Healthcare IoT Security: A Practical Guide for Hospital Teams

A hospital security team has two mandates that pull against each other. Protect thousands of connected devices from attackers, and never be the reason a device supporting active care goes offline. Infusion pumps, patient monitors, imaging systems, and building controls all sit on the network, most of them running software the team cannot patch on its own schedule and cannot take down to try.

That constraint, not a lack of urgency, is what makes healthcare IoT security its own discipline. The controls that work in a clinical environment are the ones that reduce risk without touching device availability.

This guide covers the risks specific to healthcare IoT and Internet of Medical Things (IoMT) devices, the defenses that hold up in a clinical setting, the regulations hospital teams have to map to, and what to ask a vendor before committing budget – all through the lens of medical device security. Having recently been named #1 Best in KLAS for Healthcare IoT Security in 2026, Asimily brings the field experience that informs and shapes these discussions.

What Is Healthcare IoT Security?

Healthcare IoT security is the practice of protecting the connected medical devices and facility systems in a healthcare environment from cyber threats, covering everything from the moment a device joins the network to how its data moves and where it is monitored. It spans both the clinical equipment that touches patient care directly and the building systems that keep a hospital running.

On the clinical side, healthcare organizations call the devices Internet of Medical Things (IoMT), a label that includes any of the following:

• Infusion pumps
• Patient monitors
• Imaging systems like MRI and CT scanners
• Connected diagnostic medical IoT equipment

IoMT is a narrower subset of IoT. IoT typically includes devices like building controls, badge readers, and HVAC systems. IoMT is specific to healthcare, which changes the devices’ risk and security profiles. If attackers remotely control a thermostat, an organization faces a temperature inconvenience, assuming an attacker cannot use it to move toward higher-value assets. However, if attackers gain remote control over an infusion pump or patient monitor, they become a direct threat to human health and safety.

The potential impact to patient health is why medical device security treats visibility, uptime, and clinical context as an integral part of the work.

Why Healthcare IoT Devices Are So Hard to Secure

Three constraints set healthcare apart from a typical IT environment, especially when fragile IoT and IoMT cyber-physical systems create operational risks.

1. They Cannot Be Patched Easily

Many medical devices run outdated, unsupported operating systems for years. Some typical reasons that healthcare organizations struggle to patch these devices include:

Manufacturer revalidation bottlenecks. Manufacturer revalidation is the bottleneck. A patch significant enough to affect a device’s safety or performance has to be tested and revalidated against the manufacturer’s own quality system before release, which is why fix timelines stretch. FDA’s postmarket cybersecurity guidance sets the expectation at 30 days to communicate an uncontrolled vulnerability and 60 days to remediate it, precisely because that internal process historically ran longer.

Longer device life cycle than vendor support windows. Many devices, like a CT scanner or infusion pump, are built to last for 15 to 20 years, but the software supporting the underlying operating system may only have a three- to five-year lifespan.

Cost locks the device in place regardless of software age. An MRI scanner or surgical robot can run into the millions of dollars, so replacing a device because its software has aged out is rarely a realistic option. Hospitals end up managing risk around a device they are financially committed to keeping in service, often for years past the point a comparable IT asset would have been retired.

2. They Cannot Go Offline

A ventilator, infusion pump, or patient monitor supporting active care cannot be pulled offline on an IT team’s maintenance window the way a workstation can. Security work in a healthcare provider organization has to happen around clinical workflows, meaning teams need to prevent events like forced reboots or network scans that disrupt device service.

Service uptime requirements extend beyond the organization’s digital perimeter as remote patient monitoring devices may be in a patient’s home with no access to an IT department. Even taking one offline briefly can lose the patient health visibility that matters most.

A missed reading, a delayed alert, or a monitor that drops connection mid-shift can create a gap in care. Ultimately, compensating controls, segmentation, monitoring, and risk-based prioritization can provide more real-world benefit to healthcare organizations.

3. They Are Invisible to IT Tools

Typically, healthcare provider organizations are unable to install agents on medical devices. Most medical devices are technically incapable of running an agent. Even when they could handle the installation, manufacturers may prohibit it because the agent can affect the FDA-cleared performance, voiding the clearance or warranty. Despite the different underlying reasons, the result is the same: standard endpoint tools fail to manage the risk.

