Zero Trust Architecture for Healthcare Systems
Updated: Sep 10
Despite regulatory pressure and massive efforts to strengthen cybersecurity, attacks continue to succeed, and healthcare organizations remain at substantial risk.
Cyberattacks on healthcare are growing. According to the 2025 Ponemon Healthcare Cybersecurity Report, 93% of the organizations asked had experienced at least one cyberattack, with nearly three in four US healthcare organizations reporting related patient care disruption.
These numbers aren't an outlier. Report after report tells the same story: hospitals are under siege daily. Once an attacker has their foot in the door, they seek to move laterally through the system by means such as escalating privileges, exploiting unpatched vulnerabilities, and other techniques, as they look for sensitive data they can encrypt or steal and critical systems they can disrupt.
The answer is a security model built on a simple premise: never trust, always verify. It's called Zero Trust, and healthcare organizations don't need regulatory approval to adopt it.
Key takeaways
The healthcare sector is facing an unprecedented scale of cyberattacks, as detailed in major industry publications.
A major argument for why this is happening is that the hybrid nature of work environments (remote work, cloud, and BYOD access) compromises the purpose of perimeter security, stretching it to unwieldy proportions and creating more opportunities for exploitation that defenders can’t cope with.
Using Zero Trust Architecture (ZTA) can serve as an optimal practice for protecting the integrity of healthcare systems, as supported by guidance from NIST and the NSA.
Zero trust architecture verifies every user and device before granting access, regardless of location. It follows a "never trust, always verify" model.
Zero trust architecture limits each user to the minimum permissions needed for their role. It divides the network into isolated segments, so a breach in one zone cannot spread to others.
Contents
1 The Reasons Behind Healthcare's Rising Cyber Risk
In a July 2026 report, IBM's Cost of a Data Breach study noted that healthcare breaches averaged $6.64 million in 2026. This is the highest of any industry for the 13th consecutive year, though down from $7.42 million in 2025.
That same year, U.S. healthcare organizations reported 772 large breaches (affecting 500 or more records) to the HHS Office for Civil Rights, a new annual record and the fifth consecutive year the count has held above 700. Compounding the problem, AI-driven attacks, now involved in roughly one in four malicious breaches, add nearly $1 million to the average cost of a breach.
Remediation timelines aren't improving either. Industry-wide, the average time to identify and contain a breach rose to 247 days in 2026.
As of March 2026, the HHS Office for Civil Rights portal reports 699 HIPAA breaches under investigation in the past 24 months.
This is mostly enabled by hybrid environments that have become more common in healthcare and add to the complexity of defending against rapidly multiplying threats:
As reported by Becker’s Health IT, a 2025 survey found that 80% of healthcare organizations are using a public cloud provider, but 40% reported that 90% or more of their IT systems remain on-prem.
Remote work is a well-established staffing strategy for both metropolitan and rural organizations that need to hire talent, regardless of where they live. HealthTech magazine reported that a nationwide staffing agency analyzed its job placements over a year and found that 69% of the healthcare support roles it filled were fully remote.
Medical IoT device use is growing for applications such as remote patient monitoring, and with this use comes the need to protect the sensitive patient information they collect and transmit.
Each of these shifts was adopted for good reason: cost efficiency, workforce flexibility, and better patient care. But together, they've dissolved the traditional network perimeter, leaving security teams to defend a moving target with tools built for a fixed one.
2 The Limits of Traditional Perimeter Security
Traditional network security is built around defending the network perimeter. Firewalls and access controls form the first line of defense, while additional layers, such as endpoint protection, intrusion detection systems, and similar tools, are meant to catch what gets through if that perimeter gets breached. Underlying all of this is a core assumption: once a user has authenticated and been granted access, they're trusted to move through the network.
This model made sense when an organization's infrastructure sat largely within its own four walls. It doesn't hold up as well today, because healthcare no longer has a single, clearly defined perimeter to defend:
Cloud services and applications operate entirely outside traditional network boundaries.
Satellite clinics and remote offices maintain their own local infrastructure, often with different security postures than the main network.
Remote and mobile staff routinely connect from inside and outside the network, sometimes in the same day, using devices IT doesn't always fully control.
