“What Comes After NIST? Future-Proofing Cybersecurity Frameworks in Healthcare”
Post Summary
Healthcare cybersecurity is under pressure. Traditional frameworks like NIST aren't keeping up with evolving threats, leaving healthcare organizations vulnerable. In 2024, breaches affected 238 million U.S. residents, with average costs hitting $9.77 million per incident. Medical data, worth up to $1,000 per record, makes healthcare a prime target for ransomware, phishing, and supply chain attacks.
Key Takeaways:
- Current Challenges: Only 47% of NIST controls are met by healthcare organizations, showing limited progress.
- Emerging Frameworks: Alternatives like HHS Cybersecurity Goals, C2M2, ISO 27001, and CIS Controls provide tailored strategies.
- Technologies to Watch: AI-driven threat detection, zero-trust architectures, automated risk assessments, and secure cloud adoption are reshaping defenses.
- Action Plan: Conduct maturity assessments, integrate new frameworks, and focus on collaboration, training, and incident response.
To stay ahead, healthcare organizations must rethink their approach, combining advanced tools, new frameworks, and continuous monitoring to safeguard patient data and maintain trust.
Ep#230 Healthcare and Cybersecurity from the Challenges to the Solutions
New Cybersecurity Frameworks Beyond NIST
While the NIST Cybersecurity Framework (CSF) remains a cornerstone for many, healthcare organizations are increasingly adopting additional frameworks to address unique challenges and evolving threats. These alternatives complement NIST by offering strategies tailored to healthcare's specific needs, such as risk management and compliance.
HHS Cybersecurity Performance Goals
The Department of Health and Human Services (HHS) has introduced cybersecurity performance goals specifically designed for the healthcare sector. These goals focus on protecting critical infrastructure by enhancing areas like incident response, supply chain security, and managing risks associated with third-party vendors.
Cybersecurity Capability Maturity Model (C2M2)
The Cybersecurity Capability Maturity Model (C2M2) offers healthcare organizations a structured way to assess and improve their cybersecurity maturity. Through a self-assessment approach, C2M2 helps organizations evaluate their strengths and weaknesses in areas such as threat management, situational awareness, and workforce capabilities. Its step-by-step implementation is particularly beneficial for smaller organizations with limited resources, enabling gradual and sustainable progress.
ISO/IEC 27001 and 27002
ISO/IEC 27001 is an internationally recognized standard for managing information security systems (ISMS). Unlike NIST, which is more technical and suited for early-stage programs, ISO 27001 takes a risk-based approach, making it ideal for mature organizations. It includes 93 controls outlined in Annex A, offering a comprehensive framework for managing risks [1]. However, ISO 27001 certification involves audits and third-party validation, which can be costly. In contrast, the NIST CSF is voluntary and does not require certification, making it a more accessible option for some [1][2].
CIS Critical Security Controls
The Center for Internet Security (CIS) Critical Security Controls provides a prioritized, action-driven approach to cybersecurity. These controls emphasize high-impact defensive measures, automation, and continuous monitoring - features that align with the healthcare sector's need for real-time security [3]. As Laura Libeer from Lansweeper explains:
"Cyber threats demand precision, speed, and adaptability. The CIS Controls have evolved from a strong foundation into an essential playbook for securing your IT environments" [3].
The human factor is also a crucial consideration. In 2024, 74% of data breaches involved human error, underscoring the importance of addressing this vulnerability [4].
