90% of
successful data breaches across industries. In healthcare, this includes exploits of flaws in medical mobile
apps, servers, APIs and device operating systems. Timely patching blocks most common attack vectors
that allow unauthorized data access or system control.
For example, the 2021 Proxy Shell vulnerabilities in Microsoft Exchange servers impacted many healthcare
entities until patched. Attackers who exploited the flaws prior to patching gained access to protected
health information. Quick application of Microsoft’s fixes would have prevented breach incidents. Patching
medical apps ensures the codebase inherits fixes for newly discovered vulnerabilities in dependencies,
libraries, frameworks and components it relies on. If a severe weakness is found in an embedded third-
party library, the app remains vulnerable until updated with the patched library version. Apps depending
on aged, unmaintained libraries pose massive risks.
Upgrading to entirely new app versions also allows large-scale software architecture improvements not
possible through patching alone. For instance, incorporating refined authentication workflows,
restructuring how sensitive data is handled, and adopting new encrypted communication standards. Major
revisions should focus both on new features as well as under-the-hood security overhauls. Healthcare
organizations often overlook their duty to maintain the medical apps they develop or procure for patients
and personnel. Budget limitations, procedural burdens, and lack of security awareness result in long delays
in deploying critical updates. Clear policies must make medical app patching as high a priority as for other
clinical systems due to the acute risks.
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For apps linked to wearables or implantable devices, compromised security directly endangers patient
health. Flaws could permit changing device settings or dosage amounts. Physicians relying on inaccurate
data from apps also risk improper treatment decisions without timely fixes. Developers of medical apps
have an ethical obligation to promptly address vulnerabilities in their products when discovered and
transparently notify users and healthcare providers of needed updates. Fostering a culture of faster
security patching across the healthcare ecosystem is imperative as medical apps proliferate. Up-to-date
medical apps strengthen institutional security postures and demonstrate commitment to protecting
patient safety. However, neglecting vigilant patching leaves known flaws open for exploitation. Ongoing
updates are the bedrock for securing healthcare’s growing mobile app ecosystem.
5. THE FUTURE OF CYBERSECURITY IN THE MEDICAL PROFESSION
5.1 Employment Prospects for the Next Generation of Doctors
As healthcare continues adopting connected technologies and amassing sensitive patient data, demand
for doctors specializing in cybersecurity will surge. The pioneers of this emerging field will be sought after
to secure medical systems and safeguard patient wellbeing in the digital age. With acute need across
healthcare settings, the future employment outlook for cybersecurity doctors is highly promising. Health
systems will seek to hire or consult cybersecurity doctors for newly created leadership roles managing
enterprise-wide security. As Chief Information Security Officers and Heads of Clinical Information Security,
they will oversee policies, awareness education, threat monitoring, and incident response. Cybersecurity
doctors’ cross-disciplinary vantage point will be invaluable for bridging divides between clinical, privacy,
compliance and technical teams.
Major hospitals and health systems are establishing dedicated cybersecurity departments requiring
physician oversight. Cybersecurity doctors will be recruited to develop security roadmaps, liaise with
regulators, and advise administrators on balancing safety with efficiency in technology deployments. Their
input will shape institutional cybersecurity from the board room to the bedside. Clinics and private
practices must also boost cyber defenses, opening doors for cybersecurity doctors. They can perform risk
assessments of electronic health record systems, WiFi-enabled medical devices, and web portals.
Cybersecurity doctors can further guide small healthcare entities on plans and training to satisfy growing
cyber insurance requirements.
As healthcare embraces telehealth, opportunities will grow for cybersecurity doctors focusing on virtual
care platforms and devices. They will apply clinical insights to strengthen remote patient monitoring, care
coordination apps, and video visit workflows. Cyber expertise tailored for telehealth's unique risks is critical
to fulfill its healthcare promises. At the healthcare technology vendor level, employment of cybersecurity-
focused medical professionals will be in high demand. Cybersecurity doctors will help assess products for
vulnerabilities early in development and advocate for security by design. Their qualified perspectives will
inform medical device approvals and standards development.