As these hybrid environments have grown more complex, the defenses built to protect them haven't kept pace. Threat actors are more persistent and more sophisticated than ever, and they regularly penetrate perimeter defenses through phishing, stolen credentials, unpatched vulnerabilities, or simply by exploiting the entry points a hybrid network creates.
Once inside, the old assumption of trust becomes a liability rather than a safeguard: because internal activity isn't inspected the way external activity is, attackers who breach the perimeter can move through the network largely undetected, escalating access and reaching sensitive systems with little to no resistance.
3 The “Never Trust, Always Verify” Model Explained
To address these security challenges, many healthcare organizations are adopting the Zero Trust security model. Zero Trust is a paradigm shift in the way we think about cybersecurity.
Unlike standard models that center on securing a network's perimeter, Zero Trust assumes that threats can come from both outside and inside the network. This approach dictates that no one, whether inside or outside the organization, should be automatically trusted. Instead, every user, device, and application must be continuously verified before being granted access to sensitive resources.
Interconnected healthcare systems, in which data flows across applications, devices, and cloud platforms, make it difficult to secure the network perimeter. Zero Trust helps reduce these risks by implementing strict access controls, encryption, and real-time monitoring to ensure that patient data remains secure at all times.
Traditional perimeter-based security models are no longer enough to protect healthcare organizations from cyber threats. As healthcare systems become more interconnected and distributed, attackers can easily bypass perimeter defenses, especially if they gain access through compromised devices or internal actors. Zero Trust ensures that every interaction within the system is scrutinized, reducing the likelihood of unauthorized access or data breaches.
In its paper, Embracing a Zero Trust Security Model, the National Security Agency (NSA) describes zero trust as follows:
The Zero Trust security model assumes that a breach is inevitable or has likely already occurred, so it constantly limits access to only what is needed and looks for anomalous or malicious activity. Zero Trust embeds comprehensive security monitoring; granular risk-based access controls; and system security automation in a coordinated manner throughout all aspects of the infrastructure in order to focus on protecting critical assets (data) in real time within a dynamic threat environment. This data-centric security model allows the concept of least-privileged access to be applied for every access decision, allowing or denying access to resources based on the combination of several contextual factors.”
Per the NSA, the guiding principles of zero trust, outlined in NIST SP 800-207, are as follows:
Never trust, always verify: Treat every user, device, application/workload, and data flow as untrusted. Authenticate and explicitly authorize each to the least privilege required using dynamic security policies.
Assume breach: Consciously operate and defend resources with the assumption that an adversary already has presence within the environment. Scrutinize all users, devices, data flows, and access requests. Log, inspect, and continuously monitor all configuration changes, resource accesses, and network traffic for suspicious activity.
Verify explicitly: Access to all resources should be managed consistently and securely, using multiple attributes (dynamic and static) to derive confidence levels for contextual access decisions.
By complying with these principles, organizations can substantially reduce their exposure to cyberattacks, boost data protection, and improve overall security posture. It is acknowledged that adopting zero trust is a non-trivial incremental effort. However, organizations that adopt a zero-trust approach reduce their risk at each step of the journey.
4 Zero Trust Architecture Pillars
Building a genuine ZTA requires a holistic approach that goes beyond simple network controls. The most effective implementations focus on securing seven key pillars: user, device, application, data, network, automation, and visibility. This layered approach ensures that security is applied across the entire digital ecosystem.
User Pillar: Focuses on continuously verifying identities, evaluating user risk, monitoring behavior, and enforcing strict control over privileged permissions.
Device Pillar: Evaluates the condition, health, and trustworthiness of endpoints (laptops, mobile devices, IoT, servers) prior to granting network access.
Applications and Workloads Pillar: Secures applications, APIs, containers, virtual machines, and cloud workloads, ensuring no workload is trusted automatically.
Data Pillar: Protects data at rest and in transit through classification, encryption, and granular access controls to ensure only authorized entities access protected data.
Network and Environment Pillar: Utilizes macro- and micro-segmentation, encryption, and flow controls to isolate resources and curtail adversarial lateral movement.
Automation and Orchestration Pillar: Automates security responses, policy enforcement, and operational integration to dynamically mitigate risk at machine speed.
Visibility and Analytics Pillar: Centralizes logging, SIEM capabilities, threat intelligence, and user/entity behavior analytics (UEBA) to continuously detect and respond to threats.