Framework Comparison Table
| Framework | Primary Focus | Certification Available | Implementation Approach | Best Suited For |
|---|---|---|---|---|
| HHS Cybersecurity Performance Goals | Healthcare-specific critical infrastructure | No | Goal-based outcomes | Healthcare organizations of all sizes |
| C2M2 | Maturity assessment and improvement | No | Self-assessment with progressive levels | Organizations seeking structured improvement |
| ISO/IEC 27001 | Information security management systems | Yes | Risk-based management approach | Mature organizations seeking formal certification |
| CIS Critical Security Controls | Prioritized defensive actions | No | Action-oriented implementation | Organizations with limited resources needing immediate impact |
| NIST CSF | Comprehensive risk management | No | Function-based framework | Organizations building initial security programs |
Each framework offers unique strengths that cater to different organizational needs. For instance, NIST is widely adopted within the U.S., while ISO/IEC 27001 serves as a global standard. Many healthcare organizations find value in blending multiple frameworks. By combining HHS's healthcare-specific goals, C2M2's maturity assessments, and the robust controls of ISO 27001 or CIS, organizations can create a well-rounded cybersecurity strategy. This layered approach not only addresses current risks but also positions healthcare providers to adapt as cyber threats continue to evolve. Together, these frameworks provide a flexible roadmap for enhancing cybersecurity in the healthcare sector.
Tools and Technologies for Modern Healthcare Cybersecurity
Modern healthcare systems face an ever-growing landscape of cyber threats, demanding advanced tools and strategies to keep sensitive data safe. According to a 2024 McKinsey report, the market for cybersecurity tools is expected to grow by 12.4% annually through 2027. This growth reflects the increasing urgency for stronger defenses, especially as phishing attacks have surged by 1,265% since generative AI platforms became widely available in 2022 [5]. These tools are now at the core of modern cybersecurity strategies.
AI-Powered Threat Detection and Response
Artificial intelligence is reshaping how healthcare organizations identify and respond to cyber threats. By speeding up alerts by 55%, AI significantly reduces response times during critical incidents [7]. This speed is vital, as the average cost of a healthcare data breach has climbed to $10.93 million, making rapid action essential to limit damage [6].
Take United Family Healthcare, for example. They implemented an AI-driven security system that enhanced threat detection and enabled faster responses to ransomware attacks, safeguarding patient data while ensuring compliance with HIPAA regulations [7]. Similarly, IBM Security offers AI-based tools like Threat Detection and Response services, AI identity management, and Unified Endpoint Management. These tools not only detect threats more quickly but also reduce access fraud by up to 90%, potentially saving millions in breach-related costs [7].
To maximize effectiveness, healthcare organizations should combine AI solutions with traditional measures such as firewalls, intrusion detection systems, and manual audits. Regular updates to AI models and robust authentication methods, like multifactor authentication, are also critical to staying ahead of evolving threats [5].
Zero-Trust Architectures
Zero-trust security operates on the principle of verifying every access request, whether it originates internally or externally [8]. This approach is particularly urgent in healthcare, where medical records can fetch up to 50 times more than credit card data on the dark web [10]. Alarmingly, 92% of healthcare organizations reported at least one major cyberattack last year, with 70% of those incidents disrupting patient care. In 2023 alone, 725 healthcare breaches exposed 133 million patient records, according to the U.S. Department of Health and Human Services [9].
Key elements of zero-trust architecture include Identity and Access Management (IAM) with role-based access control and multifactor authentication, micro-segmentation to limit the spread of threats, and continuous monitoring with real-time analytics [10][11]. A dynamic policy engine works alongside enforcement points to grant or deny access based on strict security policies. To implement zero trust effectively, organizations must conduct thorough security audits, segment their networks, modernize authentication methods, and maintain an up-to-date catalog of all data, applications, and services [8][9].
Automated Risk Assessments
Automation is transforming risk assessments in healthcare cybersecurity, addressing the inefficiencies of traditional methods. For instance, 40% of vendor contracts are finalized without a proper security risk assessment, leaving organizations vulnerable [13]. Censinet AI™ offers a prime example of how automation can streamline this process. It allows vendors to complete security questionnaires in seconds, automatically summarizes evidence, identifies third- and fourth-party risks, and generates concise risk reports. This approach balances efficiency with the oversight needed to ensure accuracy.