In a hospital, connected devices often communicate using specialized protocols, like DICOM and HL7. Standard network tools were never built to parse these types of proprietary vendor traffic, meaning they fail to identify them. In many cases, even non-medical IoT devices like building management systems, badge readers, HVAC controllers, and elevator systems fail to show up when traditional IT asset tools attempt to identify them.

Since traditional IT asset discovery tools fail to identify these devices, many security teams lack visibility into:

• The devices connected to their networks
• The IP address for each device
• What a normal device profile looks like

Since they lack a clear baseline defining normal activity, they have no real-time visibility into device behavioral changes and may miss a potential cyber incident.

The Healthcare IoT Threat Landscape in 2025-2026

While most healthcare organizations know that their industry struggles to mitigate cybersecurity threats, their innate feelings correspond to the data available over the last year:

• 772 healthcare data breaches affecting 500 or more individuals and theft of protected patient data for 139,721,832 individuals (HIPAA Journal)
• Nearly 3 in 4 US healthcare organizations reported that a cyberattack disrupted patient care (ProofPoint 2025 Ponemon Healthcare Cybersecurity Report)
• Health Delivery Organizations reported “disruption in the normal operation of medical technology” as the number one impact facing them (Health ISAC 2026 Global Health Sector Threat Landscape)
• The average cost of a healthcare data breach is $6.64 million, the highest across all industries (IBM Cost of a Data Breach 2026)
• Healthcare records were worth anywhere from $250 to $310 per record over 2024-2025, more than a stolen card number, because medical history cannot be canceled and reissued (Dark Owl)

Attackers target the healthcare industry because it offers high-value data and a target with a broad attack surface. Medical records also hold their value in a way payment data does not, since a medical history cannot be canceled and reissued. Further, healthcare organizations have a low risk tolerance for downtime because they need to keep patient care consistent, like ensuring patient ventilators remain available and surgeries can continue on schedule.

Connected devices offer a point of initial access. Once an attacker gains unauthorized access, they move laterally across the network, escalating privileges as they go. As they grant themselves more access, they move toward systems that hold valuable information, like electronic health record (EHR) solutions or scheduling platforms.

How to Secure Healthcare IoT and IoMT Devices

Cybersecurity risk is real, but organizations can implement controls that reduce their attack surface and make monitoring more manageable.

1. See Every Device

The starting point for healthcare IoT security is ensuring that the organization knows all the devices that connect to its networks. For IoT and IoMT, organizations need a solution that collects information without taking fragile devices offline. A passive, agentless device discovery tool can build a live inventory of every IoT device and connected medical device on the network, providing the following information:

• IP address
• Manufacturer
• Model
• Firmware version
• Communication pattern

This full device visibility transforms static device data into asset intelligence that informs other security activities, like risk scoring, compliance reporting, and incident response. Once security and biomed teams have a shared, accurate device profile for every asset, they can use this real-time visibility to identify abnormal activity, like a device that suddenly starts talking to a new destination or an unusual port, which might be the first sign of compromise before confirming a data breach.

2. Segment the Network

After identifying devices, network segmentation acts as a security control to limit what a compromised device can actually reach. When working with IoT and IoMT devices, organizations need policies that reflect how a device actually behaves rather than applying a generic rule to a device category. Building policies based on risk-based segmentation groups devices by their attack surface, looking at:

• Observed device behavior
• What a device communicates with
• Ports a device uses
• Protocols a device uses

By converting this risk intelligence into an enforceable network policy, the healthcare organization can mitigate lateral movement risk.

3. Prioritize Vulnerabilities by Real Risk

Not all vulnerabilities are created equal, so trying to patch every single one is neither possible nor necessary. Risk-based prioritization narrows the list by weighing:

• The device inventory
• Vulnerabilities that sit on a reachable attack path
• Real-world exploitability data
• Real-world impact

When organizations can surface the most important vulnerabilities, they reduce risk more effectively and efficiently. In some cases, they may implement compensating controls, such as network segmentation, virtual patching, or restricting a device’s traffic to only what its clinical function requires.