5 How to Implement Zero Trust Architecture
Implementing zero trust security does not mean deploying a single technology or solution. Instead, it’s a reimagining of your enterprise’s approach to network security. Successfully implementing zero trust architecture requires a methodical approach that encompasses strategic planning, careful execution, and continuous monitoring.
Here's a breakdown of the key steps and considerations:
Define the scope: Identify the critical assets, applications, and data that require protection. This involves a thorough assessment of the organization's IT infrastructure and data flow patterns.
Identify users and devices: Establish a comprehensive inventory of all users and devices that will access the network. This includes employees, contractors, partners, and BYOD devices.
Implement identity and access management (IAM): Deploy a robust IAM solution to manage user identities, authenticate access requests, and enforce granular access control policies.
Segment the network: Divide the network into smaller, isolated segments to limit the impact of security breaches and prevent lateral movement.
Deploy security tools: Implement essential security tools such as multi-factor authentication (MFA), intrusion detection and prevention systems (IDPS), and data loss prevention (DLP) solutions.
Monitor and maintain: Continuously monitor the network for suspicious activity and regularly review and update security policies to adapt to evolving threats.
Rather than attempting a wholesale Zero Trust rollout, healthcare organizations can use a maturity model, such as the one published by CISA, to advance each of the seven pillars independently, at a pace that matches their resources and risk tolerance. An organization might, for example, prioritize maturing its Data and User pillars first, given the sensitivity of patient records and the prevalence of credential-based attacks, while taking a more gradual approach to network micro-segmentation as legacy medical devices are phased out.
The three stages of the Zero Trust Maturity Model (ZTMM) journey that advance from a Traditional starting point to Initial, Advanced, and Optimal will facilitate federal ZTA implementation. Each subsequent stage requires greater levels of protection, detail, and complexity for adoption.
The following guiding criteria for each stage can be used to identify maturity for each zero trust technology pillar and provide consistency across the maturity model:
Traditional: manually configured lifecycles (i.e., from establishment to decommissioning) and assignments of attributes (security and logging); static security policies and solutions that address one pillar at a time with discrete dependencies on external systems; least privilege established only at provisioning; siloed pillars of policy enforcement; manual response and mitigation deployment; and limited correlation of dependencies, logs, and telemetry.
Initial: starting automation of attribute assignment and configuration of lifecycles, policy decisions and enforcement, and initial cross-pillar solutions with integration of external systems; some responsive changes to least privilege after provisioning; and aggregated visibility for internal systems.
Advanced: wherever applicable, automated controls for lifecycle and assignment of configurations and policies with cross-pillar coordination; centralized visibility and identity control; policy enforcement integrated across pillars; response to pre-defined mitigations; changes to least privilege based on risk and posture assessments; and building toward enterprise-wide awareness (including externally hosted resources).
Optimal: fully automated, just-in-time lifecycles and assignments of attributes to assets and resources that self-report with dynamic policies based on automated/observed triggers; dynamic least privilege access (just-enough and within thresholds) for assets and their respective dependencies enterprise-wide; cross-pillar interoperability with continuous monitoring; and centralized visibility with comprehensive situational awareness.
