In today’s industrial and critical infrastructure sectors, Operational Technology (OT) plays a vital role and OT cybersecurity is emerging as an evermore critical requirement of organisations within the healthcare sector. OT encompasses the hardware and software systems that monitor and control physical devices, processes, and industrial operations. Unlike traditional IT systems, OT is responsible for managing industrial control systems (ICS), supervisory control and data acquisition (SCADA) networks, and other mission-critical systems. From manufacturing plants and energy grids to healthcare facilities and transportation networks, OT underpins essential services that millions rely on every day.
With the growing convergence of OT and IT systems, the risk landscape has shifted dramatically. Cyber threats targeting OT environments can have far-reaching consequences, not just financial, but also operational, safety-related, and reputational. For organisations operating in industries like healthcare, energy, and manufacturing, the stakes could not be higher; OT Cybersecurity needs to become a key part of your defence strategy.
Understanding the Unique Challenges of OT Cybersecurity
OT systems differ fundamentally from traditional IT systems in several ways. They often run legacy software, require continuous uptime, and are connected to proprietary hardware that may be difficult to patch or upgrade. These characteristics create unique vulnerabilities:
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Legacy Systems: Many organisations operate a hybrid of modern and legacy OT systems. While legacy components are essential for day-to-day operations, they are frequently unsupported and unpatched, leaving exploitable gaps.
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Interconnected Environments: OT networks are increasingly integrated with IT networks for operational efficiency and data analysis. This interconnectedness, however, creates additional entry points for cyber adversaries.
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Physical Safety Risks: A successful OT attack can have consequences beyond data loss, potentially causing physical damage, operational downtime, or even endangering human life.
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Compliance Pressure: Industries such as healthcare, utilities, and manufacturing must adhere to strict regulatory frameworks that include OT cybersecurity requirements. Non-compliance can result in heavy fines, litigation, and reputational damage.
Mitigating Risks from Legacy Systems and Lateral Movement
One of the most critical lessons in OT cybersecurity is addressing the risk posed by legacy systems and lateral movement. Legacy OT components—often running outdated operating systems or unpatched software—represent prime targets for attackers. Once inside the network, malicious actors can move laterally, exploiting weak points to compromise additional systems or access sensitive operational data.
Recommended Actions Following a Cyber Incident:
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Catalogue and Manage Legacy Systems: Identify all end-of-life (EOL) systems and create a time-bound plan to upgrade, isolate, or decommission them. Proactively replacing unsupported components reduces exploitable attack surfaces and enhances operational resilience.
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Enforce Principle of Least Privilege: Apply minimum network permissions and restrict access credentials to only those who require it. Limiting administrative privileges and network access helps contain lateral movement in the event of a breach.
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Strengthen Remote Access Controls: Implement multi-factor authentication (MFA) across all remote access points, restrict administrator access, and enforce regular password changes. Remote access is a frequent attack vector in OT environments, making stringent controls essential.
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Enhance Monitoring and Detection: Increase monitoring for unusual logins, anomalous internal traffic between servers, and unusual device behaviour. Early detection of lateral movement can prevent attackers from progressing deeper into OT systems.
By integrating these measures, organisations can significantly reduce the likelihood of successful lateral movement and improve the resilience of legacy OT systems.
The Growing Threat Landscape in OT
Cyberattacks targeting OT systems have increased substantially in recent years. According to a 2024 report by the Industrial Control Systems Cyber Emergency Response Team (ICS-CERT), the number of reported incidents affecting OT infrastructure rose by over 35% compared to the previous year. Adversaries are targeting OT environments for several reasons:
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Financial Gain: Ransomware attacks on OT systems can force organisations to pay significant sums to restore operations.
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Espionage and Intellectual Property Theft: Industrial espionage often targets proprietary production processes and operational blueprints.
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Disruption of Critical Services: Attacks on critical infrastructure, such as energy grids or healthcare facilities, can disrupt essential services, creating societal and economic consequences.
