“From Downtime to Disaster: Why Clinical Resilience Demands New Thinking”
Post Summary
Healthcare organizations are under constant attack from cyber threats, with ransomware, phishing, and outdated systems creating serious risks. The stakes are high: system downtime costs hospitals $7,900 per minute, delays critical care, and can even lead to increased mortality rates. Traditional cybersecurity approaches focused solely on prevention are no longer enough. Instead, clinical resilience - the ability to detect, respond to, and recover quickly from attacks - is now essential to protect patient safety and ensure uninterrupted care.
Key Points:
- Cyber Threats Are Escalating: Healthcare is the most targeted industry, with ransomware attacks up 94% in recent years.
- Downtime Impacts Lives: Delayed treatments, increased test turnaround times, and compromised systems directly harm patient outcomes.
- Outdated Systems Are a Major Risk: Many healthcare platforms still run on unsupported software, leaving them vulnerable.
- Prevention Alone Fails: Resilience-based models prioritize minimizing impact and rapid recovery over trying to stop every attack.
- Resilience Strategies: Real-time monitoring, disaster recovery systems, employee training, and zero-trust principles are critical.
Healthcare organizations must shift their focus from preventing attacks to ensuring they can operate through them. Resilience is no longer optional - it’s a matter of patient safety.
Building Cyber Resilience: Navigating Healthcare's New Reality
Growing Cybersecurity Threats in Healthcare
Healthcare organizations are under siege, with cyberattack rates climbing from 88% in 2023 to a staggering 92% today[1]. This surge in threats highlights the growing dangers of ransomware, phishing, and outdated systems within the healthcare sector.
Ransomware and Other Cyber Attacks on Healthcare
Ransomware has become the top threat to healthcare, with 74% of attacks targeting hospitals and 26% focusing on secondary institutions like dental clinics and nursing homes[1]. What makes healthcare data such a tempting target? It’s simple: healthcare breach data can fetch prices up to 50 times higher than financial data on the black market[1].
The numbers are alarming. In 2023 alone, cyberattacks impacted over 100 million people, with the average cost of a breach hitting $9.8 million[1]. Recent incidents in 2024 emphasize how vulnerable healthcare organizations remain. For example:
- February 2024: A ransomware attack on Change Healthcare compromised data for 190 million individuals. Despite paying a $22 million ransom, the organization couldn’t recover the data[3].
- May 2024: Ascension Healthcare suffered a breach that took pharmacies offline and exposed the personal data of 5.6 million patients[3].
Phishing remains the most common entry point, accounting for over 90% of attacks[1]. Cybercriminals are now using artificial intelligence to make their scams more convincing.
"AI-generated phishing emails have a 54% click-through rate, compared to just 12% for human-written emails. Deepfake technology is now being used for business email compromise, including a $25.6 million transfer scam last year using a deepfake video."
- Adam Meyers, CrowdStrike's head of counter adversary operations[2]
The threat landscape is also evolving. Today, 79% of attacks are malware-free, relying instead on identity-based tactics and social engineering. Attackers now move through breached networks at record speeds, with an average breakout time of just 48 minutes[2]. Third-party providers are another weak link, responsible for 58% of the 77.3 million individuals impacted by data breaches in 2023 - a 287% increase from the previous year[1].
These trends underline the urgent need for robust cybersecurity measures to protect critical healthcare operations.
Legacy Systems Create Security Gaps
Outdated systems are a ticking time bomb. About 85% of healthcare organizations still rely on legacy platforms, even though maintaining them costs more than upgrading to modern solutions[4]. The 2017 WannaCry attack serves as a cautionary tale: the National Health Service (NHS) in the UK faced widespread disruption when malware exploited vulnerabilities in their outdated Windows XP systems[4].
Shockingly, many critical healthcare systems and devices still run on unsupported platforms like Windows XP, which hasn’t been updated since 2014. Financial and operational hurdles often delay modernization efforts, leaving these systems increasingly exposed. As one healthcare CEO put it:
"Our challenge lies in finding a way to modernize our technology without compromising care or introducing unnecessary risk during the transition."
- CEO of a Healthcare Organization[6]
These older systems lack essential security features like encryption, multi-factor authentication, and advanced monitoring tools, making them prime targets for cybercriminals[5]. Additionally, they complicate compliance efforts, highlighting the need for stricter regulatory oversight.
