新加坡：卫生部高级政务部长陈杰豪周二（11月3日）在国会表示，受聘服务供应商未完成必要的安全更新，这一“可预防”的疏失导致了10月13日新加坡公立医疗集群长达九个半小时的服务中断。
SINGAPORE: A "preventable" lapse by a contracted service provider to complete a required security update led to the nine-and-a-half hour disruption to services across Singapore's public healthcare clusters on Oct 13, Senior Minister of State for Health Tan Kiat How told parliament on Tuesday (Nov 3).
陈杰豪说，约4000个门诊预约被重新安排，部分患者经历了长达两小时的延误。没有接获因中断导致的患者安全不良事件报告。
About 4,000 outpatient appointments were rescheduled, and some patients experienced delays of up to two hours, Mr Tan said. No adverse patient-safety incidents attributable to the disruption were reported.
此次中断影响了所有三个公立医疗集团——国家医疗集团（NHG Health）、国立大学医疗体系（NUHS）和新加坡医疗集团（SingHealth）的服务。受影响的服务包括预约挂号、访客登记、发药和缴费。
The disruption impacted services across all three public healthcare clusters - NHG Health, the National University Health System (NUHS) and SingHealth. Services affected included appointment bookings, visitor registration, medication dispensing and billing.
陈杰豪说，医疗机构启动了停机应急程序，增派人员支持运作，临床医生使用选定的只读患者记录和人工工作流程，以维持基本医疗服务。
Healthcare institutions activated downtime procedures, with additional staff supporting operations and clinicians using selected read-only patient records and manual workflows to continue essential care, Mr Tan said.
国家卫生科技机构Synapxe曾聘请一家服务供应商负责执行必要的更新，但该更新未获执行，陈杰豪说。
National health technology agency Synapxe had contracted a service provider to manage the necessary update, but it was not carried out, Mr Tan said.
“Synapxe正在审查该供应商的合同义务，并将就任何确定的疏失采取适当行动。
"Synapxe is reviewing the provider's contractual obligations and will take appropriate action for any established lapses.
“无论外包安排如何，Synapxe仍需对其关键系统的韧性负责，”陈杰豪说。
"Regardless of the outsourcing arrangement, Synapxe remains accountable for the resilience of its critical systems," Mr Tan said.
公立医疗系统设有备份基础设施，包括两个数据中心。但两者都依赖同一个底层域名系统（DNS）服务和安全配置，陈杰豪说。
The public healthcare systems have backup infrastructure, including two data centres. But both depended on the same underlying DNS service and security configuration, Mr Tan said.
“因此在两者之间切换无法解决此次中断。Synapxe将检视此类共享依赖，并强化替代恢复安排。”陈杰豪说，共享域名系统（DNS）所需的安全更新未在预定的全球变更前完成，他将DNS比作互联网通讯录，帮助系统定位并连接到应用程序。陈先生表示：“这是一个已知的变更，也是一起可预防的疏失。”
"Switching between them would therefore not have resolved this disruption. Synapxe will review such shared dependencies and strengthen alternative recovery arrangements." The required security update to a shared Domain Name System, or DNS was not completed before a scheduled global change, Mr Tan said, likening the DNS to an internet address book that helps systems locate and connect to applications. "This was a known change and a preventable lapse," Mr Tan said.
陈先生说，10月13日的中断给患者及其家属带来了不便和担忧，也给医护人员增加了额外工作。
The disruption on Oct 13 caused inconvenience and concern to patients and their families, and created additional work for healthcare workers, said Mr Tan.
“我们道歉。这不该发生。”他补充说，调查发现这并非网络攻击，且没有发生患者数据被未经授权访问、泄露或丢失的情况。
"We apologise. It should not have happened." The investigation found that this was not a cyberattack, and there was no unauthorised access to, compromise or loss of patient data, he added.
陈先生指出，考虑到中断持续的时长，监测系统曾检测到异常活动，但花费了一段时间才查明根本问题并安全恢复服务。
Noting the duration of the disruption, Mr Tan added that monitoring detected abnormal activity, but it took time to identify the underlying problem and restore services safely.
陈先生说，Synapxe正在加强监测和故障诊断，以实现更快恢复。
Synapxe is strengthening monitoring and fault diagnosis to enable faster recovery, Mr Tan said.
专家小组 陈先生表示，政府正在三个方面强化韧性：预防，通过改进对关键技术变更的追踪和验证；控制，通过解决共享依赖问题并改进恢复安排。
EXPERT PANEL Mr Tan said the government is strengthening resilience in three areas: prevention, by improving the tracking and verification of critical technical changes; and containment, by addressing shared dependencies and improving recovery arrangements.
第三个方面涉及医疗服务连续性，通过改进停机应用系统、员工应变能力和定期演练，包括针对部分中断的演练。“卫生部将监督整改行动并验证其有效性，”他说。
The third area involves continuity of care, by improving downtime systems, staff readiness and regular exercises, including for partial outages "MOH will oversee the corrective actions and verify that they are effective," he said.
Synapxe已委任一个专家小组，成员来自其他具有类似工程背景的组织，负责审查调查结果和拟议的补救措施，并找出进一步改进之处。
Synapxe has appointed an expert panel comprising representatives from other organisations that have similar engineering profiles to review the investigation findings and proposed remediation measures and identify further improvements.
陈先生说：“数字化为医疗保健带来重要效益。但随着我们的系统变得更加互联互通，韧性也必须提升。
"Digitalisation brings important benefits to healthcare. But as our systems become more interconnected, resilience must improve too.
“我们必须让技术更可靠，同时确保即使技术失效，医护人员仍能继续安全地照护患者。”
"We must make our technology more reliable, while ensuring healthcare workers can continue caring for patients safely even when technology fails," said Mr Tan.