Israeli Disaster Conference Focuses on Cyberattacks, Other Dangers

In recent decades the Israeli government and its emergency organizations recognized the need to cope with mass-casualty events and acquired the relevant experience to confront those both natural and manmade. However, the stabbing and car-ramming attacks that started in the fall of 2015 were not one of the main scenarios for which the country’s complex emergency management system had been prepared.

Israel has since made significant progress in preparing for these attacks and others, such as cyberattacks on hospitals. Comprehensive planning, intensive drilling on various scenarios, and conceptual and operational preparedness for unexpected, unfamiliar, and changing situations are at the forefront of meeting these challenges.

Every two years the Israeli Ministry of Health and Home Front Command host the Israeli International Conference on Preparedness and Response to Emergencies and Disasters (IPRED). This conference provides an opportunity for emergency professionals from around the world to share the latest findings and new experiences concerning health system readiness for disasters and emergencies of all types.

The IPRED VI conference took place at the Hilton Hotel in Tel Aviv in January 2020, with representatives from more than 35 countries in attendance.

The conference brought together professionals from multiple disciplines—including healthcare providers, government bodies, cybersecurity entities, and academic institutions—to discuss the challenges facing the medical sector and strategies for dealing with cyberattacks on medical centers and devices.

The Threat to Hospitals

Cybersecurity in hospitals has become a serious concern both in Israel and abroad. One of the panels dealt with the dangers facing hospitals and means to counter cyberattacks. The medical sector is one of the most exposed and vulnerable. Hospitals rely significantly on computerized records. In some of them information systems are obsolete and relatively difficult to maintain.

Connected medical devices are the most vulnerable assets on any hospital network. Insecure devices increase potential cyberattack surfaces and pose a major risk to patient safety and operational continuity. The main challenge hospitals face is lack of visibility; identifying the existing devices, network connection points, and the role and significance of each device is crucial.

“The healthcare industry’s accelerating adoption of sophisticated networks, connected devices, and digital records has revolutionized clinical operations and patient care but has also left modern hospitals acutely vulnerable to cyberattacks,” said Eliav Noori of the Israeli National Cyber Directorate. “Israeli hospitals are not ready for the cyberage. There are new technologies entering the field, including remote healthcare, but at a slow pace. We are trying to promote international cooperation in this field in order to gather insights that will benefit the healthcare sector in Israel.”

Noori spoke about the preparation for cyberincidents occurring during existing crises. He is a cybersecurity expert whose main experience is from the IDF, where he served in technical units and headed the Home Front Command’s information and communications technology unit. Noori now works at the Cyber Directorate and is responsible for cybersecurity in the healthcare sector.

He spoke about the emergency management system and how it can be affected by the cyberdomain. Emergency management (EM) is an essential tool in responding to emergency scenarios. Its purpose is to support all emergency procedures, manage resources and local incidents, communicate with command centers and direct resources.

“This system must comply with the appropriate standards to preserve [confidentiality, integrity, and availability],” Noori said. “Cybersecurity is vital in any emergency management system, and cyberattacks must be taken into consideration in all cases. The threats and their contribution to breakdowns in the system must be understood.”

What Threats?

The first threat is lack of system hygiene—as time passes systems become more vulnerable to weaknesses of technology and infrastructure. Updates and upgrades of software and hardware are vital. If they are not maintained on a regular basis, vulnerabilities can become targets.

Other threats include the supply chain. Every link of the chain can jeopardize the functioning of subsequent links. And last but not least is the human factor, where a lack of operational safety emphasis and safeguards can pose risks.

“There are many more threats, and they are all connected,” said Noori. “To make sure your [emergency systems] work when you need them, you have to map and define your critical processes and adjust your system to support them. The most important step is to be prepared for all scenarios.”

In preparing for disasters, a recovery plan is essential, even while working with less functionality. Routine maintenance, including backing up all files, is an important safety measure.

Lastly, use all cyberdefense systems available and make sure they are installed correctly and properly maintained.

Faster Response Times

In another panel Ido Rosenblatt, a senior official with Israel’s national emergency service, Magen David Adom (MDA), described how the organization has reduced ambulance response times.

MDA operates 169 stations across Israel, providing lifesaving medical treatment to 750,000 people annually, and is the first to respond to crisis situations, including rockets, terror attacks, natural disasters, road accidents, and more.

Emergency calls at MDA’s 101 emergency dispatch center come every 14 seconds, and dispatchers answer in less than five. A single system manages all the resources: ambulances, motorcycles, two helicopters, and 40,000 mobile devices. The country is divided into 10 regions managed by eight dispatch centers. There are no divisions between the regions, which means if an ambulance from one region crosses into another, that ambulance can be called from the other regional center.

In this way response time is reduced. As well, all ambulances are equipped with GPS, so their location is known at all times. The system has algorithms to mobilize the nearest ambulance for any reported incident. It can also assess the most relevant platform for any particular incident, whether it’s a regular ambulance, intensive care ambulance, or motorbike.

All drivers are trained on a simulator that replicates all conditions, resulting in safer, more efficient responses. This records and corrects errors in real time across scenarios specific to Israel’s roads.

Joe Charlaff is a freelance journalist based in Israel. He specializes in topics such as technology, business, and homeland security. For more see www.joecharlaff.com.