Was ist das eigentlich? Cyberrisiken verständlich erklärt

Es wird viel über Cyberrisiken gesprochen. Oftmals fehlt aber das grundsätzliche Verständnis, was Cyberrisiken überhaupt sind. Ohne diese zu verstehen, lässt sich aber auch kein Versicherungsschutz gestalten.

Beinahe alle Aktivitäten des täglichen Lebens können heute über das Internet abgewickelt werden. Online-Shopping und Online-Banking sind im Alltag angekommen. Diese Entwicklung trifft längst nicht nur auf Privatleute, sondern auch auf Firmen zu. Das Schlagwort Industrie 4.0 verheißt bereits eine zunehmende Vernetzung diverser geschäftlicher Vorgänge über das Internet.

Anbieter von Cyberversicherungen für kleinere und mittelständische Unternehmen (KMU) haben Versicherungen die Erfahrung gemacht, dass trotz dieser eindeutigen Entwicklung Cyberrisiken immer noch unterschätzt werden, da sie als etwas Abstraktes wahrgenommen werden. Für KMU kann dies ein gefährlicher Trugschluss sein, da gerade hier Cyberattacken existenzbedrohende Ausmaße annehmen können. So wird noch häufig gefragt, was Cyberrisiken eigentlich sind. Diese Frage ist mehr als verständlich, denn ohne (Cyber-)Risiken bestünde auch kein Bedarf für eine (Cyber-)Versicherung.

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Exam Number : NCBTMB
Exam Name : National Certification Board for Therapeutic Massage & Bodywork
Vendor Name : Medical
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BOARD CERTIFICATION IN THERAPEUTIC MASSAGE & BODYWORK (BCTMB)
Board Certification in Therapeutic Massage and Bodywork represents the highest attainable credential within the massage therapy and bodywork profession. Board Certification is a separate credential above and beyond entry-level massage therapy licensure.

As Board Certification is voluntary, its achievement represents the highest level of commitment to clients and to the advancement of the massage therapy and bodywork profession. Board Certificants must meet higher standards of education and experience, as well as pass a rigorous test that tests massage therapy and bodywork technique and application, critical thinking, communication, law, ethics, evaluation, documentation, and planning.

NCBTMB is the only certifying body for the massage therapy and bodywork profession. For that reason, NCBTMBs certification processes are founded upon a superior Code of Ethics and Standards of Practice, which all Board Certificants must adhere to. Like their Certificants, the advancement of the profession and the improvement of client care is their focus.

Board Certification in Therapeutic Massage and Bodywork (BCTMB) is the highest attainable credential within the massage therapy and bodywork profession. It is a separate credential above and beyond entry-level, mandatory state licensure.
Board Certificants must meet stringent requirements, clear a recurring criminal background check, and pass the Board Certification Exam.
Board Certification is so much more than having an entry-level massage license. By achieving the profession's highest attainable credential, you represent advanced standards of education, experience, critical thinking, and test skills to provide clients and patients positive outcomes.

In the past, massage therapists have not made Board Certification a priority as it is voluntary—but that is changing rapidly in both clinical and staff positions. As massage therapy gains traction as a reimbursable, non-pharmaceutical method for pain relief, insurance companies and other approval entities will look for, or may even require, Board Certification to make this possible.

