How Modern Zero Trust Finally Delivers on Its Promise
By Piotr Kupisiewicz, Chief Technology Officer, Elisity
LinkedIn: Piotr Kupisiewicz
LinkedIn: Elisity
The Stark Reality Facing Healthcare CISOs Today
Healthcare organizations find themselves in an impossible position. With ransomware attacks occurring at hospitals with alarming regularity, Chief Information Security Officers face relentless pressure to implement comprehensive cybersecurity measures. The Department of Health and Human Services reports 884 incidents affecting healthcare providers since January 2023, most labeled as “hacking” or “IT incidents” against servers, electronic records systems, email, and workstations (U.S. Department of Health and Human Services). Yet traditional security approaches have proven too complex, expensive, or disruptive for healthcare environments where patient care cannot be interrupted.
Ransomware demands are severe in healthcare, with 78 percent reporting payments over $500,000 due to ongoing ransomware attacks. Claroty research revealed that 45 percent of respondents said at least half of their organization’s cyber-physical systems assets are connected to the internet, as increased connectivity and convergence have exacerbated the need for remote access to cyber-physical systems. These breaches resulted in significant operational downtime, substantial financial damage, and prolonged recovery periods, severely impacting business operations.
The report reveals that 72% of healthcare organizations that experienced common cyberattacks, ransomware, cloud compromise, supply chain attacks, and business email compromise (BEC), suffered disruption to patient care, up from 69% last year. These attacks are not merely operational nuisances: 54% of impacted organizations reported increased medical procedure complications, 53% reported longer patient stays, and 29% said mortality rates rose as a direct result.
The Resource Constraint Dilemma
Healthcare CISOs understand the urgent need for advanced cybersecurity, yet operate within constraints that make traditional security implementations nearly impossible. Budget limitations remain paramount, while staffing presents another critical challenge, 67% of organizations report cybersecurity staff shortages, and 92% of cybersecurity professionals report skills gaps at their organization.
Modern hospitals operate thousands of connected devices, from life-critical medical equipment to building automation systems, many of which were never designed with cybersecurity in mind. Legacy medical devices, often FDA-regulated and difficult to patch, create inherent vulnerabilities. A single hospital might operate a thousand infusion pumps, all communicating with electronic medical records, all potentially serving as jumping-off points for lateral movement attacks.
Traditional network segmentation requires extensive hardware investments, multiple full-time employees for implementation, and hundreds of hours per site to deploy. For organizations with multiple locations, this translates to multi-year implementations costing tens of millions of dollars—resources many healthcare organizations cannot afford.
Zero Trust: From Theory to Healthcare Reality
Zero Trust has emerged as the gold standard for modern cybersecurity architecture, based on the principle that no user, device, or network traffic should be trusted by default. The concept resonates strongly with healthcare leaders who understand attackers leverage lateral movement in over 70% of successful breaches (Industry Cybersecurity Research). However, traditional Zero Trust implementations have historically remained out of reach due to complexity and resource requirements.
The breakthrough lies in identity-based microsegmentation, an approach fundamentally changing how Zero Trust can be implemented. Rather than requiring extensive network hardware changes, agents on every device, or complex VLAN reconfigurations, modern identity-centric architectures work with existing network infrastructure to deliver comprehensive security rapidly and cost-effectively.
Consider a major healthcare system mandated by its CEO and board to implement network microsegmentation quickly. Faced with traditional segmentation challenges, significant hardware investments, extensive staff training, and disruptive network changes, they instead deployed an identity-based microsegmentation platform, accomplishing in weeks what traditional approaches would take years to achieve.
This healthcare system discovered and classified 99% of devices within four hours without downtime or patient network disruption. Implementation required only two full-time employees per site, with 2 hours for virtual machine staging and 2-8 hours for configuration. Their forecasted spend decreased from $38 million to $9 million, a 76% reduction in total cost of ownership.
