Ransome Wire Attack POC

My hospital had a 14 day downtime due to a cyber event. Point of care was really complicated for us because the downtime wristbands did not have barcodes for staff to scan. Since the devices still were trying to query the LIS, every manual ID entry would give an error "patient not on file" and require the ID to be entered a second time to proceed with testing. Downtime fatigue set in quickly and people cut corners by using the emergency patient ID - this is a number used if a patient requires emergent testing before they have been assigned an account., which made us unable to reconcile these results in RALS to cross over to LIS. Another complication was the downtime account number assigned to some patients during their stay had to be merged with a new number due to registration issues, again making it hard to reconcile in RALS. All results were documented in the paper chart and scanned into the EHR when we were live. Since the majority of the point of care testing done was on inpatients, the billing was part of the DRG. Any other charges unable to be reconciled can be submitted as a loss through the hospitals insurance claim for the cyberattack. When coming up with a plan it is important to understand what barriers end users will experience when the devices are not connected, like our issue with entering the patient ID twice, and how to make the use as convenient as possible because there will be so many manual processes slowing down the end users. For future state, I would create a paper log to be part of the patient's paper chart specific to any point of care testing. Some results were imbedded in chart notes and a log would be cleaner, making it easier for recovery. If you rely on the devices to hold the data, you should have a clear understanding of how much memory the devices have - some of our devices only kept data for 10 days.