Meeting Regulatory and Compliance Requirements
Healthcare organizations face mounting regulatory pressures. Under HIPAA, entities must implement administrative, physical, and technical safeguards to protect patient data. Meanwhile, the Office for Civil Rights (OCR) has expanded its audits to focus more on technical and physical protections, while overlapping state laws add to the complexity[9]. Failing to comply can lead to severe penalties, including hefty fines and even jail time[7].
The regulatory environment is adapting alongside the growing cyber threats. In the first half of 2024, 387 breaches involving 500 or more records were reported to the Health and Human Services' Office for Civil Rights - an 8.4% increase compared to the same period in 2023[1].
Beyond HIPAA, healthcare organizations must navigate international standards like GDPR and industry-specific frameworks. Establishing a robust cybersecurity framework is no longer optional; it’s critical for both compliance and operational resilience[9]. However, the rise of technologies like artificial intelligence and telemedicine introduces new challenges, such as concerns about algorithmic bias and the reliability of AI-driven tools[10].
Managing third-party vendors is another crucial aspect, as these partners must meet strict security standards to avoid compliance failures. The stakes are high: healthcare data breaches cost an average of $408 per record, significantly higher than the $148 average across other industries[1]. According to Cybersecurity Ventures, the healthcare sector is projected to spend over $125 billion on cybersecurity products and services between 2020 and 2025[1].
These evolving threats and regulations make it clear that healthcare organizations must prioritize cybersecurity to protect patient data and ensure uninterrupted care.
Moving from Prevention to Resilience
Cyber threats have become more sophisticated, and healthcare organizations can no longer rely solely on keeping attackers out. The focus now needs to shift to a new approach - one that acknowledges the inevitability of cyberattacks and ensures organizations can continue operating even when breaches occur. This is especially critical in healthcare, where uninterrupted clinical operations are essential.
Why Prevention-Only Models Fall Short
Relying exclusively on prevention assumes that all attacks can be stopped before they breach the system. While this might have worked in the past, today’s cyber landscape tells a different story.
The numbers are alarming. In 2023, hospital cyberattacks surged by 120%, with over half of healthcare security professionals reporting ransomware incidents over the past year[12].
"There is no such thing as a secure perimeter in today's digital ecosystem."
- EY, 2023 Global Cybersecurity Leadership Insights Study[12]
The financial toll of failed prevention strategies is staggering. Healthcare organizations paid $1.3 billion in ransomware payments in 2023, with 40% opting to pay attackers. Worse, 68% reported disruptions to patient care as a result of these attacks[12]. On top of that, the average cost of a healthcare data breach has skyrocketed to nearly $11 million per incident, a 50% increase over the past three years[12].
Traditional defenses, like perimeter security, are ill-equipped to handle modern threats. The rise of cloud services, remote work, interconnected devices, and digital supply chains has created countless new vulnerabilities. This reality underscores the need for a strategy that prioritizes swift recovery over an unachievable goal of absolute prevention.
How Resilience-Based Cybersecurity Works
Resilience-based cybersecurity offers a more realistic and effective way to defend against cyber threats. It starts with a simple but critical assumption: attacks will happen, but their impact can be controlled.
This approach layers robust protection with advanced detection, response, and recovery capabilities. Instead of solely relying on perimeter defenses, resilience strategies focus on continuous monitoring, real-time threat detection, and automated responses to contain attacks before they spread.
Healthcare data is particularly attractive to cybercriminals. As Sandeep Kumbhat, Field CTO at Okta, explains:
"Healthcare is a top target for ransomware because they have the crown jewel of data from a patient care perspective."[11]
Key elements of resilience-based cybersecurity include:
- Proactive threat prevention and continuous endpoint monitoring
- Enhanced security for medical devices
- Strong backup and disaster recovery systems
- Employee training and adoption of zero-trust principles
Real-time monitoring and rapid response capabilities are central to this strategy. These systems detect irregularities, contain threats, and initiate recovery in minutes rather than hours or days. The goal isn’t to eliminate all risks but to manage and mitigate them while ensuring critical healthcare services remain operational.
Prevention vs. Resilience: Key Differences
The differences between prevention-focused and resilience-based models are striking. For healthcare organizations, understanding these distinctions is vital to building a stronger cybersecurity framework.
| Aspect | Prevention-Only Model | Resilience-Based Model |
|---|---|---|
| Focus | Blocking all attacks at the perimeter | Minimizing impact and ensuring rapid recovery |
| Core Assumption | Attacks can be completely stopped | Attacks are inevitable and must be managed |
| Security Approach | Perimeter defenses, signature-based detection | Multi-layered defenses, real-time monitoring, and response |
| Response Strategy | Reactive, addressing breaches after they occur | Proactive, with real-time detection and containment |
| Ultimate Goal | Eliminate all risks | Maintain operations and minimize disruption |
| Approach | Build impenetrable walls | Enable quick recovery and continuity of care |
The resilience model accepts what many security experts already know: perfect prevention is impossible. Instead of chasing an unattainable goal, resilient organizations prepare for inevitable breaches by building systems capable of responding effectively and recovering quickly.
