“When Cyber Risk Meets the Bedside: Clinical Continuity in the Ransomware Era”
Post Summary
Healthcare organizations are facing an alarming surge in ransomware attacks, with a 300% increase since 2015. These attacks don't just disrupt operations; they directly threaten patient safety. Hospitals rely on electronic systems for everything from accessing medical histories to managing life-critical devices. A single cyberattack can delay treatments, divert emergencies, and even cost lives. For example, ransomware incidents have been linked to increased cardiac arrest deaths and delays in cancer care.
Key takeaways:
- Ransomware in healthcare is on the rise: Two-thirds of healthcare organizations were hit in 2024, with recovery costs averaging $2.57 million per incident.
- Patient safety is at risk: Downtime impacts emergency care, delays surgeries, and compromises critical procedures.
- Financial toll is severe: Healthcare breaches cost $10.1 million on average, and stolen health records are 10x more valuable than credit card data.
- System vulnerabilities: Outdated IT infrastructure, unpatched software, and phishing attacks are common entry points for hackers.
To combat these threats, healthcare leaders must prioritize clinical continuity plans. This includes robust incident response strategies, staff training, network segmentation, and advanced cybersecurity tools like multi-factor authentication and endpoint detection systems. Organizations like Censinet offer tailored solutions to help healthcare providers protect patient care and manage risks effectively.
The stakes are clear: safeguarding patient care in the ransomware era requires proactive measures to ensure uninterrupted clinical operations.
CS EP 008- Ransomed Healthcare: Balancing Patient Safety and Cyber Defense. With Thomas Ritter
Ransomware Threats Targeting Healthcare
The healthcare sector has become a prime target for cybercriminals, with increasingly sophisticated ransomware attacks causing significant harm. Protecting patient data and maintaining clinical operations require an in-depth understanding of these threats and how they unfold. Let’s examine the tactics attackers use to breach healthcare systems.
How Attackers Target Healthcare Systems
Healthcare networks are often breached using a variety of methods, with email phishing standing out as the most prevalent. These phishing campaigns are designed to deceive staff by mimicking legitimate messages from trusted sources, such as vendors or colleagues, tricking them into clicking malicious links or downloading harmful attachments.
"Email remains one of the largest vectors for delivering malware and phishing attacks for ransomware attacks."
- Jack Mott, Microsoft Threat Intelligence [3]
Apart from phishing, attackers exploit unpatched systems and weak user credentials. Healthcare organizations often struggle to keep their software updated across sprawling networks that include medical devices and administrative tools, leaving gaps that attackers can exploit.
Third-party vendor breaches are another growing concern. A notable incident occurred in February 2024, when the BlackCat ransomware group targeted Change Healthcare, a unit of UnitedHealth Group. This attack disrupted billing and payment processing nationwide, impacting approximately 190 million individuals and causing severe financial strain for healthcare providers due to delayed reimbursements [6].
The rise of Ransomware-as-a-Service platforms has further lowered the technical barriers for attackers, enabling even less-skilled criminals to launch complex attacks.
Recent examples show just how disruptive these attacks can be. In May 2024, Ascension Healthcare - managing 140 hospitals across 19 states - was hit by ransomware that forced its IT systems offline. This attack led to appointment cancellations, delayed access to electronic health records, and disrupted patient care, ultimately affecting 5.6 million patients [6].
Why Healthcare Is Vulnerable to Cyber Attacks
Healthcare systems face several vulnerabilities that make them attractive targets for cybercriminals. The critical nature of healthcare operations often forces organizations to restore systems quickly, sometimes by paying ransoms, to avoid prolonged disruptions.
The high value of patient data adds to the risk. Criminals prize healthcare records for their wealth of sensitive information. Many facilities also rely on outdated IT infrastructure, including legacy systems and medical devices that lack modern security updates.
The interconnected nature of healthcare systems compounds the problem. A breach in one system can ripple through others, affecting everything from patient monitoring devices to pharmacy operations. Smaller organizations face even greater challenges, often relying on IT generalists rather than dedicated cybersecurity experts.
"These IT generalists, often just someone proficient in network and computer management, are used to dealing with things like, 'I can't print, I can't log in, what's my password?' They're not cybersecurity experts. They don't have the staff, they don't have the budget, and they don't even know where to start."
