Survey Exposes Disconnect: Compliance Scores High, but Risk and Resilience Scores Trail Behind

Healthcare organizations are excelling at meeting regulatory compliance but falling short in managing cyber risks and ensuring system resilience. While passing audits and adhering to standards like HIPAA is common, many systems remain vulnerable to cyberattacks and lack effective recovery plans. This gap poses serious risks to patient safety, operational stability, and financial health.

Key Takeaways:

• Compliance vs. Resilience: Compliance ensures organizations meet regulatory requirements, but it doesn’t guarantee strong defenses or quick recovery from cyber incidents.
• Survey Findings: High scores in compliance areas like access controls and data encryption contrast with low resilience in risk assessments and incident response.
• Challenges in Healthcare: Legacy systems, delayed vulnerability patching, and vendor risks weaken resilience efforts.
• Impact: System downtime disrupts patient care, increases costs, and damages reputations.
• Solutions: Adopting frameworks like NIST CSF 2.0, leveraging AI tools, and fostering cross-department collaboration can help close the gap.

To move beyond compliance, healthcare organizations must focus on building resilience to safeguard patients, data, and operations against evolving cyber threats.

Survey Results: High Compliance, Low Resilience

Main Survey Findings

Recent survey results highlight a pattern in healthcare organizations: while they excel at meeting regulatory requirements, such as those outlined in HIPAA, this doesn’t always translate into strong cyber resilience. Healthcare IT departments are adept at implementing established cybersecurity frameworks to stay compliant. However, compliance alone doesn’t guarantee the ability to swiftly detect new threats, respond effectively to cyberattacks, or restore operations quickly after an incident.

While organizations handle documented controls efficiently, many struggle to develop flexible strategies that address real-world cyber threats. Let’s take a closer look at how compliance and resilience stack up across critical cybersecurity areas.

Comparing Compliance and Resilience Scores

A closer analysis reveals a noticeable gap between compliance and resilience. Areas like access controls, data encryption, and thorough documentation often score high due to clear regulatory guidelines. On the other hand, domains that require proactive measures - such as risk assessments, incident response, and business continuity planning - show significant weaknesses in resilience.

This disparity suggests that focusing heavily on compliance, while essential for meeting legal standards, may unintentionally divert resources from building the practical capabilities needed to handle evolving cyber threats.

How Healthcare Compares to Other Industries

When compared to other industries, healthcare faces unique challenges. Strict regulatory demands, driven by mandates like HIPAA, often push organizations to prioritize compliance over adaptive risk management. This leaves little room for developing proactive strategies that could strengthen their overall cyber defenses.

As cyber threats grow more complex, healthcare organizations must find a way to balance the necessity of regulatory compliance with the equally important goal of improving their cyber resilience. It’s a delicate but critical balancing act for the industry.

Why This Gap Exists

Survey findings highlight that these gaps arise from deeper strategic and systemic challenges within healthcare organizations.

The Problems with Compliance-First Thinking

Many healthcare organizations approach compliance as a checklist to satisfy regulations, rather than using it as a foundation for strong cybersecurity practices. This mindset can create a false sense of security, where meeting regulatory benchmarks is seen as the ultimate goal instead of the starting point for more comprehensive protection.

When compliance drives cybersecurity strategies, the focus often shifts to documented controls and processes aimed at passing audits, rather than developing real-world capabilities to respond to threats. Resources are frequently directed toward policies, procedures, and reporting mechanisms that meet regulatory standards but fail to address sophisticated cyberattacks effectively.

Treating compliance as a one-and-done milestone also leads to stagnation. Organizations may overlook the need for continuous adaptation to new and evolving cyber threats. Beyond these strategic missteps, outdated systems further weaken their ability to defend against attacks.

Old Systems and Disconnected Infrastructure

One of the biggest challenges healthcare organizations face is the reliance on legacy medical devices and outdated technology that were not built to handle today’s cybersecurity threats. These older systems create significant obstacles to achieving robust cyber defenses.