Recent incidents highlight the real-world risks of insufficient OT cybersecurity. In early 2024, a major MedTech provider experienced a cyberattack that disrupted supply chain systems and delayed critical healthcare services. The attack underscored how even large, resource-rich organisations remain vulnerable to sophisticated threats.
Best Practices for OT Cybersecurity
Effective OT cybersecurity requires a layered, risk-based approach that combines technology, process, and personnel measures. Below are several essential best practices:
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Network Segmentation: Separate OT networks from IT networks to limit attack propagation. Segmentation prevents threats in one part of the network from impacting mission-critical systems.
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Patch Management and Updates: Develop a robust patch management strategy for both legacy and modern systems. Regular updates close vulnerabilities and reduce the attack surface.
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Asset Inventory: Maintain a comprehensive inventory of all OT assets, including hardware, software, and connected devices. Knowing what is on the network is the first step toward effective security management.
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Incident Response Planning: Create and regularly test incident response plans tailored for OT environments. Plans should include procedures for detection, containment, eradication, and recovery to minimise operational impact.
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Employee Training: Cybersecurity awareness for operational staff is crucial. Staff should be trained to recognise phishing attempts, suspicious activity, and proper procedures for reporting incidents.
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Third-Party Risk Management: Evaluate and monitor the security posture of vendors, contractors, and suppliers who interact with OT systems. Supply chain vulnerabilities have been a common source of major OT incidents.
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Advanced Monitoring and Threat Detection: Deploy tools capable of continuous monitoring and anomaly detection in OT environments. Solutions such as intrusion detection systems (IDS) and security information and event management (SIEM) platforms tailored for OT networks provide early warnings of suspicious activity.
Regulatory Compliance and OT Cybersecurity
Many sectors have specific regulatory requirements that directly impact OT cybersecurity. For example:
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Healthcare: HIPAA requires protection of electronic protected health information (ePHI), including when stored or processed in OT systems that interface with medical devices or clinical systems.
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Energy and Utilities: NERC CIP standards govern the security of bulk electric systems, requiring robust access control, monitoring, and incident reporting.
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Manufacturing and Industrial: ISO/IEC 62443 provides an international framework for securing industrial automation and control systems.
Non-compliance can result in substantial fines, legal consequences, and reputational damage. For instance, failing to secure OT systems that handle healthcare data could lead to HIPAA penalties ranging from $50,000 per violation to $1.5 million per year, alongside potential civil or criminal liability.
The Business Case for OT Security
Investing in OT cybersecurity is not merely a regulatory requirement—it is a business imperative. Organisations that prioritise OT cybersecurity benefit from:
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Operational Continuity: Reducing downtime caused by cyberattacks ensures uninterrupted delivery of critical services.
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Patient and Stakeholder Trust: In healthcare, strong OT cybersecurity demonstrates a commitment to protecting patient data and safety.
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Financial Protection: Preventing cyber incidents mitigates potential losses from ransomware, regulatory fines, and operational disruption.
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Competitive Advantage: Organisations with robust OT cybersecurity are better positioned to collaborate with partners and customers who value data and operational integrity.
Conclusion
Operational Technology csecurity is a critical component of modern enterprise risk management. As OT systems continue to converge with IT, the attack surface grows, and so do the potential consequences of a breach. Legacy systems, lateral movement, remote access, and third-party interactions all represent areas of heightened risk.
By implementing robust security measures—including network segmentation, strong access controls, multi-factor authentication, continuous monitoring, and incident response planning—organisations can protect critical infrastructure, sensitive data, and operational continuity. In sectors such as healthcare, the stakes are even higher, with lives, patient safety, and regulatory compliance on the line.
Investing in OT cybersecurity is an investment in resilience, trust, and long-term operational success. Organisations that take proactive steps today will be better equipped to withstand tomorrow’s cyber threats.
To find out more about MediShield’s OT cybersecurity consultants could help your organisation build resilience, book a consultation today: Contact Us – medishield.tech