- Doctors Christian Dameff and Jeff Tully, Co-Directors and Co-Founders of the University of California San Diego Center for Healthcare Cybersecurity [3]
In 2024, 67% of healthcare organizations reported experiencing a cyberattack, marking a four-year high. Overall, the industry saw a 32% increase in cyberattacks compared to the previous year [7][1].
Financial Impact of Healthcare Cyber Incidents
The financial toll of ransomware attacks on U.S. healthcare organizations has been staggering, reaching $21.9 billion between 2018 and 2024 [7]. Paying ransoms often doesn’t guarantee quick recovery. In 2024, 53% of healthcare organizations affected by ransomware admitted to paying, with an average payment of $4.4 million [3]. However, even after payment, recovery can be slow. For instance, Change Healthcare paid a $22 million ransom but never managed to recover its data [6].
Data breaches add further financial strain, with the average cost of a healthcare data breach hitting $10.1 million in 2022 [7]. These costs include expenses like notifying affected individuals, providing credit monitoring, paying legal fees, and handling regulatory fines.
The July 2024 ransomware attack on OneBlood, a major blood center serving hospitals in the southeastern U.S., highlights the cascading costs of such incidents. The attack forced OneBlood to switch to manual distribution methods, causing delays in blood supply deliveries and prompting hospitals to adopt conservation measures [6].
Regulatory penalties also pile on additional costs. Under HIPAA regulations, data breaches can result in fines ranging from thousands to millions of dollars, depending on the severity of the incident.
However, the financial costs pale in comparison to the human toll. Between 2016 and 2021, research estimates that ransomware attacks contributed to the deaths of 42 to 67 Medicare patients [2]. These tragedies emphasize that while financial losses are substantial, safeguarding patient safety and ensuring uninterrupted care must remain the top priorities.
Building Clinical Continuity Plans
With ransomware attacks posing a direct threat to patient safety, having a strong clinical continuity plan isn't just a good idea - it's a necessity. This plan acts as a blueprint for keeping critical care services running smoothly when cyber incidents occur.
Developing Your Clinical Continuity Plan
An effective clinical continuity plan bridges the gap between IT systems and clinical operations. It’s not just about getting tech back online - it’s about ensuring patient care continues uninterrupted, even during outages.
"Planning is not solely a one- to two-hour meeting or an afternoon planning session, but rather it is having the framework...a written plan known to all leaders, practice sessions demonstrating execution of the plan, and finally, self-evaluation of their plan or practice." - Barbara Pelletreau, former senior vice president of patient safety for a large healthcare organization [5]
Your plan should include several key elements. Start with an incident response plan that outlines the steps to take after a security breach, including clear escalation paths and communication protocols. Pair this with disaster recovery strategies that prioritize restoring life-critical systems before other applications.
Employee training protocols are another essential piece. These should cover everything from spotting phishing attempts to carrying out manual procedures during system downtime. Following the 3-2-1 backup rule - keeping three copies of data on two different media types, with one stored offsite - adds an extra layer of protection.
Communication is equally important. Establish redundant channels to keep staff, patients, vendors, and regulators informed, even if primary systems fail.
The Joint Commission mandates that healthcare organizations conduct a hazards vulnerability analysis and maintain continuity, disaster recovery, and emergency operations plans [5]. Incorporating these into your clinical continuity plan ensures you're prepared to tackle challenges like ransomware attacks head-on.
Finally, focus on identifying and addressing the most pressing cyber risks.
Identifying and Ranking Cyber Risks
To manage risks effectively, you need to understand your assets and their vulnerabilities. Healthcare organizations must shift from reacting to threats to proactively addressing them, treating cyber risks as critical patient safety concerns - not just IT issues.
The process involves several steps:
Step | Description |
---|---|
Asset classification | Identify and assign value to assets within the IT ecosystem |
Threat analysis | Document potential threats and how they could exploit vulnerabilities |
Risk analysis | Assess the impact and likelihood of these threats |
Risk prioritization | Rank risks based on their severity, impact, and likelihood |
This structured approach is vital, especially when resources are limited. Healthcare data is highly sought after, often fetching up to 10 times more than stolen credit card information on the black market [4]. The financial toll is steep, with an average cost of $408 per stolen healthcare record compared to $148 for non-health records [4].
