How 100 Romanian hospitals switched to pen and paper to defeat a national cyber-attack

Medical staff had to switch to pen and paper, improvising workarounds to protect patients while IT teams scrambled and the national cyber response centre tried to find out how the hackers had got in - and how they could stop them.Their actions over four days from 10 February 2024, and those of the doctors and nurses, have been widely praised.How they reacted and how they coped has become a test case for disaster planners internationally, as officials look for advice on responding to a mass hospital hack.As head of Romania's Cyber-Security Directorate Dan Cimpean (L) was in charge of co-ordinating the crisis responseSurgeon Oana Goidescu was on shift at Buzău Hospital, 120km (75 miles) north-east of Bucharest, when the alert came that attackers had breached Bucharest-based software firm RSC, burrowing into a widely used medical system called Hippocrates."It was quite an unpleasant experience, because an IT record is not just a list of patients," she said. "For each patient, we request lab tests, radiology, medicines and supplies. All of that was gone."Hippocrates is used by doctors, nurses and surgeons to manage everything from admissions to payroll, pharmacy logistics and test results.Quietly, the cyber-attackers had begun infecting hospitals across the country that used the system with a ransomware strain called BackMyData. Files were being scrambled into gibberish and the demand was a ransom in bitcoin.