Course Outline | Syllabus | Objectives
I. Massage Modalities, Techniques, And Manual Forces (20%)
• Knowledge
• General massage protocols
• Compression
• Tension/decompression
• Friction/shearing
• Bending
• PNF, MFR, pin and stretch, etc.
• Torsion
• Range of motion
• Muscle Energy Techniques
• Stretching
• Hydrotherapy
• Indications and contraindications
• Vibration (jostling, shaking)
• Tapotement
• Client/patient positioning
• Special population (pregnancy massage, oncology massage, etc.)
• Appropriate tools and appropriate use
• Efficient body mechanics
• Benefits and effects of modalities (forms), and techniques
• Modality literacy Skills
• Determine applicable massage techniques when working with clients
• Apply massage techniques safely
• Perform massage on special populations
• (athletes, geriatric, prenatal, etc.)
• Identify contraindications and apply affective techniques
• Identify fundamental characteristics of bodywork modalities
• Perform proper body mechanics while working with different populations
• Position clients for comfort and safety
II. Applied Science: Anatomy, Physiology, Kinesiology, Pathology/ Injury, and Pharmacology (25%)
Knowledge
• Anatomy (structure of the human body including joints, tissues, muscles, functions, origins, insertions, and actions, nerve structure, etc.)
• Physiology – systems of the body with:
• i. in-depth knowledge in muscle, skeletal, and nervous systems
• ii. intermediate knowledge in integumentary, cardiovascular, lymphatic and digestive systems iii. basic knowledge in respiratory, endocrine, reproductive and urinary systems
• Kinesiology (mechanics of body movement including levers, agonists, antagonists, synergist, etc.)
• Pharmacology (contraindications of prescription and non-prescription medication, implications for massage, etc.)
• Standard precautions
• Endangerment sites
Skills
• Identify structures and functions of all body systems
• Identify muscle and joint physiology
• Recognize mechanics of body movement –
• agonists, antagonists and synergists
• Identify and apply range of motion techniques
– passive, active, active assisted and resistive range of motion
• Identify endangerment/cautionary sites
• Recognize muscle and orthopedic testing
• Identify indications and contraindications of common prescription drugs
• Determine proper stretching techniques and “end feels”
III. Professional Communication (15%)
Knowledge
• Medical terminology
• How to communicate with client/patient in understandable terms
• Reporting formats (appropriate language in medical history, treatment plan, SOAP notes, EMR etc.)
• HIPAA
• Communication with clients/patients (asking questions to clarify information)
• Client/patient sensitivity and vulnerabilities (how to make clients comfortable during treatment)
• Verbal and non-verbal cues
• Informed consent
Skills
• Effectively communicate with clients when explaining treatment plans
• Describe techniques, anatomy, physiology and kinesiology in understandable terms
• Identify HIPAA procedures
• Work within client comfort levels
• Adapt to verbal and non-verbal cues when working with clients
• Document sessions appropriate to the work setting – SOAP, EMR, spa etc.
• Uphold all HIPAA confidentiality standards
• Effectively communicate in proper medical terminology when working with other healthcare professionals
IV. Professionalism & Ethics (10%)
Knowledge
• Current standard of care for safe and effective massage
• Professional boundaries
• Draping laws and techniques
• When to refer clients to other health professionals
• When, why and how to refuse treatment
• How to report misconduct and who to report to
• Transference and countertransference
Skills
• Maintain proper physical and emotional boundaries
• Respect clients right to say no
• Identify when to refer out and whom to refer clients with pathologies
• Identify transference and countertransference situations
• Identify when to refuse to treat clients
• Identify correct entities to report client or fellow massage therapists misconduct
V. Laws & Business Practices (5%)
Knowledge
• Appropriate draping
• Continuing education requirements
• Scope of practice and applicable licensing laws
• Record keeping (business and client/patient)
Skills
• Maintain client confidentiality
• Perform only within the massage therapy scope of practice
• Maintain appropriate draping for client protection and privacy
• Represent educational and professional
• qualifications honestly
• Demonstrate proper business and client record keeping
• Abide by national organizations code of conduct and policies
• Comply with all federal state and local laws
VI. Assessment (25%)
Knowledge
• Comprehensive intake
• Interview and data collection techniques
• Observation techniques (posture deviation, etc.)
• Range of motion (normal and abnormal body motions)
• Treatment session planning techniques in collaboration with client/patient and other healthcare professionals when necessary
• Indications and contraindications
• Functional exams and reassessments
• Customized treatments
• Pain scale and pain management
• Medical terminology (SOAP charting, etc.)
• Clinical reasoning (analyzing information from client/patient)
• Research associated with massage therapy
Skills
• Conduct an effective and thorough intake interview to gather information
• Interpret client health history information
• Customize treatment plans to fit the needs of • each client
• Discuss treatment plan and alternate plans if requested by the client
• Determine common pain scale descriptions
• Utilize palpatory skills to assess soft tissue
• Perform and interpret active and passive range of motion exams
• Perform and interpret postural analysis
• Perform and interpret gait exam
• Perform and interpret manual resistance tests
• Perform and interpret special orthopedic tests
• Reassess client movement, strength and range of motion post – treatment
• Document all findings properly pre and post treatment and change treatment plans accordingly
• Collaborate with other healthcare professionals as needed
• Communicate using appropriate medical terminology when speaking with other medical professionals and in official documentation
• Work effectively as part of an integrated healthcare team
• Recognize and analyze research
• Identify different areas of research