Third-party vendors also represent a significant risk. Studies show that 74% of cybersecurity issues in healthcare stem from external vendors [10]. To mitigate this, perform detailed risk assessments before entering contracts and regularly review these partnerships as threats evolve.
"The connection between healthcare providers and third-party vendors is critical but also fraught with risk." - ECRI [10]
Training Staff and Testing Systems
A continuity plan is only as strong as the people implementing it. With organizations in North America experiencing an average of 1,357 cyberattacks per week in early 2025 [9], regular training and testing are non-negotiable.
Staff training should cover a range of cybersecurity practices, such as email security, strong passwords, and two-factor authentication. Training must evolve alongside new threats to keep employees vigilant.
"Many healthcare organizations have a myopic view of ransomware attacks. Their plan doesn't encompass proper handling of downtime documentation including paper records, test results, and orders." - Shawn Van Doren, RN, BSN, CCS [11]
Simulated attacks are an excellent way to test preparedness. For instance, one healthcare organization had to address over 35,000 diagnostic tests after a malware incident. The lack of a downtime documentation plan and reliance on manual charting highlighted the importance of thorough preparation [11].
Testing should also include data backup verification to ensure recovery systems work as intended. Offline or off-site backups are crucial to prevent ransomware from encrypting recovery data.
Tabletop exercises are another valuable tool. These simulations help teams practice communication, decision-making, and manual processes under realistic conditions. Set timelines for validating documentation, updating electronic health records, and restoring operations. Consider factors like documentation volume and the accuracy of manual charting.
Make it a habit to review and update the plan annually, using insights from both drills and real incidents to refine your approach. Testing should confirm that critical systems can operate independently if the network is isolated. Proper network segmentation is key to ensuring that isolating one system doesn’t disrupt patient care elsewhere.
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Cybersecurity Risk Reduction Methods
Defending against ransomware requires more than just basic security measures - it demands a well-rounded approach. With cyberattacks rising by 32% and two-thirds of organizations experiencing ransomware incidents in 2024 [1], the stakes are high. Each day of downtime now costs an average of $1.9 million, with recovery expenses climbing from $1.27 million in 2021 to $2.57 million in 2024 [13]. These figures make proactive security measures a necessity, not a luxury. One of the most effective ways to tackle these challenges is by employing layered defenses.
Using Multiple Security Layers
A strong defense starts with building multiple protective layers to guard against ransomware. A defense-in-depth strategy ensures that every layer of your infrastructure is fortified, creating hurdles for attackers and reducing the likelihood of a breach.
Multi-factor authentication (MFA) serves as a vital first line of defense. For instance, the February 2024 ransomware attack on Change Healthcare was directly linked to the absence of MFA on remote-access systems [12]. To mitigate similar risks, MFA should be implemented across all critical systems, including EHRs, remote access, email, and administrative accounts [13].
Network segmentation plays a crucial role in containing ransomware. By isolating networks using tools like Virtual Local Area Networks (VLANs), firewalls, and access controls, you can limit the spread of threats. This ensures that even if one segment is compromised, critical systems in other areas remain unaffected, safeguarding patient care operations [13].
Endpoint Detection and Response (EDR) solutions provide real-time monitoring across devices, enabling swift threat identification and containment before ransomware can spread further [13].
Regular patch management is another essential layer. With 60% of data breaches linked to unpatched software [13], keeping systems updated is critical. A structured process that prioritizes security updates can address vulnerabilities while minimizing disruptions to clinical workflows.
Security Layer | Primary Function | Integration Points | Patient Care Impact |
---|---|---|---|
Multi-Factor Authentication | Verifies user identity beyond passwords | EHR, VPN, email, admin systems | Minimal disruption with training |
Network Segmentation | Isolates network segments | VLANs, firewalls, access controls | Limits lateral ransomware movement |
Endpoint Detection | Monitors devices for threats | Workstations, mobile devices, servers | Rapid threat containment |
Patch Management | Updates software vulnerabilities | All connected systems | Scheduled maintenance windows |
Strengthening Staff Security Awareness
Human error remains a leading cause of cybersecurity incidents, with 88% of data breaches stemming from employee mistakes [14]. However, targeted training can significantly reduce risky behaviors - by as much as 90% [16].