This mindset is already gaining traction in healthcare. Research shows that 61% of healthcare organizations have integrated their cybersecurity teams with business operations, signaling that resilience is increasingly seen as a critical business priority[13]. Additionally, nearly 60% of organizations now measure leadership performance against cybersecurity metrics[13].
Jason Koler, Deputy Chief Information Security Officer at Eaton Corporation, highlights the importance of this shift:
"A cyber resilience strategy ensures that when our defenses are penetrated, and our data is exfiltrated, we can recover quickly and completely, thus limiting damage. Most importantly, cyber resilience ensures that we continue to operate on a nearly continuous basis with little or no downtime and with minimal negative impact."[14]
The move from prevention to resilience is more than just a tactical adjustment - it’s a complete rethinking of how healthcare organizations handle cybersecurity in an era where patient safety and operational continuity must remain top priorities, even under attack.
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Tools and Solutions for Better Clinical Resilience
Strengthening clinical resilience requires tools designed to navigate healthcare's unique challenges, such as regulatory demands, managing vast networks of vendors, and responding to threats without disrupting patient care. To meet these needs, healthcare organizations must adopt solutions built with their specific complexities in mind.
Advanced Cybersecurity Platforms for Healthcare
Healthcare systems face a level of complexity that demands specialized cybersecurity tools. As Matt Christensen, Sr. Director GRC at Intermountain Health, puts it:
"Healthcare is the most complex industry... You can't just take a tool and apply it to healthcare if it wasn't built specifically for healthcare." [15]
Censinet RiskOps™ is one such platform, tailored to healthcare’s requirements. This cloud-based solution supports the entire Third-Party Risk Management (TPRM) lifecycle, from onboarding to offboarding vendors, while fostering collaboration across teams. Its extensive network connects over 50,000 vendors and products across the healthcare sector, offering shared intelligence and benchmarking opportunities [15].
The platform's impact is clear. Terry Grogan, CISO at Tower Health, shares:
"Censinet RiskOps allowed 3 FTEs to go back to their real jobs! Now we do a lot more risk assessments with only 2 FTEs required." [15]
Another critical feature is cybersecurity benchmarking, which helps organizations evaluate their security measures. Brian Sterud, CIO at Faith Regional Health, highlights its importance:
"Benchmarking against industry standards helps us advocate for the right resources and ensures we are leading where it matters." [15]
This data-driven approach empowers healthcare leaders to justify security investments and secure buy-in from executives and boards.
Using AI and Automation for Risk Management
Artificial intelligence is reshaping how healthcare systems manage cyber risks. By analyzing vast amounts of data, AI can detect unusual patterns that might signal a breach [17].
Censinet AI™ builds on this by addressing risks tied to third-party AI tools and vendors. As healthcare increasingly integrates AI into clinical and administrative processes, ensuring these tools meet security and patient care standards is vital [16]. Censinet AI™ enhances risk management through:
- Vulnerability Management: Automates the identification and prioritization of security risks, allowing IT teams to focus on the most critical threats [17].
- Behavioral Analytics: Monitors user activity to spot insider threats by identifying unusual behavior patterns [17].
- Medical Device Protection: Tracks network traffic around connected medical devices to detect anomalies [17].
- Real-time Threat Detection: Continuously monitors for threats to enable rapid response [17].
A great example of AI in action is Jorie AI’s Pre-Authorization system, which processes patient data and integrates it with Hospital Information Systems. This innovation has reduced delays and denials by 70%, streamlining administrative tasks and improving patient care [17].
While AI offers powerful tools, human oversight remains essential. Experts are needed to validate findings and make critical decisions, ensuring AI-driven processes align with broader security goals.
Creating Collaborative Networks for Better Security
Healthcare organizations are deeply interconnected, meaning a breach in one can have widespread consequences. Recent attacks have shown the importance of shared threat intelligence in strengthening collective defenses.