The Identity-Centric Advantage
Identity-based microsegmentation transforms healthcare security by understanding and securing every user, workload, and device based on who they are rather than network location. Modern platforms automatically discover every device, then correlate metadata from existing systems to build comprehensive identity profiles including device types, software versions, patch levels, business functions, and risk scores. For healthcare, this means automatically distinguishing between cardiac monitors, infusion pumps, nurse workstations, and guest devices, then applying appropriate security policies to each.
Automation capabilities address healthcare’s ongoing policy management challenge. Rather than manually configuring thousands of firewall rules, identity-based systems automatically adjust policies based on changing risk profiles, device behaviors, and threat intelligence.
Practical Implementation for Resource-Constrained Organizations
Healthcare CISOs evaluating Zero Trust should focus on solutions working within existing constraints rather than requiring infrastructure changes. Successful implementations begin with comprehensive asset discovery, leveraging existing network infrastructure for complete device visibility.
Integration with existing security tools proves crucial. Rather than replacing current investments in endpoint detection, configuration management databases, or asset tracking platforms, effective microsegmentation platforms enhance these tools by providing comprehensive network visibility and automated policy enforcement.
Deployment must prioritize business continuity. Healthcare organizations cannot afford disruptions to patient care, so solutions must offer extensive simulation capabilities, allowing teams to test policies before enforcement. Gradually implementing policies, starting with monitoring before moving to enforcement, provides the confidence healthcare leaders need.
Staff training remains critical, but identity-based approaches significantly reduce the learning curve compared to traditional segmentation, abstracting complex networking concepts into user-friendly interfaces operable by existing security staff without extensive networking expertise.
Addressing Implementation Barriers
Healthcare organizations often hesitate to pursue Zero Trust due to perceived complexity, cost, and operational risk. These concerns usually stem from experience with traditional networking approaches rather than modern identity-centric solutions. Proof-of-concept implementations demonstrate rapid value without significant upfront investments.
Compliance alignment provides compelling reasons for prioritizing Zero Trust. Modern microsegmentation naturally supports HIPAA requirements for access controls and audit logging while addressing HITRUST framework requirements. Rather than viewing Zero Trust as an additional compliance burden, healthcare leaders should recognize it as a force multiplier, simplifying existing requirements.
The evolving cyber insurance landscape supports Zero Trust investments. Organizations using the National Institute of Standards and Technology’s Cybersecurity Framework as their primary cybersecurity framework report one-third lower cyber insurance premium cost growth, according to the 2024 Healthcare Cybersecurity Benchmarking Study, produced by Censinet and KLAS Research in collaboration with the AHA, Health Information and Analysis Center (Health-ISAC), and Healthcare and Public Health Sector Coordinating Council. For network teams struggling to justify the investment to leadership, the insurance angle can deliver concrete financial benefits: 60% of surveyed organizations reported premium reductions as a result of improved segmentation posture.
A Practical Path Forward
Healthcare organizations no longer need to choose between comprehensive cybersecurity and operational practicality. Identity-based microsegmentation represents a fundamental shift in implementing Zero Trust, offering security benefits within resource constraints.
Transformation begins with a commitment to modernizing security architecture and tools. Healthcare CISOs should evaluate solutions based on their ability to work with existing infrastructure, deliver rapid time-to-value, and scale across complex environments without excessive management overhead.
Success stories demonstrate that comprehensive Zero Trust security can be achieved more quickly and cost-effectively than traditional alternatives. As healthcare continues to digitize and threats evolve, identity-centric Zero Trust implementations provide the foundation for secure, resilient healthcare delivery, protecting both patient data and care.
The question for healthcare leaders isn’t whether to implement Zero Trust, but which approach delivers the most effective security within operational and financial constraints. For organizations ready to move beyond security paralysis toward practical protection, identity-based microsegmentation offers a proven path, making Zero Trust promise a healthcare reality.