"People are your best defense (and vulnerability) to an organization. The number one thing an organization can do is provide regular and current education to employees. Help them understand how to identify potential threats and alert IT quickly." - Cecil Pineda, Senior Vice President and Chief Information Security Officer at R1 [15]
Training should be tailored to specific roles. Nurses, doctors, administrators, and IT staff each face unique risks, so their training should reflect their responsibilities. Incorporating regular phishing simulations can help assess and improve employees’ ability to detect and report suspicious emails [15].
"The human factor remains a top vulnerability in healthcare, necessitating comprehensive security training for staff is crucial." - Bill Murphy, Director of Security & Compliance at LeanTaaS [15]
To make training effective, connect cybersecurity practices to real-life scenarios. Engaging sessions that relate personal habits to organizational policies can leave a lasting impression. Additionally, establish clear reporting channels so employees feel safe reporting potential threats without fear of blame.
Adopting Advanced Security Technologies
While human factors are critical, advanced technologies provide an extra layer of protection against evolving threats. Modern tools not only secure data but also support uninterrupted patient care by integrating seamlessly with existing systems.
Zero Trust architecture shifts the focus to continuous verification. Instead of assuming trust after initial access, this approach requires ongoing authentication for all users, devices, and applications [17]. By implementing least-privilege access controls, organizations ensure that individuals only have access to what’s strictly necessary for their roles.
Cloud-based security solutions offer scalability and real-time updates, providing advanced threat detection capabilities that adapt to new risks.
Managed Detection and Response (MDR) combines cutting-edge tools with human expertise to deliver comprehensive protection. Unlike traditional solutions that focus on isolated areas like endpoints, MDR covers a wide range of vulnerabilities, from networks to devices. This approach is particularly valuable for healthcare organizations that need 24/7 monitoring but lack the internal resources to maintain it [8].
Automated incident response tools can also make a huge difference. By isolating affected systems and initiating recovery procedures within seconds, these tools can prevent ransomware from spreading to critical areas, such as patient care systems.
Healthcare organizations can benefit from partnering with cybersecurity specialists who understand the unique demands of the field. These partnerships provide access to expertise and resources that might otherwise be too costly, ensuring that security measures align with both clinical workflows and regulatory requirements [13].
The success of advanced technologies depends on their ability to enhance clinical operations rather than disrupt them. Collaborating with clinical staff during implementation can help identify and address potential workflow issues, ensuring that security measures protect data without compromising patient care.
Using Censinet for Healthcare Risk Management
Healthcare organizations face unique challenges when it comes to cybersecurity. Generic tools often fall short because they don’t address critical factors like clinical workflows, regulatory standards, or patient safety. To stay resilient during cyber threats, healthcare providers need solutions specifically designed for the complexities of their field.
"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." - Matt Christensen, Sr. Director GRC, Intermountain Health [19]
This complexity demands tailored solutions that integrate seamlessly with healthcare systems, ensuring operations continue smoothly - even during ransomware attacks. Let’s explore how Censinet’s offerings are designed to meet these specific needs.
Censinet RiskOps™ Platform Overview
The Censinet RiskOps™ platform is built to streamline risk management for healthcare organizations. It provides full-spectrum risk assessments, real-time insights, and tools to strengthen cybersecurity programs. With a network of over 40,000 vendors and products [18], the platform simplifies third-party and enterprise risk evaluations through automated scoring and standardized questionnaires - cutting out time-consuming manual processes.
For example, Tower Health saw significant efficiency improvements by adopting Censinet RiskOps. They reduced staffing needs for risk assessments, reallocating three full-time employees to other critical roles while managing assessments with just two dedicated staff members [19]. The platform also includes features like delta-based reassessments, alerts for breaches and ransomware, and scheduled risk tiering, giving organizations constant visibility into their risk environment. Baptist Health further demonstrated the platform’s value by replacing spreadsheets with a more collaborative system, simplifying risk data management across a network of hospitals [19].
Censinet AITM Features and Benefits
Censinet takes risk management a step further with its AI-powered automation, known as Censinet AITM. This tool accelerates the process by summarizing vendor evidence, documenting integration details, and identifying fourth-party risks. It also generates comprehensive risk summary reports [21].