For instance, 15% of healthcare PCs lack basic security controls, such as endpoint protection, vulnerability management, and encryption tools ^[1]. This gap often exists because managing and updating legacy systems can be incredibly difficult - many of these systems don’t support modern security updates.

Another issue is the 48-day average delay in patching critical vulnerabilities in healthcare systems ^[1]. While this is an improvement from the 77-day delay reported in 2024, it still leaves systems exposed to known threats for far too long. Legacy systems often require extensive testing before patches can be applied, and in some cases, older devices may not receive updates at all.

These outdated systems not only put individual devices at risk but also weaken overall network security. Disconnected infrastructure compounds the problem by creating visibility gaps. Without centralized control over devices and network segments, IT teams struggle to enforce consistent security measures or respond quickly to emerging threats.

The lack of comprehensive asset inventories and detailed network mapping further complicates matters. When organizations don’t have a clear understanding of their entire attack surface, it becomes nearly impossible to address vulnerabilities effectively. Simply put, you can’t secure what you can’t see. These outdated systems and fractured networks are key reasons for the lower resilience scores reflected in the survey.

Vendor Risk and Supply Chain Gaps

Healthcare organizations depend heavily on third-party vendors for services ranging from electronic health records to medical device maintenance. While these partnerships are vital, they also bring cybersecurity risks that are often outside the organization’s direct control.

A single vulnerable vendor can act as a gateway for attackers, compromising even the most secure healthcare systems. This risk grows exponentially as organizations work with dozens - or even hundreds - of vendors, many of which are smaller companies with limited resources to invest in cybersecurity.

The issue doesn’t stop with direct vendors. Fourth-party risks - where a vendor’s subcontractors introduce vulnerabilities - add another layer of complexity. Ensuring that these extended supply chain partners meet security standards is challenging, as these relationships are harder to monitor and manage.

The problem is further exacerbated by the rapid pace of mergers and acquisitions in the healthcare sector. Each new acquisition introduces additional vendor relationships and legacy security setups that may not align with current cybersecurity protocols. Limited resources and expertise for ongoing vendor monitoring make managing these risks even harder, contributing to the compliance-resilience gap highlighted in the survey results.

The Cost of Ignoring Risk and Resilience

When healthcare organizations focus only on regulatory compliance without prioritizing risk management and resilience, the consequences can be severe. This narrow approach can weaken patient care, drive up costs, and disrupt operations. Let’s break down how these gaps lead to operational, financial, and legal challenges.

System Downtime and Patient Safety Issues

Cyberattacks don’t just threaten systems - they can directly impact patient safety, and a compliance-only mindset often falls short in addressing these risks. Without a solid resilience plan, vulnerabilities can lead to widespread system downtime, forcing hospitals to rely on error-prone manual processes and delaying critical care. Essential services like accessing electronic health records, coordinating care through connected medical devices, processing lab results, and managing prescriptions can grind to a halt.

In high-stakes environments such as emergency rooms or intensive care units, even brief outages can have serious consequences. For instance, communication delays might force ambulances to divert to other facilities, or surgeries could be postponed. These interruptions not only jeopardize timely care but also erode patient trust. On top of that, healthcare workers face added stress, increasing the likelihood of burnout and mistakes.

Financial and Legal Costs

Overlooking risk and resilience planning can lead to a domino effect of financial and legal problems. The immediate costs of responding to incidents and restoring systems can be steep. Regulatory fines may add to the financial strain, creating an even heavier burden.

But the financial toll doesn’t stop there. Prolonged outages can reduce patient volumes and disrupt care delivery, leading to business interruption losses. Rising cyber insurance premiums and the complexities of navigating claims can add further strain. Legal action from patients - whether due to compromised data or delayed care - can result in expensive settlements. And long-term reputational damage? That can erode patient confidence and hurt future revenue.