By integrating automation with human expertise, organizations can scale their risk management efforts without compromising precision. Advanced routing and orchestration across Governance, Risk, and Compliance teams ensure that critical findings are quickly escalated to the appropriate stakeholders.
Secure Cloud Adoption in Healthcare
As healthcare organizations embrace digital transformation, secure cloud adoption has become a vital component of cybersecurity. Protecting patient data in cloud environments requires end-to-end encryption of all Personal Health Information (PHI), whether it's stored on internal networks, VPNs, or cloud systems [9]. Training staff on new access protocols and conducting periodic system reviews are also essential [13].
Under the shared responsibility model, healthcare providers must regularly evaluate their cloud vendors' security practices, compliance certifications, and incident response capabilities while ensuring internal data remains protected.
Third-Party and Supply Chain Risk Management
Third-party risks are a major concern for healthcare organizations, with 35% of cyberattacks originating from vendors [13]. A stark example occurred in 2024, when a ransomware attack on the nation's largest claims processor compromised the data of 190 million people [12].
Platforms like Censinet RiskOps™ simplify the management of third-party risks by streamlining vendor assessments, benchmarking cybersecurity practices, and fostering collaborative risk management. This approach helps organizations maintain consistent security standards across multiple vendor relationships.
Effective management of third-party risks involves maintaining a centralized vendor inventory, prioritizing assessments through tiered risk classifications, continuously monitoring vendor security, and embedding clear security requirements into contracts [13]. Regular scenario planning and establishing crisis management teams further strengthen resilience. By leveraging modern tools, healthcare organizations can unify data, streamline workflows, and make informed decisions in an increasingly complex threat landscape [13].
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How to Add New Frameworks to Current Systems
Integrating new cybersecurity frameworks into existing healthcare operations is no small task. It demands a thoughtful approach that balances the need for improvement with maintaining day-to-day operations. To succeed, healthcare organizations must assess their current systems, create actionable plans, and ensure collaboration across teams to drive continuous progress.
Evaluating Current Cybersecurity Maturity
Before diving into a new framework, it’s important to understand where your organization stands. This starts with a cybersecurity maturity assessment, which looks at how well your organization can handle and respond to cybersecurity threats. This involves examining processes, policies, technologies, and even the organizational mindset toward security [14]. Key areas of focus include governance, risk management, security controls, and incident response.
"In 2025, healthcare entities will need to go beyond checking off compliance boxes. True cybersecurity maturity is embedded in daily operations and cultural practices. Organizations that don't evolve risk not only data breaches but also the erosion of patient trust." – Ryan Sanders, Chief Information Security Officer at PatientLock [15]
Unlike a standard risk assessment, a maturity assessment provides a broader view, focusing on strategic and operational readiness for new frameworks [14]. Tools like the NIST Cybersecurity Framework or the CMMI Cyber Maturity Platform are commonly used for these evaluations [16]. Internal audits and reviews by external experts can also uncover gaps and provide insights into areas needing improvement.
| Maturity Level | Description |
|---|---|
| Initial (Ad Hoc) | Cybersecurity practices are inconsistent and reactive, lacking formal processes. |
| Developing (Repeatable) | Policies and procedures are starting to take shape and are documented. |
| Defined (Established) | Processes are well-documented and integrated into the organization’s risk strategy. |
| Managed (Quantitatively Managed) | Practices are tracked using metrics and key performance indicators (KPIs). |
| Optimizing (Adaptive) | Processes are continuously refined to address evolving threats and technologies. |
Keeping detailed records of cybersecurity practices, incidents, and improvements is essential. These records provide a clear baseline for planning framework transitions and tracking progress over time [16].
Creating a Transition Plan
A well-thought-out transition plan is key to implementing new frameworks effectively. This starts with executive leadership committing time and resources to cybersecurity. Leadership should make cybersecurity a priority in organizational policies and consider appointing a clinical cybersecurity director to oversee the alignment of operations with security goals.