Regulatory bodies like the FDA are recruiting cybersecurity doctors to support policymaking and
enforcement around connected medical technologies and patient data. Their input helps balance
innovation, clinical needs, and appropriate safeguards given evolving risks. Public health service is another
avenue to apply expertise. With threats looming, the healthcare cybersecurity job market is ripe for those
cross-trained at this novel intersection of medicine and technology. Passionate to protect patients in
increasingly digitized care, cybersecurity doctors will find fulfilling roles securing our data-driven
healthcare future.
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6. CONCLUSION
6.1 Summary of Key Points
As medical devices, health data systems, and patient care tools become integrated with connectivity, the
cybersecurity risks to healthcare organizations and patient wellbeing grow exponentially. However, the
traditional medical field is underprepared to address the sophisticated threats introduced by new
technologies. There is an urgent need for cross-trained cybersecurity doctors who combine clinical
knowledge with data protection expertise to lead healthcare's digital transformation securely. Several
concerning trends highlight the increasing cyber vulnerabilities in the healthcare sphere. Medical devices
like pacemakers and insulin pumps now contain security flaws that could allow life-threatening hacking if
exploited. Breaches of healthcare records are surging as data becomes highly valuable to cybercriminals
on the black market. Most healthcare providers lack staff dedicated to cybersecurity or even basic training
for personnel on threats.
Meanwhile, patients are eager to adopt consumer wearable devices, telemedicine platforms, and mobile
health apps that improve access and convenience but also expose more attack surfaces. Medical
professionals require discernment to determine which technologies can be safely integrated into clinical
services versus those carrying intolerable cyber risks. Bridging these gaps requires establishing
cybersecurity medicine as a specialized healthcare profession. Formal training programs at universities
are emerging to build integrated curriculum covering both medical courses and technical cybersecurity
skills. Graduates will be prepared to serve as Cybersecurity Doctors, leading healthcare organizations' data
protection and fulfilling specialized responsibilities.
These include directing enterprise security strategy, conducting risk assessments on new technologies,
training staff on cyber hygiene, monitoring networks for threats, responding to incidents, advising product
developers on medical device security, informing health policies and regulations, and educating patients
on protecting their data. With vigilance and expertise from cybersecurity doctors, the lifesaving benefits of
connected medicine can be harnessed while keeping systems secure and maintaining public trust.
Securing healthcare innovation against intensifying cyber threats is imperative as medical care becomes
increasingly digitized. Specialized cybersecurity doctors, combining clinical and technical proficiency, are
essential to guide hospitals, device manufacturers, and health systems safely into the future. Their
emergence will close a critical gap and ensure patient wellbeing remains the top priority as care
transforms. With dedication and foresight, we can build a healthcare ecosystem where groundbreaking
technology and data accessibility enhance patient outcomes without sacrificing privacy or safety.
6.2 The Vital Role Cybersecurity Doctors Will Play in Protecting Patient Health Data
As healthcare embraces digitization, from electronic medical records to internet-connected devices, an
immense amount of highly sensitive patient data is increasingly at risk. Cyberattacks on hospitals, insurers,
and other healthcare organizations are surging, motivated by the wealth of personal and medical
information concentrated in these entities. However, the traditional medical field lacks professionals with
cross-training in both clinical expertise and cybersecurity skills to comprehensively safeguard data. This is
where the emerging role of the cybersecurity doctor will prove vital. Cybersecurity doctors possess a truly
multidisciplinary background combining patient care knowledge with data protection tradecraft. This
enables them to bridge the gap between healthcare providers focused on delivery and technical teams
concerned with bits and bytes. As translators between these spheres, cybersecurity doctors will be perfectly
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positioned to assess risks and implement solutions that balance security, clinical needs, and patient
experience.