Compliance-Only vs. Resilience-Focused Approaches

These operational and financial setbacks highlight why resilience planning is far more effective than a compliance-only approach. Organizations that focus solely on meeting regulatory requirements often find themselves unprepared when a cyber incident strikes. On the other hand, those that adopt resilience-focused strategies benefit from:

• Quicker detection and recovery, with automated, proactive responses that help protect their reputation.
• Minimal disruptions to patient care, thanks to reliable backup systems and well-rehearsed response plans.
• Lower financial impact, as swift action reduces downtime and associated losses.
• Smoother regulatory responses, with fewer fines or penalties due to better preparedness.
• Stronger third-party risk management, supported by continuous monitoring and vendor oversight.
• Better staff readiness, with clear, practiced protocols that reduce errors during high-pressure situations.

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How to Close the Gap: Building Real Cyber Resilience

To effectively protect patients, data, and operations while meeting compliance requirements, healthcare IT leaders need strategies that go beyond ticking boxes on a checklist. By focusing on both compliance and operational resilience, organizations can build defenses that are both comprehensive and adaptive.

Use Integrated Cyber Risk Management Frameworks

Start by using established cybersecurity frameworks, like the NIST Cybersecurity Framework (CSF) 2.0, which outlines five key functions: Identify, Protect, Detect, Respond, and Recover. This framework is flexible enough to adapt to an organization’s specific needs while ensuring it meets compliance standards and strengthens resilience.

In August 2025, the National Institute of Standards and Technology (NIST) updated its SP 800-53 guidelines, adding new controls aimed at improving how organizations manage cybersecurity risks - especially in industries like healthcare ^[4].

For sector-specific challenges, consider adopting the Health Industry Cybersecurity Practices (HICP). For example, one healthcare provider that implemented the NIST Risk Management Framework saw a major reduction in vulnerabilities by categorizing systems and applying appropriate controls. This approach also helped them stay compliant with federal regulations ^[4].

To further enhance governance, organizations can integrate ISO 31000 into their decision-making processes. This method encourages a broader view of risk management, incorporating not just technical controls but also business continuity and operational resilience.

Use Automation and AI for Risk Management

Manual processes are no match for today’s fast-moving cyber threats. Organizations using AI in their cybersecurity programs have significantly improved their ability to detect and contain breaches - cutting response times by 21–31%, depending on the level of AI integration ^[5]. These improvements also translate to cost savings, with data breach expenses reduced by $800,000 to $1.77 million on average ^[5].

AI tools like Censinet RiskOps™ help centralize risk data, speeding up decision-making and addressing staffing shortages faced by 74% of healthcare organizations ^[5][6]. Similarly, Censinet AITM automates third-party risk assessments, streamlining processes like security questionnaires and integration reviews.

AI’s capabilities go far beyond basic automation. Advanced systems can analyze unstructured data to detect emerging threats specific to healthcare, using techniques like natural language processing. These tools adapt in real time, updating security policies as new threats emerge. They also prioritize patching efforts by assessing vulnerabilities in the context of an organization’s unique environment, ensuring that critical risks are addressed first ^[7].

By leveraging automation and AI, healthcare organizations can bridge the gap between meeting compliance requirements and achieving real-time cyber resilience.

Get All Departments Involved

Cybersecurity isn’t just an IT issue - it requires collaboration across clinical, administrative, and operational teams. A coordinated, organization-wide effort is essential to close the gap between compliance and resilience.

"Effective risk management significantly influences patient and stakeholder outcomes, ensuring that compliance and quality of care are maintained."

• Matthew Clarke, MD, Dalhousie University ^[2]

Each department brings unique insights to the table. Clinical staff understand workflows and patient safety implications, administrative teams are well-versed in regulatory and business continuity needs, and operations teams have a clear view of supply chain dependencies. Together, these perspectives create a more practical and effective security strategy.

This collaboration is especially critical given that more than half of network-connectable medical devices in hospitals have known critical vulnerabilities ^[5]. Clinical teams must work closely with IT to address these risks without disrupting patient care. Clear communication, defined roles, and shared responsibility are key to ensuring cybersecurity is a priority across all levels of the organization.

