Healthcare security is regularly evaluated through scheduled compliance reviews. Real cyberattacks take place under very different conditions, often in environments where patient care can’t be interrupted. This difference helps explain why many healthcare organizations meet regulatory guidelines, but struggle to respond effectively to live attacks. Compliance provides a set of metrics to measure adherence to rules, but it doesn’t account for the operational realities that shape security in clinical settings.
Healthcare Can’t Patch Its Way Out of Risk
The journey from vulnerability to remediation in most industries is straightforward. Organizations take systems offline, install patches, and fix the vulnerable technology.
In healthcare, remediation decisions are shaped by the need to keep patient care running. Systems that support diagnosis, treatment, and monitoring remain in continuous use, and taking them offline introduces immediate patient risk. Even short interruptions can disrupt care delivery in emergency departments, operating rooms, and intensive care units.
This challenge is made worse because many clinical devices have been in use for years. They often run old operating systems that are no longer supported or easy to upgrade. Limited resources keep this situation going. Hospitals spread out the costs of expensive equipment over many years, so replacement depends on budgets, approvals, and clinical needs rather than security warnings.
Such environments inherently allow known vulnerabilities to exist. Security teams are aware of this, but standard security recommendations, such as rapid patching or replacing systems, rarely align with the hospitals’ operations, and they leave the facilities with no means of mitigating exposure.
When Remediation Fails, Risk Containment Takes Over
In healthcare, security often becomes an exercise in containment rather than elimination. Instead of attempting to fix every issue, teams focus on limiting how far an attacker can move, and how much damage they can cause once inside the environment.
That approach depends on understanding which systems exist, and how they communicate. Hospitals operate thousands of connected devices managed by different teams across clinical, facilities, and operational domains. Because these systems often fall outside standard inventories, visibility into assets and communication paths becomes a prerequisite for meaningful risk reduction.
With that visibility in place, it’s important to implement compensating control measures, such as network segmentation and access restrictions. These can help lessen exposure without requiring any changes to devices. By limiting which systems can communicate with others, and which have internet access, the attack surface is reduced, even if vulnerabilities remain.
Prioritization matters as much as architecture. Healthcare security teams face thousands of disclosed vulnerabilities each year. Treating all of them as if they were urgent leads to burnout. Risk-based prioritization focuses on vulnerabilities that are exploitable and connected to critical patient workflows. This allows teams with limited personnel to direct effort toward the systems they need to protect, reducing time spent on low-impact vulnerabilities.
To determine which risks are high priority, teams need to understand how real-world attack techniques behave in a specific environment, which controls stop them, and where gaps remain. This helps them to stop relying on theoretical risk scores, and focus on exposures with operational impact.
Resilience Is a Clinical Requirement
Even with strong controls in place, failure remains possible. Healthcare security planning must assume disruption, and prepare for it.
Resilience shifts the question from whether an attack can be prevented to how care continues when something breaks. If a critical imaging system becomes unavailable, can patients be rerouted to other systems? If one device model is compromised, are alternatives available? If digital systems fail, are clinical staff prepared to operate safely under degraded conditions?
Cyber incidents are increasingly similar to operational emergencies. They disrupt workflows, delay treatment, and add to the stress on already limited staffing. To build resilience into healthcare systems, single points of failure must be minimized, and cybersecurity planning must be integrated into clinical continuity planning.
The role of training can’t be overstated. Healthcare employees remain prime targets for phishing and social engineering. Education needs to position cybersecurity awareness as a critical component of patient protection, rather than just an administrative function.
From Passing Audits to Protecting Patients
Healthcare organizations operate under regulatory and clinical constraints that shape how security programs function. Long replacement cycles for legacy systems and the need to maintain continuous patient care limit the effectiveness of traditional remediation approaches, allowing certain risks to persist.
Healthcare organizations must design for containment, visibility, prioritization, and resilience to minimize the impacts of attacks and protect patients. Security planning also needs to include how to provide care during a disruption, as an organization’s capacity to deliver safe, effective patient care is measured by its cyber readiness and not by audits or checklists.
Hüseyin Can Yüceel
Hüseyin Can Yüceel is Security Research Lead for Picus Security.
