Healthcare Cybersecurity → Ransomware in Hospitals
When Hospital Systems Lock, Patients Wait
Ransomware doesn't just encrypt files—it forces ambulance diversions, cancels surgeries, and puts lives at risk. In 2024, 389 U.S. hospitals shut down operations after attacks. Recovery took weeks, not hours.
of healthcare organizations were hit by ransomware in 2024
That's up from 60% in 2023. And half of them linked the attacks to increased patient mortality.
What Ransomware Actually Does to a Hospital
When malware encrypts your EHR, pharmacy systems, and lab interfaces, you're not just locked out of files. You lose the ability to deliver patient care safely.
Systems Start Failing
Staff notice they can't access patient records. Lab results aren't coming through. Scheduling systems are down. IT gets flooded with helpdesk tickets.
Emergency Protocols Activate
You pull systems offline to contain the spread. Clinical staff switch to paper charts—if you still have them. You start diverting ambulances because you can't safely admit new patients.
Care Delivery Slows Down
Surgeries get canceled. Patients wait hours for medication because pharmacists can't access orders. Physicians can't see test results. Revenue stops while expenses continue.
Rebuilding Takes Time
You're restoring systems from backups—if they weren't also encrypted. Validating data integrity. Testing interfaces. Average recovery: 19 days. Some hospitals take over a month.
The Bills Come Due
Patient volume hasn't recovered. Insurance premiums doubled. Regulatory fines arrived. You're negotiating settlements with patients whose care was delayed. Total cost: millions.
These Aren't Hypothetical Scenarios
Three major healthcare ransomware attacks in 2024 show what happens when systems fail:
Change Healthcare
February 2024
Attackers compromised the nation's largest prescription processing network. Claims and payments froze for thousands of pharmacies and providers nationwide.
Impact: $2.9 billion in losses. 100 million patient records compromised. Weeks of disrupted care delivery across the entire U.S. healthcare system.
Ascension Health
May 2024
One of the largest Catholic health systems in the U.S. lost access to critical care coordination systems. Providers couldn't see medication types, doses, or adverse reaction alerts.
Impact: Patient volumes dropped 8-12% for two months. Revenue losses in the hundreds of millions. Care delays affected thousands of patients.
Synnovis (UK)
June 2024
Pathology provider to several NHS hospitals got hit. Lab results stopped flowing. Blood tests, cancer screenings, and transfusions all delayed.
Impact: 170 documented incidents of patient harm. Delayed cancer screenings and maternal care. One confirmed patient death linked to delayed blood test results.
Community Hospitals (Multiple)
Throughout 2024
Smaller facilities with limited IT resources faced ransoms they couldn't afford to pay—and couldn't afford not to pay. Recovery stretched for months.
Typical Impact: $500K ransom paid. $3M+ in recovery costs, new equipment, legal fees, and regulatory penalties. Some never fully recovered operationally.
Pattern recognition: Attackers target healthcare specifically because hospitals can't afford downtime. They know you'll pay—or suffer consequences worse than the ransom.
What Ransomware Actually Costs
The ransom is just the beginning. Here's what hospitals paid in 2024:
What That $2.57M Includes
Direct Response Costs
- Incident response team fees
- Forensic investigation
- Legal counsel
- Notification to patients (often millions in postage and monitoring services)
- Public relations crisis management
Operational Costs
- Lost revenue from canceled procedures
- Overtime pay for staff working on paper
- Hardware replacement (if endpoints were destroyed)
- Software license renewals
- System validation and testing
Regulatory Penalties
- HIPAA violations for unencrypted data
- State breach notification fines
- OCR investigations and settlement costs
- Consent decree monitoring expenses
Long-Term Impact
- Cyber insurance premium increases (often 2x-3x)
- Patient volume doesn't immediately recover
- Reputation damage affecting market share
- Litigation from patients whose care was delayed
Four times as many hospitals suffered losses over $200,000 in 2025 compared to 2024. The problem is getting worse, not better.
How to Reduce Your Hospital's Ransomware Risk
You can't eliminate the threat entirely. But you can make your hospital a harder target—and recover faster when attacks happen.
Before an Attack
- Run tabletop exercises: Test your incident response plan quarterly with both IT and clinical staff
- Segment your network: Medical devices shouldn't communicate with billing systems
- Test your backups: Offline, immutable backups that attackers can't encrypt
- Train staff continuously: Phishing remains the #1 ransomware entry point
- Move beyond annual pen tests: Continuous threat exposure management finds gaps before attackers do
When an Attack Happens
- Activate your IR plan immediately: Pre-approved escalation paths save critical hours
- Isolate affected systems: Contain the spread before it hits backups
- Don't pay without forensics: You need to know if paying will actually decrypt files
- Document everything: For insurance claims, regulatory reports, and legal defense
- Communicate proactively: Patients, staff, regulators, and insurers all need updates
Why Continuous Testing Matters
Annual penetration tests give you a snapshot from March. Ransomware groups find new vulnerabilities in April. Continuous Threat Exposure Management detects exposures as they emerge—before attackers can exploit them.