Sharing information is key to understanding the evolving threat landscape. When one organization identifies a new attack vector or vulnerability, sharing that knowledge helps others prepare and respond [21]. Collaborative efforts, such as the HHS 405(d) Program, provide resources and strategies to combat emerging cyber threats [19]. Similarly, the Health Sector Coordinating Council (HSCC) Cybersecurity Working Group unites over 400 healthcare stakeholders to address risks to health data, systems, and patient care [18].
Smaller healthcare facilities, often lacking resources for robust cybersecurity measures, benefit greatly from the expertise and support of larger organizations and government partnerships [19]. This collective approach underscores the principle that cyber safety is patient safety [18]. By pooling knowledge, sharing best practices, and coordinating responses, healthcare organizations can build a stronger, more resilient system capable of withstanding cyber threats while ensuring patient care remains uninterrupted.
Practical Steps to Build Clinical Resilience
Strengthening clinical resilience isn't just about adopting the latest tools - it requires a well-rounded strategy that reshapes how healthcare organizations handle cyber risks. Below are actionable steps to enhance cybersecurity frameworks while encouraging continuous improvement.
Setting Up Risk-Based Assessments and Improvement Cycles
Healthcare organizations should embrace ongoing risk management processes. Conduct risk assessments annually or whenever major system changes occur [22]. These assessments should cover all aspects of the organization, including access controls, employee training, incident response plans, and contingency strategies [22]. Technical measures like encryption and strict access protocols are crucial for safeguarding electronic protected health information (ePHI) [22].
To get ahead of potential threats, perform vulnerability scans twice a year and penetration tests annually. These proactive measures can minimize downtime and financial losses, which can exceed $1 million per day during cyberattack-induced outages [22].
A continuous improvement cycle is also vital. Establish clear communication channels for sharing threat updates and resolving user concerns quickly [20]. Regular security audits, vulnerability assessments, and penetration tests should become routine to evaluate the effectiveness of current defenses and identify areas needing attention [20][23]. With the average HIPAA fine topping $1.5 million and unplanned downtime costing around $7,900 per minute [23], these practices can significantly lower risks.
This consistent monitoring creates a strong framework for addressing vulnerabilities, especially those tied to outdated systems.
Fixing or Replacing Legacy Systems
Legacy systems remain one of the biggest cybersecurity challenges in healthcare. These outdated platforms often lack basic protections, such as data encryption or secure password protocols, making them prime targets for cyberattacks [27].
"Some of the legacy technology does not have basic security features such as encryption of data, encryption of transmission. Some of them still have no passwords or hard-coded passwords you can look up on the internet in the technician's manual." - John Riggi, American Hospital Association national adviser for cybersecurity and risk [25]
A methodical approach to addressing these vulnerabilities is essential. Start by identifying all network-connected devices, evaluate their risks, and apply network segmentation to isolate high-risk devices. If a device remains too risky, disconnect it from the network altogether [25].
Form a Medical Technology/IoT Management Committee with members from clinical, IT, and security teams to oversee the risk management of medical devices [26]. This team should establish a formal risk management plan, leveraging frameworks like ISO 14971, and create a lifecycle management strategy that includes milestones like End of Life and End of Support to plan upgrades or implement security measures proactively [26].
Modernizing these systems isn't just about security - it can also lead to significant cost savings. Hospitals can cut costs by up to 70% through automation [24], while phased modernization efforts targeting high-risk backend systems have reduced IT operational expenses by 25–40% over three years, all while minimizing service disruptions [27]. These upgrades also enhance an organization’s ability to respond swiftly during security incidents.
Building Team Collaboration and Leadership Support
Once technical and infrastructure improvements are underway, maintaining progress requires strong leadership and teamwork. Support from organizational leaders is crucial for creating a security-focused culture that unites IT, clinical, and administrative teams [20].
Leadership begins with allocating resources. Many organizations dedicate 5% to 10% of their IT budgets to cybersecurity, with 10% being the recommended minimum [28]. Beyond financial investment, leaders must champion cybersecurity initiatives, allocate sufficient resources, and model secure practices themselves [20].
Collaboration across departments is equally important. IT, clinical, and administrative leaders should work together to align security measures with clinical workflows. Clinicians need to be involved in security discussions, while IT teams should prioritize solutions that integrate smoothly into day-to-day operations [20].
Training and communication also play a key role. Offer regular training sessions on topics like password management, phishing awareness, data handling, and device security, tailoring content to specific user groups [20]. Create clear reporting protocols and provide user-friendly tools for reporting potential threats, making cybersecurity a shared responsibility [29].
