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MITRE Works to Secure Networks for Global Telemedicine Nonprofit with Royal Patronage

By Catherine Trifiletti

We’re collaborating with a United Kingdom-based humanitarian telehealth platform to protect the exchange of provider-to-provider medical information.

Picture this: An infant in a far corner of Papua New Guinea is stricken by heart failure. His parents canoe for two days to get him to a hospital. There, he is diagnosed with severe anemia requiring a blood transfusion. To arrange for the appropriate match, they must understand the cause of his blood-cell breakdown. It’s a situation requiring input from a specialist the hospital does not have. 

Enter Swinfen Telemedicine, a nonprofit platform enabling the boy’s doctors to connect with volunteer hematologists from across the world, with a simple email. This story is just one of the charity’s thousands of life-saving anecdotes from the last 25 years.  

The effort has been a widely used and well-respected humanitarian resource since established by the late British philanthropists Lord Roger and Lady Patricia Swinfen in 1999.

MITRE is part of an effort to make those connections more secure and resilient. 

We offer a virtual hospital that never runs out of beds, has no political master, and welcomes every patient, free of charge.

Katherine Davies, Swinfen Charitable Trust trustee

Connecting with Clinicians

“Our mission is a simple one in theory,” says Katherine Davies, Swinfen Charitable Trust trustee. “We offer a virtual hospital that never runs out of beds, has no political master, and welcomes every patient, free of charge.”

For reference, the World Health Organization calculates that 40% of countries in the world have fewer than 10 doctors per 10,000 people. A closer look shows that specialist knowledge is even harder to find. 

Remember the legacy game show “Who Wants to Be a Millionaire?” in which contestants were given the option to phone a friend for help? In the case of Swinfen Telemedicine, “friends” are a network of volunteer doctors from across Europe, the United Kingdom, United States, Canada, Australia, India, and Iraq who offer their assessments to less-resourced practitioners in rural areas and conflict zones in 96 countries.

Together with the Swinfen Charitable Trust, UVA Health, and Telemedicine AI, MITRE is helping the planned OpenTelemed platform extend its reach by bringing cybersecurity protections up to speed in the face of an increasingly hostile cyber landscape. 

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Cyber Infrastructure Protection Innovation Center

We develop technologies, practices, and approaches to protect critical infrastructure from malicious cyber or non-kinetic attack or disruption.

Securing Sensitive Medical Information Exchanges

Experts from our Critical Infrastructure Protection Innovation Center (CIPIC) will conduct cyber assessments to protect the free flow of medical knowledge between providers. Cj Rieser, Ph.D., a cyber and artificial intelligence (AI) principal engineer spearheading the project, explains: “Our goal is to make the network’s digital plumbing more reliable, more effective, more secure, more scalable, and more trusted.”

With MITRE’s help, a doctor in Africa querying a specialist in the U.S. doesn’t have to be concerned about sharing sensitive patient care needs. “Part of the assessments and analytics will provide standards-based cyber attestation protecting provider and patient identities as well as the clinical queries themselves, which could involve vulnerable populations and put the provider at risk,” Rieser says. “Building proper infrastructure will protect against the threat of information being observed by a malicious third party and ensure questions get sent directly to appropriate recipients.”

To that end, the team will also study trusted edge processing cyber infrastructure and analytic exchange AI frameworks to help route each message to the most relevant doctors as quickly as possible.

For example, a doctor’s question about an eye injury would be filtered to volunteer ophthalmologists only. “Our work will help get providers in need to the right doctors on the receiving end at the right time.” says Steve Battista, CIPIC operations manager, who’s also involved with the project.

This infrastructure maintenance prevents ‘mailbox fatigue’ of participating doctors from different specialties and promotes accountability. “When someone faints in public, you point to a specific onlooker and tell them to ‘dial 911,’” he further explains. “You don’t get the same result when you just yell out to a large group.”

Once established, the protected infrastructure reference design will include AI enhancements enabling Swinfen Telemedicine to operate as a knowledge network. It incorporates a digital “medical librarian” for providers to query vetted collective analytics from around the world and connect to relevant medical literature and educational resources.

In addition to tactical impact, MITRE’s cybersecurity upgrades will go a long way to help doctors feel more comfortable participating in knowledge exchanges.

Accounting for Cultural Context in Hostile Cyber Landscapes

As cyberattacks become more common and more targeted, vulnerable populations face a growing risk for exploitation. That fact, combined with the consideration that volunteer doctors require cultural context to inform their recommendations, raises the stakes for Swinfen’s platform.

“From a technical point of view, we need an elevated security posture to make sure cultural context communications are protected from corruption or manipulation and delivered securely,” says Rieser. 

Setting Global Standards and Applying them to Different Domains

Our work with Swinfen is a natural extension of Rieser’s efforts in the global standards space, where she has helped create international cyber analytic exchange standards such as IEEE P2795. “MITRE is well-positioned as an adviser, standards bearer, and group who can help shape designs and frameworks for the public good,” she says.

The project will also help MITRE learn insights on how to protect medical providers and sensitive information in austere rural settings within the United States.

“Once this architecture is built, it can be applied to different domains,” Battista explains, citing endless options for less-resourced practitioners to tap a pool of experts, whether it’s critical infrastructure operators or other non-health areas of practice.  

Two people standing in front of the Royal Society of Medicine

Connecting with Princess Anne to Support a Blossoming Partnership

In February, MITRE’s involvement was further solidified at a reception hosted by Swinfen Charitable Trust at The Royal Society of Medicine in London. At the event, Battista and Matt McKaig, one of our Europe-based department managers, were introduced to the charity’s patron, Her Royal Highness Princess Anne. They took the opportunity to amplify our mission and discuss the cybersecurity expertise we’re applying to the telehealth domain.  

“Our hope for this project is to showcase MITRE’s breadth on a world stage and lead us to more-fruitful humanitarian partnerships,” McKaig says. 

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