When operational technology (OT) devices in hospitals are compromised, the consequences extend beyond financial losses; they can jeopardize patient safety. Recent vulnerabilities discovered in devices from manufacturers like Siemens and Advantech highlight the urgent cybersecurity risks hospitals face. These devices, including infusion pumps, ventilators, and imaging systems, are critical to clinical operations but are increasingly targeted by cybercriminals.
Investigations revealed serious flaws in Siemens imaging and control systems that could allow attackers to bypass authentication or even cause equipment malfunctions. Similarly, Advantech faced scrutiny due to remote code execution vulnerabilities in its industrial and IoT platforms, widely used in healthcare settings. These vulnerabilities can serve as gateways for broader attacks, threatening the integrity of patient monitoring, building management, and medical imaging systems.
Impact of Cyberattacks on Patient Care
The healthcare sector has become a prime target for cybercriminals, who recognize that hospitals are often willing to pay ransoms swiftly to restore operations. The repercussions of such attacks are severe. For instance, during the DCH Health ransomware incident, ambulances were rerouted from critical care patients, while the CommonSpirit attack delayed treatments and appointments across multiple states. These incidents not only disrupt hospital operations but also erode public trust in healthcare systems.
According to the Picus Blue Report, even when healthcare organizations implement multiple layers of security, significant detection and prevention gaps remain. Vulnerabilities in OT devices can facilitate lateral movements within hospital networks, enabling attackers to access sensitive electronic health records and administrative platforms.
Several factors contribute to the heightened vulnerability of healthcare systems. Many OT devices operate on outdated software that cannot be patched without interrupting clinical services. This issue was notably evident during the WannaCry attack on the NHS. Additionally, the long operational lifespans of high-value equipment, such as MRI machines, often extend well beyond typical IT lifecycles, making them susceptible to exploitation.
The interconnectedness of clinical devices and corporate systems further complicates security, as it allows attackers to pivot from compromised OT equipment to critical patient data systems. Operational constraints in healthcare mean that taking devices offline for updates can directly affect patient care, creating a challenging environment for cybersecurity teams.
Strategies for Enhancing Cybersecurity in Healthcare
Given the complex landscape of cyber threats, healthcare Chief Information Security Officers (CISOs) must adopt innovative strategies to manage cyber risks effectively. Traditional approaches that focus solely on patching vulnerabilities fall short in today’s environment. Instead, healthcare organizations should embrace a proactive security model that emphasizes continuous validation and context-aware prioritization.
Continuous validation of security measures is essential. Traditional vulnerability management often considers all high-severity Common Vulnerabilities and Exposures (CVEs) as critical. However, research from Picus Exposure Validation indicates that less than 2% of vulnerabilities categorized as high or critical are exploitable in specific environments. By simulating real-world attacks across OT and IT environments, hospitals can identify which vulnerabilities pose actual threats and prioritize their remediation efforts accordingly.
Prioritization should also consider the context of vulnerabilities. Not every CVE requires an immediate response. For instance, a flaw in an isolated laboratory device may be less urgent than a vulnerability in patient monitoring software operating on the main clinical network. By weighing asset criticality, exploitability, and existing controls, healthcare organizations can allocate resources more effectively.
When patching vulnerabilities is not feasible, security teams should implement compensating controls, such as updated intrusion prevention rules or enhanced endpoint detection signatures. These measures can provide temporary relief while minimizing risk to patient safety. Continuous testing of resilience through breach and attack simulations can help reveal blind spots that conventional audits might overlook, allowing hospitals to close potential attack paths before they can be exploited.
Collaboration with stakeholders across the organization is vital. CISOs should engage with clinical and operational leaders to promote security awareness and best practices. Transparent reporting, including evidence-based exposure scores, can enhance understanding and support for cybersecurity initiatives that align with patient care objectives.
Healthcare organizations must navigate a landscape marked by limited budgets, complex regulations, and persistent cyber threats. By focusing on reducing actual risk, restoring control, and ensuring continuity of care, hospitals can fortify their defenses. Transitioning to continuous validation, context-aware prioritization, and layered defenses enables healthcare institutions to mitigate exposure, enhance patient safety, and strengthen public trust.
In the high-stakes environment of healthcare, every moment of downtime can have dire consequences for patient lives. By modernizing their approach to vulnerability management and securing OT devices, hospitals can better protect their systems, safeguard sensitive data, and, most importantly, ensure the wellbeing of the patients who rely on their services.
