When the Tertiary Care Hospital Becomes Technologically Austere: Communication Lessons Learned from an American Health System Cyberattack

Introduction: Cyberattacks continue to plague medical systems across the world with nearly 24% of all cyber breaches impacting health systems. In Fall 2021, a large, tertiary care county hospital in Indianapolis, Indiana, USA suffered cyberattack, causing over four weeks downtime, forcing system revert paper charting and operate without electronic record (EMR) or internet. Communication Emergency Department is structured through EMR wireless local area network (WLAN) phones, communication difficulties when online are disrupted. Method: twelve months following breach, series communications-focused interviews stakeholders including residents, faculty, nurses, consultants were analyzed using thematic analysis. Results: Through interviews, key themes recommendations identified for every internet-dependent establish maintain links primary form compromised access internet limited nonexistent: Expect fail–plan ahead Develop multilayered tools that stored at different sites Notify affected teams immediately initiate downtime action plan Reassess adapt as information becomes available Conclusion: While going experience struggles during cyberattacks hospitals can benefit from improving structures established pathways no longer available. Consider cybersecurity threats your emergency planning meetings designate protect abilities downtime.