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Warum sind Cyberrisiken so schwer greifbar?

Als mehr oder weniger neuartiges Phänomen stellen Cyberrisiken Unternehmen und Versicherer vor besondere Herausforderungen. Nicht nur die neuen Schadenszenarien sind abstrakter oder noch nicht bekannt. Häufig sind immaterielle Werte durch Cyberrisiken in Gefahr. Diese wertvollen Vermögensgegenstände sind schwer bewertbar.

Obwohl die Gefahr durchaus wahrgenommen wird, unterschätzen viele Firmen ihr eigenes Risiko. Dies liegt unter anderem auch an den Veröffentlichungen zu Cyberrisiken. In der Presse finden sich unzählige Berichte von Cyberattacken auf namhafte und große Unternehmen. Den Weg in die Presse finden eben nur die spektakulären Fälle. Die dort genannten Schadenszenarien werden dann für das eigene Unternehmen als unrealistisch eingestuft. Die für die KMU nicht minder gefährlichen Cyber­attacken werden nur selten publiziert.

Aufgrund der fehlenden öffentlichen Meldungen von Sicherheitsvorfällen an Sicherheitsbehörden und wegen der fehlenden Presseberichte fällt es schwer, Fakten und Zahlen zur Risikolage zu erheben. Aber ohne diese Grundlage fällt es schwer, in entsprechende Sicherheitsmaßnahmen zu investieren.

Erklärungsleitfaden anhand eines Ursache-Wirkungs-Modells

Häufig nähert man sich dem Thema Cyberrisiko anlass- oder eventbezogen, also wenn sich neue Schaden­szenarien wie die weltweite WannaCry-Attacke entwickeln. Häufig wird auch akteursgebunden beleuchtet, wer Angreifer oder Opfer sein kann. Dadurch begrenzt man sich bei dem Thema häufig zu sehr nur auf die Cyberkriminalität. Um dem Thema Cyberrisiko jedoch gerecht zu werden, müssen auch weitere Ursachen hinzugezogen werden.

Mit einer Kategorisierung kann das Thema ganzheitlich und nachvollziehbar strukturiert werden. Ebenso hilft eine solche Kategorisierung dabei, eine Abgrenzung vorzunehmen, für welche Gefahren Versicherungsschutz über eine etwaige Cyberversicherung besteht und für welche nicht.

Die Ursachen sind dabei die Risiken, während finanzielle bzw. nicht finanzielle Verluste die Wirkungen sind. Cyberrisiken werden demnach in zwei Hauptursachen eingeteilt. Auf der einen Seite sind die nicht kriminellen Ursachen und auf der anderen Seite die kriminellen Ursachen zu nennen. Beide Ursachen können dabei in drei Untergruppen unterteilt werden.

Nicht kriminelle Ursachen

Höhere Gewalt

Häufig hat man bei dem Thema Cyberrisiko nur die kriminellen Ursachen vor Augen. Aber auch höhere Gewalt kann zu einem empfindlichen Datenverlust führen oder zumindest die Verfügbarkeit von Daten einschränken, indem Rechenzentren durch Naturkatastrophen wie beispielsweise Überschwemmungen oder Erdbeben zerstört werden. Ebenso sind Stromausfälle denkbar.

