The State of Cybersecurity in Healthcare 2025: Insights from Echelon Experts 

The proliferation of IoMT devices in healthcare presents one of our most urgent security challenges. While these devices bring undeniable benefits—such as real-time patient monitoring and automated treatment adjustments, they are often deployed without fundamental security controls. Many legacy devices were designed with functionality as the priority, not security, making them attractive targets for attackers. 

One of the most overlooked risks is the lack of centralized visibility into hospital IoMT ecosystems. Many organizations lack an inventory of all connected devices, leaving them unaware of potential vulnerabilities. Attackers know and exploit this, using IoMT devices as entry points for broader network compromises. In 2023, we saw ransomware groups leveraging unsecured infusion pumps and patient monitoring devices to pivot into hospital networks, causing widespread system outages. 

Healthcare organizations must prioritize network segmentation, enforce strict access controls, and implement real-time anomaly detection to identify malicious activity before it leads to operational disruptions. It's also critical to push medical device manufacturers to adopt secure-by-design principles assuring that new devices have built-in security features such as encrypted communication, automatic updates, and multifactor authentication. The industry must shift from a reactive approach to proactively securing medical IoMT devices as part of patient safety initiatives. 

The modernization of the HIPAA Security Rule is long overdue. The current framework, established more than a decade ago, was built for a pre-ransomware, pre-cloud, and pre-IoMT healthcare system. Today, we operate in an environment where cybercriminals specifically target electronic protected health information (ePHI) due to its high black-market value. A single compromised medical record can fetch more than a stolen credit card number because of its richness in personally identifiable information (PII) and insurance details. 

The proposed HIPAA updates emphasize proactive risk management, annual security audits, and enhanced reporting mechanisms. These are necessary changes, but the biggest challenge will be implementation, especially for smaller healthcare organizations that lack the resources of large hospital systems. Many regional clinics and private practices still struggle with basic security hygiene, such as regular patching and enforcing multifactor authentication. 

To bridge this gap, we need incentives and financial support for smaller providers to comply—perhaps through federal grants or reimbursement programs for cybersecurity investments. HIPAA modernization should also encourage alignment with NIST frameworks to provide clear, actionable guidance for compliance. Finally, business associates and third-party vendors must be held to the same security standards as covered entities. A significant percentage of breaches occur due to vulnerabilities in third-party services, and without stricter oversight, attackers will continue to exploit these weak links. The Evolving Governance Landscape: Regulations, Standards, and Best Practices.

Cybersecurity governance in healthcare is evolving but still lags behind other critical infrastructure sectors. Unlike finance or energy, which have heavily regulated cyber standards enforced by federal agencies, healthcare has long relied on self-regulation and fragmented oversight. While HIPAA and FDA regulations provide a baseline, they do not go far enough in mandating real-time risk assessments, incident response exercises, or cross-sector collaboration. 

One of the most pressing governance challenges is the lack of cybersecurity accountability at the executive level. Many healthcare boards still view cybersecurity as an IT issue rather than a patient safety concern. This must change. We need CISOs and cybersecurity leadership embedded at the highest levels of decision-making, with direct reporting lines to CEOs and Board Risk Committees. 

Additionally, healthcare organizations must invest in cyber resilience, not just compliance. Too often, we see providers doing the bare minimum to meet regulatory requirements without considering how prepared they are for real-world cyber incidents. Governance should emphasize continuous improvement, red teaming exercises, and zero-trust architectures to prevent and respond to attacks effectively. 

The federal government's increased involvement through CISA's cybersecurity performance goals and the FDA's cybersecurity mandates for medical devices is a step in the right direction. However, enforcement must be consistent and rigorous, with clear penalties for noncompliance. Ultimately, healthcare cybersecurity governance should be as stringent as clinical safety standards, ensuring that protecting patient data is treated with the same urgency as preventing medical errors.