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A tale of two districts, and of side-stepping ransomware

While health systems across much of the world were crippled by the recent WannaCry ransomware attacks, there were oases of relative calm – the New Zealand health system in general and in the UK where the National Health Service (NHS) was severely disrupted, South Tyneside NHS Foundation Trust who weathered the crisis very well. 

Good fortune plays an important part, but sometime you make your own luck. More accurately in this instance, you have good systems and innovative people – Canterbury District Health Board in New Zealand and South Tyneside have that in common. They also have HealthPathways in common and that’s how South Tyneside were was able to bridge what could have been a huge gap in communications between primary care and secondary care.

Originally developed by the Canterbury District Health Board in partnership with Christchurch-based company Streamliners, HealthPathways is a comprehensive online manual of clinical information. It enables doctors and other clinicians to make assessment, management and specialist request decisions for more than 900 health conditions through best practice and evidence-based “pathways”. Importantly too, HealthPathways supports more equitable access to care by making sure clinicians use the same criteria and can apply them consistently.

So what do you do when you can’t trust email and you are concerned hospital-based systems might be compromised? You look for other ways to exchange information so you can continue to provide that vital first point of contact for the community through general practice, no matter what.

Mark Girvan, Manager - Service Planning and Reform for North of England Commissioning Support says that the cyber-attack impacted many of the NHS systems.

“We made the decision to disconnect our general practices from our usual NHS network to prevent the ransomware from spreading. With the NHS communication systems down and great round-the-clock support from the HealthPathways team in Canterbury we were able to maintain a vital connection with our practices, hospital and community providers.

“HealthPathways worked exceptionally well with high usage of the site throughout Monday and Tuesday, despite limited access to the Internet within primary care. It’s great to be part of the international HealthPathways community.”

Carolyn Gullery, General Manager Planning and Funding for Canterbury District Health Board says HealthPathways was designed in such a way as to allow for an ongoing process of refinement and review. New pathways are being developed and shared all the time, including a ground-breaking new set of Hospital HealthPathways in Canterbury designed for use in acute care settings.

“Over 35 versions of HealthPathways are being implemented throughout Australia and New Zealand, with one in the UK so far. More than 50 primary care and hospital care organisations have formed partnerships to jointly localise HealthPathways. In August last year, the first 80 localised pathways were launched in South Tyneside and, as their recent performance shows, it has helped change the way they approach a problem and work through or around it.

“In the process, the HealthPathways community has developed into a tremendously powerful clinical alliance, with clinicians able to share their knowledge, processes, pathways and infrastructure yet – importantly – retaining a sense of ownership at a local level,” Ms Gullery says.

“It is testimony to the flexibility of HealthPathways as a tool and a tribute to the Canterbury-based Streamliners team that South Tyneside were able to use it to ensure clinicians were kept up-to-date about how they were responding to the cyber-attacks in real time, while bridging the communication gap when normal communication channels weren’t available.

“Throughout, HealthPathways was also able to carry out its primary function, which is acting as a superb clinical resource.”

Credit: Mick O’Donnell, Communications Team Leader, Canterbury and West Coast District Health Boards, New Zealand.