Healthcare organizations face an increasingly difficult to manage cybersecurity environment. New classes of medical devices are constantly being added to the list of devices needing security controls. The connectivity requirements of many of these devices increase as their integration into healthcare information ecosystems become more common. Threats also become more advanced as hackers’ skills improve. Regulations change but legacy equipment can’t be made up-to-date. Rather than leveling off, complexity grows; securing devices provides a moving target that requires constant adjustments just to maintain the same level of protection.
The increasing complexity of healthcare cybersecurity impacts hospitals, clinics, medical device manufacturers, and healthcare technology firms in a way that was not true five years ago. The approach taken to security in 2020 is already insufficient in 2025. Organizations that manage cybersecurity as a project rather than an ongoing program find themselves continuously behind the curve in dealing with threats that increase in capability faster than the organizations can keep up.
The Device Proliferation Challenge
Healthcare organizations are adding new types of connected devices at astonishing rates. Smart infusion pumps. Wireless monitors. Imaging devices with networked functionality. Implantable devices that connect with monitoring systems. Diagnostic equipment that connects with electronic medical records systems and on and on. Each new type of device increases the surface area that needs to be secured.
The problem is not just the sheer number of devices. It is the diversity of devices. Each type of device operates on its own software, has its own security capabilities, is manufactured by different manufacturers with different security practices, and is used for different clinical tasks that have their own levels of risk associated with them. An approach to security that works for one category of devices may be completely inappropriate for another.
This diversity makes it extremely difficult to implement consistent security practices across an organization. Organizations cannot just implement a single security tool for all medical devices. Security measures have to be tailored for each category of device.
The Connectivity Expansion Challenge
Devices that used to operate by themselves now connect by default. They connect to enable useful functions such as remote monitoring and updating, automatic data logging, and integration with other systems. The convenience offered by this connectivity, however, also increases the risk posed by connected devices.
Connected medical devices tend to have even more integration requirements now than they did when they were first introduced. Devices need to interact with electronic health record systems. They need to upload data to cloud services for processing and storage. They need to receive updates from manufacturers. They need to connect to facilities’ networks for non-clinical functions like administrative services. Each one of these dependencies increases the complexity and difficulty of securing a device.
Healthcare organizations that are trying to deal with the challenges posed by increasing numbers of connected devices often rely on specialists who recognize what a unique environment healthcare cybersecurity presents. Companies that focus on healthcare cybersecurity, such as Blue Goat Cyber, help organizations deal with the legal issues and technical challenges that come with securing medical technology.
The Threat Sophistication Challenge
Not all threats are static either. Hackers targeting healthcare organizations continuously develop new techniques, learn to exploit new vulnerabilities, and adapt their attacks based on what security practices a victim organization attempts to implement. The threat landscape in healthcare cybersecurity is very different today from what it was just a year ago.
Ransomware schemes have become more sophisticated and damaging. Supply chain attacks target medical devices before they reach healthcare organizations. Nation-state actors target healthcare related infrastructure and services. Criminal enterprises develop detailed knowledge about the specific vulnerabilities in medical technologies they can exploit. The potential threats are becoming more refined as well as increasing in number.
The same security tools that were effective against last year’s threats may not be effective anymore. Organizations have to update their assessment of threats regularly if they want to maintain effective security environments.
The Regulatory Complexity Challenge
Healthcare cybersecurity regulations also change as regulators respond to changing types of equipment and actual breaches in security that highlight weaknesses in existing regulation. Rules from organizations like the FDA for medical device manufacturers continue to become more intricate as manufacturers keep discovering new and better ways of using technology to improve patient care yet struggle to do so without also increasing the risks they pose. HIPAA regulations change as well. Each time regulations change, organizations must adapt their practices or run the risk of non-compliance.
Organizations sometimes may never know if their existing cybersecurity practices will meet the current requirements of policymakers.
The Legacy Equipment Complexity Challenge
Healthcare organizations also usually cannot replace medical equipment whenever a new security issue is identified. Medical devices are expensive and critical pieces of equipment for patient care delivery processes, many of which are designed to have decade-long lifespans. That means the software running on these devices may be decades old and unable to be patched due to concerns that changing software would impact the clinical functionality of the product.
This legacy equipment creates gaps in security that cannot be directly corrected. Organizations may have to rely on compensating controls such as network segmentation and access monitoring or restrictions in order to account for legacy devices they still need to incorporate into their clinical environments.
The Knowledge Challenge
The growing complexity of healthcare cyber security management has exceeded the knowledge necessary to manage it successfully within knowledge domains usually associated with non-healthcare industries like finance or information technology services companies. Protecting medical technologies requires a combination of knowledge about traditional cybersecurity challenges along with knowledge of clinical workflows, regulatory issues, product vulnerabilities, manufacturer policies, the role equipment plays in patient safety, and on and on.
Few individuals possess this level of knowledge, which makes it challenging for healthcare organizations attempting to manage cybersecurity threats internally.
Managing Complexity
Organizations cannot do anything about the increasing complexity of managing cybersecurity risk; however, they can adopt an approach for dealing with complexity effectively over time rather than attempting to “solve” a problem because it is complex by nature. They can treat cybersecurity management as a program rather than a project, invest in ongoing monitoring and risk assessments instead of treating these assessments as once-off initiatives, incorporate third party specialist resources into their risk management ecosystem, and accept that once relatively stable security controls need to be updated regularly in response not only potential changes in product design but also changing threats.
The types of organizations managing this increasing complexity effectively today are those that recognized years ago that cybersecurity within healthcare was going to continue becoming more challenging, and built an approach for their organization around managing the complexity rather than expecting it would eventually become less challenging. The challenge does not have any intention of becoming less challenging; thus, the response needs to be one that recognizes this reality.