Menschliches Versagen/Fehlverhalten

Als Cyberrisiken sind auch unbeabsichtigtes und menschliches Fehlverhalten denkbar. Hierunter könnte das versehentliche Veröffentlichen von sensiblen Informationen fallen. Möglich sind eine falsche Adressierung, Wahl einer falschen Faxnummer oder das Hochladen sensibler Daten auf einen öffentlichen Bereich der Homepage.

Technisches Versagen

Auch Hardwaredefekte können zu einem herben Datenverlust führen. Neben einem Überhitzen von Rechnern sind Kurzschlüsse in Systemtechnik oder sogenannte Headcrashes von Festplatten denkbare Szenarien.

Kriminelle Ursachen

Hackerangriffe

Hackerangriffe oder Cyberattacken sind in der Regel die Szenarien, die die Presse dominieren. Häufig wird von spektakulären Datendiebstählen auf große Firmen oder von weltweiten Angriffen mit sogenannten Kryptotrojanern berichtet. Opfer kann am Ende aber jeder werden. Ziele, Methoden und auch das Interesse sind vielfältig. Neben dem finanziellen Interesse können Hackerangriffe auch zur Spionage oder Sabotage eingesetzt werden. Mögliche Hackermethoden sind unter anderem: Social Engineering, Trojaner, DoS-Attacken oder Viren.

Physischer Angriff

Die Zielsetzung eines physischen Angriffs ist ähnlich dem eines Hacker­angriffs. Dabei wird nicht auf die Tools eines Hackerangriffs zurückgegriffen, sondern durch das physische Eindringen in Unternehmensgebäude das Ziel erreicht. Häufig sind es Mitarbeiter, die vertrauliche Informationen stehlen, da sie bereits den notwendigen Zugang zu den Daten besitzen.

Erpressung

Obwohl die Erpressung aufgrund der eingesetzten Methoden auch als Hacker­angriff gewertet werden könnte, ergibt eine Differenzierung Sinn. Erpressungsfälle durch Kryptotrojaner sind eines der häufigsten Schadenszenarien für kleinere und mittelständische Unternehmen. Außerdem sind auch Erpressungsfälle denkbar, bei denen sensible Daten gestohlen wurden und ein Lösegeld gefordert wird, damit sie nicht veröffentlicht oder weiterverkauft werden.

Ihre Cyberversicherung sollte zumindet folgende Schäden abdecken:

Cyber-Kosten:

  • Soforthilfe und Forensik-Kosten (Kosten der Ursachenermittlung, Benachrichtigungskosten und Callcenter-Leistung)
  • Krisenkommunikation / PR-Maßnahmen
  • Systemverbesserungen nach einer Cyber-Attacke
  • Aufwendungen vor Eintritt des Versicherungsfalls

Cyber-Drittschäden (Haftpflicht):

  • Befriedigung oder Abwehr von Ansprüchen Dritter
  • Rechtswidrige elektronische Kommunikation
  • Ansprüche der E-Payment-Serviceprovider
  • Vertragsstrafe wegen der Verletzung von Geheimhaltungspflichten und Datenschutzvereinbarungen
  • Vertragliche Schadenersatzansprüche
  • Vertragliche Haftpflicht bei Datenverarbeitung durch Dritte
  • Rechtsverteidigungskosten

Cyber-Eigenschäden:

  • Betriebsunterbrechung
  • Betriebsunterbrechung durch Ausfall von Dienstleister (optional)
  • Mehrkosten
  • Wiederherstellung von Daten (auch Entfernen der Schadsoftware)
  • Cyber-Diebstahl: elektronischer Zahlungsverkehr, fehlerhafter Versand von Waren, Telefon-Mehrkosten/erhöhte Nutzungsentgelte
  • Cyber-Erpressung
  • Entschädigung mit Strafcharakter/Bußgeld
  • Ersatz-IT-Hardware
  • Cyber-Betrug