4. Monitor Continuously

Healthcare IoT security is not a once-and-done project. Threat detection must run continuously against each device’s established behavioral baseline. To identify cybersecurity threats before they become incidents, security teams need to monitor continuously for:

• Abnormal device communications
• Unauthorized services
• Unfamiliar external connections
• Sudden spikes in traffic volumes

Using threat intelligence specifically related to IoT and IoMT, organizations can create custom detection rules that match their environment’s unique risks. When something looks abnormal, they can quarantine an impacted device to limit damage and collect the forensic evidence necessary to support the post-incident reporting.

Regulations and Frameworks for Healthcare IoT

Three sets of rules shape how hospitals secure connected devices, and only one of them applies to the hospital directly. HIPAA regulates the organization. FDA requirements bind the device manufacturer. NIST publishes the frameworks most programs are structured around. Understanding which is which determines where the hospital’s own obligation actually sits.

1. HIPAA

HIPAA regulates the electronic protected health information (ePHI) that devices create, store, or transmit. Under HIPAA’s Security Rule, healthcare organizations must implement the following requirements around the CIA Triad (confidentiality, integrity, and availability):

• Risk analysis
• Access controls
• Audit logging
• Technical safeguards

In January 2025, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR), which enforces HIPAA, published a proposed update that would change the following safeguards from optional to mandatory:

• Multi-factor authentication
• Encryption of ePHI at rest and in transit
• Network segmentation to isolate ePHI systems

The proposal is still just that. OCR has moved final action to a July 2027 target, more than 100 hospital systems and provider associations have asked the department to withdraw the rule, and it may yet be finalized only in part. The current Security Rule remains fully enforceable in the meantime. The practical read for a hospital security program is that multi-factor authentication, encryption, and segmentation of ePHI systems are worth building toward on their own merits, regardless of what the final rule says.

2. FDA Cybersecurity

The FDA regulates device manufacturers directly. On the premarket side, Section 524B of the FD&C Act requires manufacturers of cyber devices to submit a cybersecurity plan and a Software Bill of Materials (SBOM) as part of the submission. On the postmarket side, the same section requires manufacturers to monitor for vulnerabilities, run a coordinated disclosure process, and make patches available for vulnerabilities that create uncontrolled risk. FDA’s postmarket cybersecurity guidance goes further, treating communication within 30 days and remediation within 60 days as the expectation for uncontrolled risk. The Quality Management System Regulation, effective February 2, 2026, incorporates ISO 13485 and further tightens how manufacturers build and document device security from the design stage forward.

Healthcare organizations still need to ensure that they implement their own defenses. The FDA’s rules bind manufacturers going forward. Since the rules are forward-looking and not backward-looking, organizations still need to use compensating controls for the large installed base of older devices they already have connected to their networks.

3. NIST and the IoMT Guidance

The National Institute of Standards and Technology (NIST) is an agency that publishes frameworks, guides, and other special publications to help organizations understand how to measure and mitigate risk. The NIST Interagency Report (NISTIR) 8228, “Considerations for Managing Internet of Things (IoT) Cybersecurity and Privacy Risks,” outlines the core cybersecurity and privacy risks related to IoT devices. Meanwhile, the NIST Special Publication (SP) 800-213 series builds on these risk definitions and sets out practical capabilities that organizations can use when securing their devices. At a very high level, NIST SP 800-213 lists the following IoT device cybersecurity considerations:

• The device’s benefit and how the organization will use it
• The data the device collects, including personal, confidential organizational, Federal government, and environmental data
• The technologies that will store and transmit the data
• The geographic areas where the data will be shared or stored
• Third parties who will receive, share, or store data
• Whether the device introduces unacceptable risks or results in noncompliance
• Whether the IoT device has known security or privacy vulnerabilities
• What organization-specific information helps define key device security requirements
• Whether the IoT device lacks key device security requirements
• Whether device cybersecurity capability implementation or maturity will fail to satisfy key security requirements
• The physical, logical access, network, and other requirements for the IoT device, especially as they relate to key security requirements
• Manufacturer secure development and supply chain practices
• Manufacturer vulnerability disclosure and remediation practices
• Expectations around delivery of software updates that respond to vulnerabilities

The broader NIST Cybersecurity Framework (NIST CSF) outlines the structure that most healthcare organizations use when building their security programs:

• Govern: set strategy, write policies, and ensure oversight
• Identify: know assets and risks
• Protect: implement safeguards to limit impact
• Detect: identify anomalies and incidents as they happen
• Respond: contain threats and act on incidents
• Recover: restore capabilities after an incident

What to Look For in a Healthcare IoT Security Solution

As healthcare organizations look to improve their security and compliance postures, they should ask any IoT and IoMT vendor the following questions:

Is discovery agentless and clinically safe? Since active scans can disrupt medical devices, passive scanners are safer for clinical use cases. Asimily’s Inventory and Visibility builds the device record without installing anything on the device.