"That integration of emergency management planning with cyber-incident response planning is critical." – John Riggi, National Advisor for Cybersecurity and Risk at the American Hospital Association
Frameworks like the NIST Cybersecurity Framework, which focuses on five core areas - Identify, Protect, Detect, Respond, and Recover - offer a structured approach to improving cybersecurity. By aligning these frameworks with existing regulatory requirements, such as the Joint Commission’s hazard analyses and emergency operations plans, organizations can create a cohesive strategy rather than managing separate initiatives.
Practical steps include developing downtime procedures for all medical and operational technologies and engaging in regional incident response planning. Establishing an office of clinical continuity can help coordinate these efforts across departments. Regular practice drills and after-action reviews following cyber incidents ensure that plans are effective and continuously refined.
Building Team Collaboration and Improvement Culture
Once the groundwork is laid, fostering collaboration across departments becomes critical. Successful framework integration relies on teamwork and a commitment to ongoing improvement. Cross-departmental collaboration and a culture of continuous learning are essential for advancing cybersecurity efforts.
Ongoing training programs can help every employee understand their role in protecting patient data and the risks posed by cyberattacks [17]. When staff members see themselves as part of the solution, they’re more likely to contribute to a secure environment.
"Empowering healthcare workers as the front line of defense is essential to a resilient cybersecurity culture." – Edward Myers, National Director of Cyber Security, Crothall Healthcare Technology Solutions (HTS) [19]
Key strategies to encourage collaboration include conducting regular security audits to find vulnerabilities, setting up systems to monitor suspicious network activity, and fostering an environment where employees feel comfortable reporting potential threats [17]. Partnering with larger healthcare networks or managed service providers can also provide access to advanced tools and expertise [18].
Maintaining an effective cybersecurity framework requires continuous monitoring and updates to address new threats [17]. This effort demands ongoing leadership support and active involvement from all staff members. Regular communication, training, and reminders about best practices help reinforce a security-first mindset.
When organizations successfully build a culture of cybersecurity awareness, integrating new frameworks becomes a smoother, more sustainable process over time. With the right combination of assessment, planning, and collaboration, healthcare organizations can strengthen their defenses while maintaining operational continuity.
Monitoring, Training, and Incident Response
Once new security frameworks are in place, the work doesn’t stop there. Healthcare organizations must stay vigilant by continuously monitoring threats, training staff, and preparing for potential incidents. These three components are the backbone of a strong defense, ensuring that patient care remains the top priority while adapting to new risks.
Ongoing Security Monitoring and Validation
Annual audits might provide a snapshot of security, but they’re not enough in today’s fast-moving healthcare environment. What’s needed is real-time visibility into potential threats. Automated tools can provide constant oversight and deliver rapid alerts, enabling faster responses when something goes wrong [21]. This shift from periodic reviews to continuous monitoring is transforming how cybersecurity is approached in healthcare.
A solid monitoring system should cover every endpoint without overwhelming the team with false alarms. Tools like vulnerability scanners can regularly identify weak spots in systems and applications, while network monitoring tools look out for unusual activity patterns.
"We need to change the model from reactive to continual monitoring capable of detecting anomalies across the organization." - Pam Nigro, IT Vice President and Security Officer, Everly Health and Board of Directors Vice Chair, ISACA [26]
It’s also crucial to keep an eye on third-party vendors, as 62% of data breaches involve them [21]. Extending monitoring to include vendor access points and data flows is essential. This requires setting clear security standards for vendors and using tools to track their activities within your systems.
In addition to automated tools, regular risk assessments provide valuable insights into potential vulnerabilities. These assessments should go beyond technical controls to evaluate operational processes and human factors that could expose the organization to risks [20]. Together, these efforts lay the groundwork for effective staff training and incident response.
Staff Training and Security Awareness
Human error is one of the biggest causes of security breaches, making staff training a critical part of any cybersecurity strategy. However, only about 10% of employees retain all the information from their cybersecurity training sessions [23].