These maturity stages and the details associated with each pillar allow agencies to assess, plan, and maintain the investments needed to progress toward a ZTA
Stage | Identity | Devices | Networks | Applications and Workloads | Data |
Traditional | Passwords or MFA; On-premises identity stores; Limited identity risk assessments; Permanent access with periodic review | Manually tracking device inventory; Limited compliance visibility; No device criteria for resource access; Manual deployment of threat protections to some devices | Large perimeter/macro-segmentation; Limited resilience and manually managed rulesets and configurations; Minimal traffic encryption with ad hoc key management | Mission critical applications accessible via private networks; Protections have minimal workflow integration; Ad hoc development, testing, and production environments | Manually inventory and categorize data; On-prem data stores; Static access controls; Minimal encryption of data at rest and in transit with ad hoc key management |
Initial | MFA with passwords; Self-managed and hosted identity stores; Manual identity risk assessments; Access expires with automated review | All physical assets tracked; Limited device-based access control and compliance enforcement; Some protections delivered via automation | Initial isolation of critical workloads; Network capabilities manage availability demands for more applications; Dynamic configurations for some portions of the network; Encrypt more traffic and formalize key management policies | Some mission critical workflows have integrated protections and are accessible over public networks to authorized users; Formal code deployment mechanisms through CI/CD pipelines; Static and dynamic security testing prior to deployment | Limited automation to inventory data and control access; Begin to implement a strategy for data categorization; Some highly available data stores; Encrypts data in transit; Initial centralized key management policies |
Advanced | Phishing-resistant MFA; Consolidation and secure integration of identity stores; Automated identity risk assessments; Need/session-based access | Most physical and virtual assets are tracked; Enforced compliance implemented with integrated threat protections; Initial resource access depends on device posture | Expanded isolation and resilience mechanisms; Configurations adapt based on automated risk-aware application profile assessments; Encrypts applicable network traffic and manages issuance and rotation of keys | Most mission critical applications available over public networks to authorized users; Protections integrated in all application workflows with context-based access controls; Coordinated teams for development, security, and operations | Automated data inventory with tracking; Consistent, tiered, targeted categorization and labeling; Redundant, highly available data stores; Static DLP; Automated context-based access; Encrypts data at rest |
Optimal | Continuous validation and risk analysis; Enterprise-wide identity integration; Tailored, as-needed automated access | Continuous physical and virtual asset analysis including automated supply chain risk management and integrated threat protections; Resource access depends on real-time device risk analytics | Distributed micro-perimeters with just-in-time and just-enough access controls and proportionate resilience; Configurations evolve to meet application profile needs; Integrates best practices for cryptographic agility | Applications available over public networks with continuously authorized access; Protections against sophisticated attacks in all workflows; Immutable workloads with security testing integrated throughout lifecycle | Continuous data inventorying; Automated data categorization and labeling enterprise-wide; Optimized data availability; DLP exfil blocking; Dynamic access controls; Encrypts data in use |
6 How Zero Trust Works With AI-enabled Threat Detection
Zero trust architecture may be further enhanced using AI-enabled threat detection. AI algorithms can identify anomalies and potential threats in real time from vast amounts of operational data from various sources, including user behavior, network traffic, and security logs.
AI algorithms can be used to detect suspicious login attempts, identify compromised accounts, and flag unusual data access patterns. By analyzing data from multiple sources, valuable insights might be obtained to identify threats more efficiently and in less time.
The methodology, built on AI algorithms, enables the system to adapt to new threats through model learning, making it a more powerful tool in the fight against increasingly sophisticated cyberattacks. By combining the principles of zero trust with the power of AI, organizations can achieve a more robust and resilient security framework.
7 Best Practices for ZTA Implementation Across Different Industries
To understand how to implement zero trust effectively requires careful consideration of industry-specific security and compliance requirements.
Healthcare
Healthcare organizations have to prioritize HIPAA compliance when implementing zero trust. This requires securing protected health information (PHI) with robust access controls, encryption, and audit trails. Integrating zero trust edge (ZTE) solutions can further enhance security for remote access to healthcare applications and data.
Finance
Financial institutions need to adhere to PCI DSS standards to protect cardholder data. Implementing strong authentication, network segmentation, and data loss prevention (DLP) solutions is fundamental for achieving compliance.
Government
Government agencies handle sensitive information that requires strict security controls. Zero trust implementations in government often involve rigorous identity verification, data encryption, and compliance with regulations such as NIST SP 800-207.
Education
Educational institutions face unique challenges in securing a diverse range of users and devices. Implementing zero trust in education requires a focus on network access control (NAC), endpoint security, and user awareness training.
Manufacturing
Manufacturing companies must protect intellectual property and OT from cyberattacks. Zero trust in manufacturing focuses on securing industrial control systems (ICS) and controlling remote access for employees and partners, with manufacturing cybersecurity providing the broader framework that keeps these protections consistent across the production environment.
8 Challenges in Zero Trust Architecture Implementation
Although the benefits of zero trust architecture are unquestionable, organizations often encounter major obstacles during implementation. Proactively handling these challenges is fundamental to ensuring a successful transition to a zero-trust model and optimizing return on investment.
Addressing legacy system integration
Integrating legacy systems into a ZTA can be complex. Organizations may need to employ workarounds or phased approaches to incorporate older technologies without compromising security.
Managing user experience and productivity
Balancing security with user experience and productivity is crucial. Implementing zero trust should not impede user workflows or hinder business operations. Careful planning and user training can help ensure a smooth transition.