Does it assess devices before you buy them? Evaluating a device’s risk profile before purchase is cheaper than compensating for it afterward. Asimily’s ProSecure draws on observed risk data for medical devices in the field, so procurement decisions carry the same risk context as security decisions.

Is discovery continuous, not a one-time scan? Since a static inventory becomes outdated quickly, a continuous asset discovery tool ensures the most up-to-date data.

Does prioritization go beyond raw CVSS scores? A CVSS score describes a vulnerability in the abstract, not on the device in front of you. Asimily’s ATT&CK Analysis determines whether a vulnerability is actually exploitable on a specific device in a specific environment and topology, which is what makes the remediation queue finite.

Does it prescribe fixes, not just flag problems? Sometimes a compensating control is the more efficient risk reduction activity. Asimily’s Risk Simulator models the impact of an action before it is executed, and IoT Patching handles the cases where patching is the right answer.

Can it simulate segmentation policy before enforcement? A segmentation policy that blocks clinical traffic is worse than no policy at all. Policy Simulation validates a policy against real observed traffic before anything is applied, showing exactly which devices and connections would be affected. That preview is what gets a segmentation project past the operational veto.

Does it handle complex, hybrid network architectures? Real hospital networks often consist of multiple network segments, on-premises deployments, and cloud-native resources. Asimily’s Segmentation Orchestration works on top of existing NAC infrastructure, including Cisco ISE, Aruba ClearPass, and Arista, so the enforcement point stays where the network team already put it.

Does it give responders clinical context during incidents? Incident responders need clinical context so they can collect forensic data without harming patient health and safety. Asimily’s Intelligent Policy Engine monitors for anomalous behavior and supports custom rules without programming, and Asimily remains the only connected device security platform with native packet capture for forensic incident response.

Asimily earned the highest overall score, 96.6 out of 100, in the 2026 Best in KLAS Healthcare IoT Security report, including the top rating in the “Money’s Worth” category, based entirely on verified feedback from healthcare providers.

FAQs

1. What Is Healthcare IoT Security?

Healthcare IoT security is the practice of protecting connected medical and facility devices from cyber threats, covering everything from device discovery to how patient data moves across the network. It spans IoMT devices like infusion pumps, patient monitors, and imaging systems, as well as building systems on the same network. Since these devices touch patient care directly, the clinical setting raises the stakes well beyond a typical IT security problem. A compromised connected device is more than a data risk. It poses a potential threat to patient safety and operational continuity.

2. What Is IoMT?

IoMT, or the Internet of Medical Things, is the network of connected medical devices used in a healthcare setting: infusion pumps, patient monitors, imaging systems, and diagnostic equipment. It’s the clinical subset of the broader Internet of Things, which also includes non-clinical connected devices like badge readers and building controls. The distinction matters because of the patient safety dimension. A compromised smart thermostat is an inconvenience; a compromised infusion pump is a direct risk to a patient’s care, not just their data.

3. Why Are Medical Devices So Hard to Secure?

Medical devices often run outdated software that can’t easily be patched. A change significant enough to affect safety or performance can trigger a manufacturer’s own internal revalidation process, especially when updating an FDA-cleared device. Devices also can’t be rebooted or taken offline on a normal IT schedule without risking active patient care. Most can’t run a security agent at all, and many use specialized protocols that standard IT tools were never built to parse, making them effectively invisible to conventional security software. These devices need purpose-built, agentless protection designed around how a clinical environment actually operates, not a general IT security approach retrofitted to fit.