Encourage open communication and reward secure behavior, such as through a cybersecurity ambassador program [28]. As risk assessments and technology updates continue, strong leadership and cross-department collaboration are essential for embedding a resilient security culture.
The benefits of these efforts are clear. Organizations that conduct regular security risk assessments are 50% less likely to face major compliance breaches, and 60% report fewer compliance incidents thanks to well-defined policies. However, only 46% of healthcare organizations currently provide regular cybersecurity training, highlighting room for improvement [30].
Conclusion: The Future of Clinical Resilience in Healthcare
Healthcare cybersecurity is facing a pivotal moment [31]. In the first quarter of 2025, organizations experienced an average of 1,357 cyberattacks per week, making healthcare the second-most-targeted industry in the U.S. [31].
Given these escalating threats, resilience has evolved beyond being just an IT priority - it’s now a critical aspect of patient safety. Shifting from a prevention-only approach to resilience-based strategies redefines how patient care is safeguarded [31]. Cyber risks are no longer confined to IT departments; they are a fundamental patient safety issue. This mindset shift must begin with leadership - boards, CEOs, and clinical executives need to treat cyber resilience as an integral part of operational readiness, not just another technology expense [31].
In 2024, the average cost of a healthcare data breach reached $9.8 million, as cyberattacks surged 93% between 2018 and 2022 [32]. Incidents like those at CommonSpirit Health, Scripps Health, and Change Healthcare highlight the stakes - downtime isn’t merely inconvenient; it jeopardizes patient safety and the very survival of healthcare organizations.
Looking ahead, continuous threat monitoring, zero-trust security models, and real-world incident drills must become standard practices [31]. Encouragingly, 70% of healthcare organizations now include cybersecurity considerations from the earliest stages of tech investment decisions, signaling a move toward more strategic integration [8]. This shift is breaking down silos between IT and clinical leadership, fostering collaboration.
The future of clinical resilience relies on dissolving barriers between IT, cybersecurity, and clinical teams while empowering CISOs to take on strategic leadership roles. As cyber threats grow increasingly complex, innovative platforms are emerging to help manage third-party risks, automate assessments, and provide visibility across the healthcare ecosystem. The integration of cyber and clinical efforts, as previously discussed, is essential for navigating these challenges.
Healthcare organizations that modernize their systems, conduct regular risk assessments, and foster cross-department collaboration will be better positioned to ensure uninterrupted patient care. The pressing question remains: is your organization prepared to maintain patient care in the face of the next cyberattack?
FAQs
What’s the difference between prevention-focused and resilience-based cybersecurity in healthcare?
Prevention-focused cybersecurity is all about stopping threats before they even have a chance to strike. This involves using tools like firewalls, encryption, and strict access controls to block potential risks from infiltrating systems. It's a proactive line of defense aimed at keeping threats out entirely.
On the flip side, resilience-based cybersecurity is more about how an organization handles itself when a breach does occur. It’s centered on adapting, recovering, and maintaining operations after an attack. This approach prioritizes rapid response, system recovery, and staying ahead of evolving threats to ensure minimal disruption.
While prevention works to lower the chances of an attack, resilience ensures that, even if something slips through, critical operations - like patient care in healthcare settings - continue without major interruptions. Both approaches are vital for managing today’s complex cybersecurity challenges.
How can healthcare organizations upgrade outdated systems without risking disruptions to patient care?
Healthcare organizations can modernize outdated systems without causing major disruptions by adopting a phased approach. This strategy focuses on upgrading one system or component at a time - like patient scheduling or billing - so essential operations continue running smoothly.
Equally important are risk assessments and change management strategies. These steps help spot potential issues early, ensuring transitions are handled effectively, with minimal downtime and no compromises to patient safety. Partnering with IT and clinical teams throughout the process ensures that the upgrades meet operational demands and support patient care priorities.
How does artificial intelligence improve cybersecurity and strengthen clinical resilience in healthcare?
Artificial intelligence (AI) is becoming an essential tool in strengthening cybersecurity and enhancing resilience in healthcare. It enables real-time detection and response to cyber threats, safeguarding sensitive patient information and lowering the chances of data breaches. AI systems are adept at spotting unusual patterns or potential vulnerabilities, allowing healthcare providers to address risks before they become major issues.
Beyond security, AI aids clinical decision-making by processing enormous amounts of data to deliver actionable insights. This helps streamline operations and reduces the likelihood of disruptions in patient care. By incorporating AI into their cybersecurity plans, healthcare organizations can protect their systems more effectively while ensuring consistent and reliable care for patients.