"Healthcare organizations need faster, more effective solutions to protect care delivery from disruption." - Ed Gaudet, CEO and founder of Censinet [21]
Censinet AITM blends automation with human oversight, empowering risk teams to maintain control through customizable rules and review processes. It enhances collaboration by routing assessment results and tasks to the appropriate stakeholders. Fully integrated into the RiskOps platform and hosted within a secure Virtual Private Cloud on AWS, it ensures that data remains protected [21].
"Our collaboration with AWS enables us to deliver Censinet AI to streamline risk management while ensuring responsible, secure AI deployment and use. With Censinet RiskOps, we're enabling healthcare leaders to manage cyber risks at scale to ensure safe, uninterrupted care." - Ed Gaudet, CEO and founder of Censinet [21]
Meeting Compliance and Safety Requirements
Cybersecurity in healthcare isn’t just about protecting data - it’s also about meeting strict compliance standards to ensure uninterrupted patient care. Censinet offers tools to safeguard Protected Health Information (PHI) and support HIPAA compliance by addressing administrative, physical, and technical safeguards [20]. The platform simplifies HIPAA Security and Privacy Rule assessments, helping organizations identify gaps, track progress, and generate detailed reports.
Compliance Feature | Function | Healthcare Benefit |
---|---|---|
HIPAA Security Rule Assessment | Evaluates technical safeguards compliance | Protects PHI during cyber incidents |
Privacy Rule Compliance | Monitors administrative safeguards | Maintains patient privacy during recovery |
Auto-generated CAPs | Creates corrective action plans | Speeds up remediation of compliance gaps |
Enterprise Reporting | Consolidates results organization-wide | Provides board-level insights into compliance |
Censinet’s curated questionnaires and built-in evidence capture make it easier for organizations to demonstrate their security posture during audits [20]. Faith Regional Health, for instance, uses these tools to advocate for necessary resources and drive improvements in key areas. Auto-generated Corrective Action Plans (CAPs) further support this effort by assigning tasks, setting priorities, and tracking progress, ensuring compliance gaps are addressed efficiently [20].
"Our collaboration with Censinet brings innovative AI capabilities to healthcare organizations facing an evolving and more ominous cyber threat landscape." - Ben Schreiner, Head of Business Innovation for SMB, U.S. at AWS [21]
Conclusion: Strengthening Healthcare Cyber Defenses
The ransomware threat in healthcare has reached a critical point. In 2024 alone, 181 ransomware attacks disrupted healthcare operations, exposing millions of patient records and forcing organizations to pay substantial ransoms [22]. Globally, over 630 ransomware incidents were reported in 2023, with more than 460 targeting the United States [22]. These attacks don’t just disrupt systems - they jeopardize lives.
"Let's be clear… ransomware and other cyberattacks on hospitals and other health facilities are not just issues of security and confidentiality; they can be issues of life and death." - Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO) [23]
Key Focus Areas for Healthcare Leaders
Healthcare leaders need to adopt a layered defense strategy that goes beyond basic cybersecurity. The goal is resilience: being able to identify attacks, restore operations quickly, and ensure patient care continues uninterrupted. Achieving this requires a combination of strategies, including regular data backups, employee training, network segmentation, and advanced threat detection tools.
The human element cannot be overlooked. Employees often serve as the first line of defense, making security awareness training and third-party risk management essential. Leadership should also empower Chief Information Security Officers (CISOs) to take on strategic roles, integrating security into every operational decision.
Zero Trust models and role-based authentication strengthen access controls, while periodic risk assessments help identify and address vulnerabilities before attackers can exploit them. Comprehensive incident response plans are critical, outlining clear steps to detect, contain, and recover from cyberattacks.
The Role of Technology in Cyber Resilience
Healthcare organizations face unique challenges that generic cybersecurity tools often fail to address. Advanced technologies tailored to healthcare's complexities - such as clinical workflows and regulatory requirements - are crucial for maintaining operations during cyber incidents.
"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." - Matt Christensen, Sr. Director GRC, Intermountain Health [19]
Solutions like Censinet RiskOps™ are designed specifically for healthcare, helping organizations manage risks at scale while prioritizing patient care. With a Digital Risk Catalog™ that includes over 40,000 vendors and products [18], this platform enables efficient risk management and supports collaborative oversight. Its AI-driven automation further speeds up risk assessments while maintaining human input through customizable rules and review processes.