4. What Are the Biggest Healthcare IoT Security Risks?

The biggest risks are ransomware, data theft, and disruption to patient care, and increasingly they’re connected. Unmanaged connected devices are now a primary entry point for attackers, who use a vulnerable device as a foothold before moving laterally toward higher-value systems like EHRs. A 2025 investigation found more than 1.2 million healthcare IoT devices and systems exposed directly to the internet, often reachable with nothing more than a default password, illustrating how much of the modern attack surface sits on connected devices rather than traditional IT infrastructure.

5. How Do You Secure Medical Devices You Cannot Patch?

When a device can’t be patched, compensating controls fill the gap: network segmentation limits where a compromised device can reach, access restrictions narrow what it’s allowed to communicate with, and continuous monitoring flags unusual behavior early. For example, an infusion pump running unsupported software can be isolated on a segment that only permits communication with the systems it actually needs, blocking the specific path an attacker would use to exploit a known vulnerability, without touching the device’s FDA-cleared software at all.

6. Does HIPAA Cover Medical Device Security?

Yes, indirectly. HIPAA doesn’t regulate devices themselves; it regulates the protected health information they handle. Any connected device that creates, stores, or transmits ePHI falls under the HIPAA Security Rule’s existing requirements for risk analysis, access controls, and audit logging. FDA requirements add device-specific obligations on the manufacturer, covering premarket cybersecurity planning and postmarket vulnerability disclosure. Together, the two form overlapping layers of accountability: HIPAA for the data, FDA for the device itself.

7. What Is Agentless Device Discovery in Healthcare?

Agentless device discovery identifies and profiles medical devices by passively monitoring network traffic, without installing any software on the device itself. This matters because most medical equipment can’t run an agent at all, and even the devices that technically could are often locked down by the manufacturer against unapproved software changes. Passive discovery builds a full inventory, device type, manufacturer, and communication pattern, without ever touching clinical equipment directly, avoiding any risk of disrupting a device that’s actively supporting patient care.

8. How Does Network Segmentation Protect Medical Devices?

Network segmentation isolates devices into controlled zones, so if one device is compromised, the attacker can’t move freely to reach clinical systems, EHRs, or other higher-value targets. It’s especially important for devices that can’t be patched, since segmentation can block the specific traffic path an exploit would need without ever touching the vulnerable device itself. Done well, segmentation policy reflects how a device actually communicates day to day, not just a generic rule based on device type or location on the network.

9. What Is the Average Cost of a Healthcare Data Breach?

Healthcare averaged $6.64 million per data breach in IBM’s Cost of a Data Breach Report 2026, the highest of any industry for the thirteenth consecutive year, though down 10.5% from $7.42 million the year prior. Across all industries, the global average rose 12% to a record $4.99 million. Unmanaged connected devices contribute directly to healthcare’s position at the top of that list, since a device nobody is monitoring can be the difference between a contained incident and a reportable breach affecting hundreds of thousands of records.

10. How Do You Choose a Healthcare IoT Security Solution?

Look for agentless, clinically safe discovery that won’t disrupt a device mid-use; IoMT-aware profiling that recognizes clinical protocols standard IT tools miss; risk-based vulnerability prioritization that goes beyond raw CVSS scores; and segmentation support that can be simulated before enforcement. Healthcare references matter too. Ask about KLAS recognition specifically, research based entirely on verified feedback from healthcare providers using the tool.

Securing connected medical devices means designing around the constraints of a clinical environment: devices that cannot be patched on a normal schedule, cannot go offline, and usually cannot run standard security software. The controls that work under those constraints are the ones already available to most hospital teams. Visibility comes first, since nothing else can be scoped without it. Segmentation contains what cannot be patched. Prioritization by real exploitability keeps the remediation list finite. And the documentation those three produce is what turns a security program into a defensible compliance position.

Start with visibility. You can’t secure a device you don’t know exists, and agentless discovery gets you there without disrupting patient care.

Segment to contain. Isolating devices by actual risk limits how far a compromise can spread.

Prioritize by patient risk. Not every vulnerability matters equally; focus resources on what’s truly exploitable and truly critical.

Map to HIPAA and FDA. Compliance isn’t separate from security; it’s the framework that proves the work is actually happening.

Asimily was named #1 in the 2026 Best in KLAS Healthcare IoT Security report, based entirely on verified feedback from healthcare providers who use the platform every day. If you’re ready to see what full device visibility and risk-based protection look like in your own environment, protect your connected medical devices with a conversation.