To address this, training should be tailored to specific roles and include real-life breach examples, hands-on exercises, and practical advice on topics like password management, recognizing phishing attempts, handling sensitive data, and securing devices [22]. With more medical devices connected to networks, staff also need to understand how these devices can become potential entry points for attackers [22].
Establishing dedicated communication channels for cybersecurity updates can help keep everyone informed about emerging threats. These channels allow security teams to quickly share warnings about new phishing campaigns or vulnerabilities that could disrupt daily operations [22].
Well-trained staff are not just better at avoiding mistakes - they’re also key players in executing incident response plans when something goes wrong.
Incident Response Planning and Implementation
When a security incident occurs, healthcare organizations must respond without disrupting clinical operations. That’s why detailed incident response playbooks are essential. These playbooks should cover scenarios such as ransomware attacks on electronic health records, compromised medical devices, and breaches involving patient data [24]. Simulations can help refine these plans and ensure they’re ready for real-world use.
"Incident response has always been important, but now it's getting visibility and attention. We've been doing incident response for years, but because of what's happened recently, there's a bigger spotlight on it. Organizations have started to realize how expensive it is to resolve incidents." - Pam Nigro, IT Vice President and Security Officer, Everly Health and ISACA Board of Directors Vice Chair [26]
Organizations with formal incident response plans save an average of $474,000 in breach costs [25]. A good plan should include clear communication channels for keeping internal and external stakeholders informed - this includes patients, regulatory agencies, and business partners. The goal is to maintain critical medical services while containing the threat [24].
Testing these plans regularly through simulations and tabletop exercises ensures they’re effective. Such exercises should involve everyone from IT teams to clinical staff and leadership. After an incident, analyzing what went wrong provides valuable lessons to improve future responses [24].
Monitoring and Response Strategy Comparison
Different approaches to monitoring and response come with their own advantages and challenges. Understanding these options can help healthcare organizations choose what works best for their needs and resources.
| Strategy | Advantages | Disadvantages | Best For |
|---|---|---|---|
| 24/7 Security Operations Center (SOC) | Continuous monitoring, expert analysis, rapid response | Expensive, requires specialized staff | Large healthcare systems with big budgets |
| Automated Threat Detection | Affordable, consistent, reduces human error | May produce false positives, lacks contextual analysis | Organizations with smaller security teams |
| Hybrid Approach | Combines automation with human expertise, scalable | Needs coordination between tools and staff | Mid-size organizations |
| Outsourced Monitoring | Access to experts, predictable costs, 24/7 coverage | Less control over processes, possible communication delays | Smaller practices or those with limited IT resources |
For many healthcare organizations, a hybrid approach strikes the right balance. Automated tools handle initial threat detection, while human experts provide deeper analysis and response. This combination offers the benefits of continuous monitoring while ensuring that decisions are informed by the context unique to healthcare settings.
Finally, it’s important to establish clear consequences for failing to follow cybersecurity policies. These measures should focus on education and improvement rather than punishment, fostering a culture of accountability and cooperation where staff play an active role in keeping systems secure [20].
Building Strong Healthcare Cybersecurity for the Future
The healthcare industry faces a critical moment. In 2024, the U.S. Department of Health and Human Services reported 677 major data breaches, exposing the personal health information of 182 million people. The financial toll of these breaches reached staggering levels [27]. These numbers highlight an urgent need for stronger, more proactive cybersecurity measures.
To stay ahead of growing threats, healthcare organizations must move beyond traditional approaches and adopt multi-layered strategies. Cyberattacks on the healthcare sector rose by 32% in 2024 compared to the previous year, with 23% of all cyberattacks targeting this industry [28][13]. This surge calls for a shift toward more dynamic and comprehensive defenses.
Advanced technologies, streamlined processes, and a focus on people are key to building a secure future. A prime example is Zero Trust Architecture, which challenges the outdated assumption that any user or system can be inherently trusted [27]. When paired with AI and machine learning for automated threat detection, this model enables real-time identification and response to cyber threats, creating a more proactive defense.