At the enterprise level, cybersecurity doctors can advise healthcare organizations on best practices for
access controls, network segmentation, endpoint security, and other mechanisms to keep sensitive
systems and data safe. They can tailor recommendations to clinical workflows rather than taking a generic
cybersecurity approach. Most importantly, cybersecurity doctors will get decision-makers to appreciate
privacy and security as foundational to care quality, not just technical hurdles. Cybersecurity doctors can
further strengthen data protections by leading the charge on training clinicians and staff in proper cyber
hygiene. Through continuing education and drills, a culture of vigilance against threats like phishing and
social engineering can take hold across healthcare organizations. Cybersecurity awareness rooted in
patient care values will click with frontline providers in a way generic corporate security training cannot.
For new health IT systems and medical devices, cybersecurity doctors will provide qualified guidance on
data security design requirements. They understand regulators like HHS and FDA are increasingly
concerned with privacy, and can insist vendors meet essential standards before systems ever touch
patient data. The specialized perspective of cybersecurity doctors is key to ensure patient wellbeing
through secure technology. When healthcare data breaches do occur, cybersecurity doctors have the
expertise to contain impacts and liaise with parties like HIPAA regulators and law enforcement. Their
technical knowledge and patient care insights facilitate accurate incident reporting and advising affected
individuals on protective measures. Cybersecurity doctors further strengthen defenses against similar
threats in the future. With lives directly impacted by the cyber protection of health data, having dedicated
professionals like cybersecurity doctors with robust medical and technical skills is increasingly essential.
Their vital bridging role will allow healthcare providers to focus on patients while ensuring data and systems
enabling care are locked down tight. Cybersecurity doctors will prove healthcare’s trustworthy data
stewards in the digital age.
6.3 A Look Ahead at the Future of This Emerging Field
As healthcare has embraced connected technologies and digitization over the past decade, the critical
need for cybersecurity expertise tailored to clinical environments has become abundantly clear. Looking
ahead, cybersecurity medicine will continue developing as a distinct healthcare profession, playing an
ever-increasing role in safeguarding patient care in our data-driven medical era. The pioneers of
cybersecurity medicine programs at universities today are only the first wave. More multidisciplinary
degree offerings combining medicine and cybersecurity will emerge to meet demand, tuned to address
healthcare’s unique environments and challenges. As graduates enter the field, they will expand the scope
and influence of cybersecurity medicine across healthcare.
For existing healthcare workers, especially physicians, accessibility to cybersecurity medicine training will
grow. Continuing education programs, certifications, and fellowships focused on the field will enable
current clinicians to pivot into hybrid roles. Their medical knowledge combined with new cyber skills will
bring profound value to healthcare institutions. Insights from early converts will refine training pathways for
others making the crossover. As more cybersecurity doctors join healthcare’s ranks, they will steadily be
integrated into organizational leadership, product design processes, and regulatory oversight bodies. With
their input, considerations around privacy, ethics and security will gain prominence in technology
deployments and data policies. Implementing their counsel will strengthen institutional defenses and
awareness.
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Academic research will elucidate core competencies and best practices for this nascent field. Consensus
guidelines will coalesce around education models, technological frameworks, regulatory needs, and
professional roles. Outcomes research will quantify cybersecurity medicine’s impacts on organizational
risk, patient safety, public perception, and healthcare costs. These insights will advance formalization of the
specialty. With demonstrated value, dedicated funding streams are likely to flow toward cybersecurity
medicine initiatives, both public and private. More healthcare venture capital will target startups
developing security-focused tools for the sector. And government grants will stimulate programs nurturing
this workforce to address critical infrastructure needs.
Patient demand may also drive adoption, as healthcare consumers increasingly seek assurances their
providers have cybersecurity expertise integrated throughout their care. Organizations promoting their
cyber maturity and teams will instill confidence. In the digital age, the possibilities of healthcare technology
are boundless. But so too are the risks as systems become interconnected. Cybersecurity medicine offers
a path to proactively build security into healthcare’s foundational frameworks. By safeguarding medical
advancement through multi-disciplinary insights, this emerging specialty will help realize technology’s
benefits without sacrificing privacy or safety.
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