Balancing security and business agility
Zero Trust should not restrain business agility. Organizations need to implement zero trust in a way that sustains innovation and allows for flexible adaptation to changing business requirements.
Lack of connected device data and network insight
Healthcare is an industry with one of the highest numbers of connected devices. Most clinical procedures nowadays rely on several medical and IoT devices that instantly sync data to medical databases and your physician's hardware. It's hard to keep up with various security patches and install them on time.
As an IT administrator, you must know precisely what is on your network. Otherwise, you're turning a blind eye to the majority of lurking threats. Without a clear understanding of what exists on your network, it's much harder to protect it.
Introduce changes without breaking the existing system
Usually, for healthcare organizations, safety comes second. Much more important is that all devices should work. Patches or transitions into a new network type could disrupt a sensitive ecosystem, and some devices might start returning errors.
This puts pressure on IT administrators, as they must plan the transition to ensure there are no flaws or regressions. In such cases, the optimal strategy is to start the transition to ZTA by gradually phasing out the most threatening risks.
Lack of scalable enforcement technology
There is no universal, scalable enforcement technology that could be adopted across the company. Your administrators will likely rely on internal segmentation, distributed firewalls, or NAC systems. Still, their effectiveness will depend on your configuration more than on other mechanisms. They won't be very straightforward, either.
Lack of resources
It doesn’t help that IT budgets are often an afterthought in most companies. According to Gartner, only 7.9% of the budget is allocated to IT. If it isn't broken, don't fix it approach has long served as a justification for why additional investments shouldn't be made.
In addition, implementing zero trust requires additional work hours, strategy, and fine-tuning to achieve the desired results. By definition, it's an expensive and lengthy process. Given that IT budgets aren't that high for most companies, a lack of resources might be a key reason holding the company back.
How Can Plexteq Help?
Plexteq helps healthcare organizations strengthen cybersecurity across applications, infrastructure, and connected systems. From small clinics to large hospital networks, Plexteq can help protect critical systems and sensitive healthcare data across complex, distributed IT environments.
Our cybersecurity and infrastructure expertise covers cloud and on-premises environments, networks, applications, endpoints, and integrations. We can assess your environment, identify vulnerabilities and architectural risks, and implement practical improvements, including security architecture, threat modeling, infrastructure security, secure software development, DevSecOps, vulnerability management, penetration testing, and compliance.
Healthcare environments can span hospitals, clinics, remote facilities, cloud platforms, medical devices, EHR/EMR systems, telehealth services, and third-party integrations. Plexteq combines cybersecurity, infrastructure engineering, and healthcare software expertise to secure these interconnected environments while maintaining the availability and performance healthcare operations depend on.
Our approach aligns security with your technology, business objectives, regulatory requirements, and actual risk exposure - helping reduce your attack surface, strengthen resilience, protect patient data, and support innovation without unnecessary friction.
Zero Trust Architecture FAQ
Q: How does zero trust architecture enhance protection against advanced cyber threats?
A: Zero trust architecture enhances protection by eliminating implicit trust and enforcing continuous verification for all users and devices. This limits the attack surface and prevents lateral movement, hindering the progression of advanced threats.
Q: What is the role of continuous verification in a zero trust architecture?
A: Continuous verification ensures that trust is continuously assessed even after initial access is granted. This dynamic approach helps identify compromised accounts and devices, mitigating risks from insider threats and stolen credentials.
Q: How does zero trust protect data during cloud migrations?
A: Zero trust secures data during cloud migrations by enforcing consistent security policies across all environments. Granular access controls, data encryption, and real-time threat monitoring protect sensitive data throughout the migration process.
Q: What steps are involved in auditing user access within a zero trust system?
A: Auditing user access in a zero trust system involves monitoring user activity, analyzing access logs, and correlating data from various security tools. This provides insights into user behavior and helps detect anomalies or policy violations.
Q: How does zero trust address insider threats and employee errors?
A: Zero trust mitigates insider threats and employee errors by enforcing least privilege access and continuous verification. This limits the potential damage from compromised accounts or accidental data exposure.
Want to strengthen your healthcare organization's security? Get in touch with Plexteq to discover how we can help secure your infrastructure, applications, and connected healthcare ecosystem.