"Healthcare organizations must revisit their entire cybersecurity strategy for threats ranging from ransomware to phishing and cloud vulnerabilities, which are often caused by weak controls." - Greg Young, Vice President of Cybersecurity, Trend Micro [29]
Blockchain technology is also making waves in healthcare cybersecurity. By enabling secure identity management and fraud detection, blockchain creates immutable data snapshots that allow for quick recovery without succumbing to ransom demands. Additionally, network segmentation helps isolate critical systems, enforcing strict access controls based on the principle of least privilege [27][28].
However, adopting these advanced solutions requires collaboration. IT teams, clinical staff, and administrative leaders must work together, with clinicians actively participating in security decisions and risk assessments [22]. This collective effort ensures that cybersecurity measures align with the realities of healthcare operations.
Continuous improvement is another cornerstone of effective cybersecurity. Regular security audits, vulnerability assessments, and penetration testing can uncover weaknesses before they become costly breaches. Organizations should also implement user-friendly security solutions that integrate seamlessly into clinical workflows, ensuring patient care isn’t disrupted [22].
The most forward-thinking healthcare organizations see cybersecurity as more than just a compliance requirement. Instead, they treat it as a strategic tool to build patient trust and ensure operational excellence. Partnering with experienced cybersecurity providers can give access to the expertise and tools needed to stay ahead of emerging threats [28]. By adopting these strategies, healthcare institutions can keep pace with an ever-changing threat landscape, safeguarding patient data, maintaining their operations, and reinforcing the trust that is so vital to quality care.
FAQs
Why does the healthcare industry need alternatives to the NIST Cybersecurity Framework?
While the NIST Cybersecurity Framework (CSF) is highly regarded, it comes with challenges when applied to healthcare organizations. Many providers in the healthcare sector struggle with barriers like tight budgets, complex technical requirements, and limited in-house cybersecurity expertise. These obstacles can make it tough to fully implement the framework. Adding to the difficulty, the NIST CSF is voluntary, leading to uneven adoption across the industry.
Healthcare organizations also face distinct cybersecurity risks. Safeguarding sensitive patient information and complying with regulations like HIPAA demand solutions that are more customized to the sector's needs. To effectively counter evolving threats, healthcare providers need to consider frameworks and tools that better align with their specific challenges, operations, and available resources.
How can healthcare organizations adopt frameworks like HHS Cybersecurity Goals and ISO/IEC 27001 to enhance their cybersecurity systems?
Healthcare organizations can strengthen their cybersecurity efforts by incorporating frameworks like HHS Cybersecurity Goals and ISO/IEC 27001 into their risk management strategies. This process typically includes regular risk assessments, setting up solid security policies, and crafting detailed incident response plans to tackle potential threats effectively.
To make the transition smoother, organizations should compare the requirements of these frameworks with their current systems. This helps pinpoint gaps and prioritize areas for improvement. ISO/IEC 27001 offers a clear, structured method for managing cybersecurity risks, while HHS Cybersecurity Goals focus on boosting resilience and fostering teamwork across departments. By adopting these standards, healthcare providers can enhance compliance, safeguard sensitive data, and stay better prepared for the constantly changing threat landscape.
How does AI-driven threat detection enhance healthcare cybersecurity, and how can it work alongside traditional security measures?
AI-powered threat detection is transforming healthcare cybersecurity by leveraging machine learning to spot unusual patterns and respond to new threats instantly. This technology enhances how threats are detected, enables quicker actions, and keeps evolving to tackle emerging risks, making it a critical asset in safeguarding sensitive healthcare information.
When paired with traditional security tools like firewalls, encryption, and access controls, AI creates a layered defense system. This combination boosts detection precision, speeds up response times, and reinforces protection against cyberattacks, helping healthcare organizations remain secure in an ever-evolving digital environment.
