Newfoundland continues to describe the crippling of the province’s IT healthcare system as a cyberattack, saying digital systems are being slowly brought back online but giving no timeline on when medical service will be completely back to normal.
During a press conference Friday afternoon the government said it’s important to make sure all evidence of malware has been erased before bringing IT systems back online.
For the time being, many of the province’s hospitals can still only offer urgent or emergency care, although chemotherapy treatments are slowly returning.
Asked if any data has been breached, Premier Andrew Furey said that is still being investigated.
Remediation of IT systems may take days, said Health Minister John Haggie. Asked if that means it won’t take weeks, he replied, “It means the next steps will take days. We may need to step forward and then take things offline again. We really don’t know how long this will take until it’s over. There’s always the possibility, despite the due diligence of Pat (Hepditch, vice-president of solutions and infrastructure at the provincial Centre for Health Information) and his excellent team and the support they’ve had from their experts, that there may be something lurking in the corner of a machine somewhere and may make itself manifest over time. We’ve seen that in other jurisdictions. So we have to be prepared to take the time, take the steps in a prudent way and be prepared to do it slowly and right rather than rush it.”
Meanwhile officials are talking to anyone with expertise in healthcare attacks, including experts from Ireland, which was hit by a devastating ransomware attack earlier this year, and Saskatchewan’s eHealth system.
Much of the burden of restoring Newfoundland’s IT system is falling on the shoulders of Hepditch. “Our technical teams continue to work with the RHAs (regional health authorities) throughout the last six days to restore our health information systems. Everyone wants that to happen as quickly as possible, but it’s equally important to do it cautiously to ensure that we restore things safely. As we continue to bring systems back online, it will have to happen step by step. Each system has to be carefully reviewed and cleaned to ensure there is no evidence of the attack … To do this as safely as possible there may be times when systems that have come up have to be taken down again.”
IT teams are working as fast as possible, he said, “but we fully expect there will be bumps in the road”
The restoration is fluid, he added, with things sometimes changing every hour.
Priority for bringing back the hundreds of healthcare applications online is being given to those linked to urgent patient care, he added. For example, applications related to cancer care and chemotherapy have a high priority.
“As we restore systems some [patient] records may not be fully available,” he said. “Teams are working with the RHAs to backfill information.”
Premier Andrew Furey called the attack “extremely troubling” and said the interruption of medical service for thousands of people is “unacceptable” He called healthcare workers “superheroes” for having to go through this crisis as well as COVID-19.
However, he refused to give any details about the attack for security reasons. CBC News has cited sources that say the incident is a ransomware attack. When a reporter said the attacker knows they are behind the incident, Furey said the government has been told “any further public discourse could inflame the situation and jeopardize the security of the system.”
The hardest-hit health authorities are the Eastern and Central regions, which need restoration of the Meditech system that logs new hospital patients, any tests they need and notes by clinicians.
David Diamond, CEO of the Eastern region, which includes the provincial capital of St. John’s, said hospitals will only be able to offer emergency surgery and urgent care into Monday. “Our systems are slowly returning,” he said, noting chemotherapy treatments began again on Thursday. “We do have some core IT functionality (with Meditech), but it’s not everything we need to open our services fully.”
Hospital staff has been told to look at restoring out-patient care and appointments for care that doesn’t require IT support. Where possible people will be phoned about new appointments.
In the Labrador-Grenfell Health Region blood collection, medical tests and breast cancer screening appointments have been postponed in certain clinics. However, dialysis treatments at two health centres continue, as do mental health and addiction counselling, flu and COVID-19 vaccination clinics and service for expectant mothers.
In the Western Health Region, the Meditech information software is being gradually restored. Chemotherapy appointments at Western Memorial hospital are proceeding, but at reduced capacity. However, only urgent appointments will proceed for surgery, blood collection, X-ray and other tests.