Cloud-based data protection, real-time network monitoring, and automated threat detection tools form the backbone of resilient operations. These technologies must work together seamlessly, creating a defense system that adapts to evolving threats without disrupting clinical workflows. This integrated approach is essential for ensuring patient care remains uninterrupted.
Preparing for Future Challenges
The cybersecurity landscape is constantly evolving, with threats becoming more advanced and the number of connected devices steadily increasing. Cybercriminals are now leveraging AI to create and mutate malicious code in real time, while ransomware groups operate like businesses, offering user-friendly toolkits to affiliates.
Healthcare organizations must modernize their infrastructure to address these challenges. Retiring outdated systems, adopting multi-factor authentication, conducting regular tabletop exercises, and segmenting critical systems are all necessary steps to limit vulnerabilities and contain potential breaches. With healthcare data breaches projected to cost an average of $11.45 million per incident in 2025, these investments are not optional - they are essential [23].
Collaboration will also play a major role in future readiness. By participating in industry-specific information-sharing networks, healthcare organizations can access timely threat intelligence and contribute to the development of stronger security standards. Partnering with experienced cybersecurity vendors can further bolster defenses, while ongoing staff training ensures employees remain an active part of the solution.
A comprehensive approach that integrates people, processes, and technology is essential. Organizations that allocate sufficient resources to cybersecurity, establish clear incident response plans, and leverage AI for proactive threat detection will be better equipped to protect patient data and ensure continuous care. The steps taken today will determine whether healthcare organizations can continue their vital mission tomorrow: delivering safe, uninterrupted care in the face of evolving cyber threats.
FAQs
How can healthcare organizations strengthen cybersecurity without disrupting clinical operations?
Healthcare organizations can uphold strong cybersecurity measures while keeping clinical operations running smoothly by using a risk-based approach. This means focusing on protecting critical systems and sensitive patient data, embedding security into everyday workflows, and ensuring minimal interference with patient care.
Some effective strategies include promoting a cybersecurity-aware culture through ongoing staff training, creating detailed incident response plans, and automating security tasks to cut down on manual work. Tools like load balancing can also improve security while maintaining system efficiency. By staying ahead of cyber threats, healthcare providers can protect patient care and ensure operations continue uninterrupted - even during ransomware attacks.
What should healthcare organizations include in a clinical continuity plan to protect patient care during a ransomware attack?
A solid clinical continuity plan is crucial to maintaining patient care during a ransomware attack. Here are the key components to focus on:
- Prioritizing critical operations: Allocate resources to keep essential services - like bedside care and emergency treatments - running smoothly, even if systems are down.
- Incident response steps: Create a clear plan for identifying, containing, and resolving ransomware incidents quickly and effectively.
- Staff preparedness: Train staff regularly on cybersecurity basics and manual workflows to ensure they can adapt if digital tools become unavailable.
- Data backups and recovery: Use reliable backup systems to protect patient information and restore critical systems as quickly as possible.
- Coordination with partners: Set up communication plans with external providers and vendors to maintain care and secure access to vital resources.
By addressing these areas, healthcare organizations can reduce disruptions and uphold patient safety, even during a cyberattack.
Why is the healthcare industry a prime target for ransomware attacks, and how can organizations protect themselves effectively?
The healthcare sector is a prime target for ransomware attacks, largely because of its reliance on interconnected systems like electronic health records (EHRs) and medical devices. Add to that the urgent, life-critical nature of patient care, and it’s easy to see why cybercriminals find this industry appealing. Unfortunately, many healthcare organizations also struggle with limited resources, such as tight cybersecurity budgets and understaffed IT teams, making it harder to build strong defenses.
To combat these risks, healthcare providers should focus on a multi-layered cybersecurity approach that includes:
- Regular offline data backups to ensure swift recovery in case of an attack.
- Employee education programs to help staff identify phishing scams and other common threats.
- Advanced threat detection tools to quickly spot and address unusual activity.
- Email filtering systems to block harmful messages before they reach inboxes.
These steps can help healthcare organizations protect patient care, reduce operational disruptions, and strengthen their defenses against ransomware attacks.