Validate Your Ransomware Defenses with Offensive Testing
CTEM shows you where vulnerabilities exist. Red team and purple team exercises prove whether your controls and your team can actually stop ransomware when attackers exploit those vulnerabilities.
Two Approaches to Offensive Testing
Red Team Exercises
The adversarial approach
Our offensive security team simulates real ransomware attacks without warning your SOC. They use the same tactics, techniques, and procedures (TTPs) actual ransomware groups employ.
What This Tests:
- Can your SOC detect an attack when they don't know it's coming?
- How long does it take to notice suspicious activity?
- Does your team follow the incident response plan without prompting?
- Can ransomware spread undetected across your network?
Best for: Testing whether your current defenses work in the real world—no hand-holding, no hints.
Purple Team Exercises
The collaborative approach
Red team (offensive) and blue team (your SOC) work together in real time. When we find a gap, we fix it immediately and retest to confirm the fix works.
What This Tests:
- Are your detection rules configured correctly?
- Can you stop ransomware once you know what to look for?
- Does your team know how to respond effectively?
- Which controls are working and which need tuning?
Best for: Rapid improvement—identify gaps, fix them immediately, validate the fix works.
What Both Approaches Test
Initial Access
- Can phishing emails with malicious attachments reach inboxes?
- Do users click and execute the payload?
- Does your email security block known ransomware indicators?
Execution & Defense Evasion
- Does EDR/antivirus detect malware before it runs?
- Can attackers disable security tools?
- Do application controls prevent unauthorized execution?
Lateral Movement
- Can ransomware spread from workstations to servers?
- Does network segmentation actually contain the spread?
- Can attackers access domain admin credentials?
Impact & Recovery
- Are backups accessible from compromised systems?
- Can you restore operations without paying?
- How long would full recovery actually take?
When to Use Each Approach
Start with Red Team if:
- You want an honest assessment of whether your SOC can catch attacks
- Your leadership needs proof that defenses work (or don't)
- You're testing incident response readiness under realistic conditions
- You want to validate that security investments were worth it
Use Purple Team if:
- You know you have gaps and want to fix them quickly
- You're tuning detection rules and need validation
- Your SOC is new or undertrained and needs coaching
- You want rapid improvement cycles with immediate validation
Real-world example: A regional hospital ran a red team exercise and discovered their SOC took 6 hours to notice ransomware spreading. They immediately ran purple team sessions to fix detection gaps, then ran another red team test three months later. Detection time dropped to 12 minutes.
Combining CTEM with Red & Purple Team Testing
Use all three approaches together for maximum protection:
- CTEM continuously finds vulnerabilities across your environment as they emerge
- Purple team exercises close gaps fast—fix issues immediately and validate the fixes work
- Red team exercises test the whole system—prove your SOC can catch attacks without hints
Think of CTEM as knowing where your doors and windows are. Purple team is fixing the locks together. Red team is testing whether your security guard catches the burglar trying to break in.
Related Healthcare Security Topics
Penetration Testing for Healthcare
HIPAA-aligned security assessments that identify vulnerabilities in EHRs, medical devices, and hospital networks—without disrupting patient care.
CTEM for Healthcare
Move beyond annual testing with continuous threat exposure management—ongoing assessment that finds vulnerabilities as they emerge, not months later.
HIPAA Cybersecurity & Data Security
Understand HIPAA Security Rule requirements, technical safeguards, and how to build a compliance program that protects patient data and avoids costly violations.
Medical Device Cybersecurity & FDA Compliance
Navigate FDA premarket and postmarket cybersecurity requirements for medical devices, including vulnerability assessments and SBOM requirements.
Test Your Hospital's Ransomware Readiness
OSec offers three ways to validate your ransomware defenses—from continuous monitoring to adversarial testing.
CTEM
Continuous Exposure Monitoring
Identify vulnerabilities as they emerge, before attackers find them. See where your risks are across your entire environment.
Purple Team
Collaborative Defense Testing
Work together to find and fix gaps. Our red team attacks while your SOC responds. Fix issues immediately, then retest to validate.
Red Team
Adversarial Attack Simulation
Prove your defenses work. We simulate real ransomware attacks without warning your SOC. See if your team catches us.
No obligation. Just a clear assessment of where your hospital is vulnerable and whether your defenses actually work when tested.