Practice Continuous Improvement

Building and maintaining resilience is an ongoing process. Regular tabletop exercises allow teams to test their response plans in various scenarios, identify weaknesses, and refine their strategies. These exercises should involve not just IT and security staff but also clinical and administrative personnel who would play key roles during an actual incident.

Go beyond theoretical discussions by conducting real-world tests, such as shutting down systems and practicing recovery procedures. This helps measure recovery times, identify bottlenecks, and build confidence in the organization’s ability to respond effectively.

Continuous monitoring is another critical component. Regular vulnerability assessments, penetration testing, and reviews of third-party vendor security are essential to staying ahead of evolving threats and maintaining compliance ^[3].

Staff training should also be ongoing, not limited to annual sessions. With the FDA approving a growing number of AI-enabled medical devices - 221 in 2023 alone, with 2024 on track to surpass that figure ^[5] - healthcare workers need frequent updates on emerging technologies and their associated risks.

Finally, establish clear metrics to track progress. Key measures like mean time to detection and response, patching rates, staff training completion, and outcomes from tabletop exercises can highlight improvements and uncover areas that need more attention. These benchmarks ensure resilience efforts remain on track and effective over time.

Conclusion: Bringing Compliance, Risk, and Resilience Together

The survey findings make one thing clear: compliance alone isn't enough to shield healthcare organizations from today’s cyber threats. Simply ticking regulatory boxes leaves dangerous gaps in protection. To truly safeguard against attacks, healthcare IT leaders must weave risk management and operational resilience into every layer of their cybersecurity strategies. This means going beyond paperwork to create defenses that adapt to threats, recover swiftly from incidents, and ensure patient care continues uninterrupted.

Achieving this requires a well-rounded approach that blends established frameworks like NIST CSF 2.0 with cutting-edge technologies and teamwork across departments. Tools such as Censinet RiskOps™ play a crucial role by centralizing risk data, automating assessments, and offering real-time insights - bridging the divide between regulatory compliance and genuine cyber resilience.

In today’s threat-heavy environment, success demands more than routine audits. It calls for constant monitoring, regular testing, and an ongoing commitment to refining security measures. Healthcare organizations that adopt this mindset can go beyond meeting their regulatory requirements. They’ll build the resilience needed to protect patients, maintain trust, and keep operations running smoothly, even in the face of growing cyber threats.

The gap between compliance scores and real-world resilience, as highlighted by the survey, isn’t an unfixable problem. By embracing integrated risk management, leveraging automation and AI, fostering collaboration across the organization, and prioritizing continuous improvement, healthcare providers can transform their cybersecurity efforts. This shift turns routine practices into powerful defense systems - ensuring compliance while building the strength to withstand modern threats and protect what matters most.

FAQs

Why do healthcare organizations often excel in compliance but struggle with risk management and resilience, and what challenges does this create?

Healthcare organizations often place a heavy focus on compliance to meet regulatory standards. While staying compliant is essential, it can sometimes overshadow the importance of developing strong risk management and resilience strategies. Compliance ensures rules are followed, but resilience is about maintaining operations - even in the face of a cyberattack or other disruptions.

This imbalance can lead to serious consequences, like extended service outages, risks to patient safety, and major financial setbacks caused by data breaches or system downtime. To address this, organizations need to adopt a more proactive approach to risk management and establish solid recovery plans that protect both patient care and operational continuity.

How can healthcare organizations use AI and automation to strengthen cyber resilience and go beyond compliance requirements?

Healthcare organizations can use AI and automation to strengthen their cyber defenses by employing AI-driven tools for real-time threat detection, automated compliance checks, and proactive risk management. These technologies allow for quicker identification of vulnerabilities, smoother operations, and more informed decision-making.

Automation also takes the pressure off critical tasks such as patch management, incident response, and enforcing data privacy. This not only reduces the chances of human error but also saves valuable time. By embedding these tools into their cybersecurity plans, organizations can go beyond just meeting compliance requirements to building a more resilient and adaptable shield against constantly changing threats.

How can healthcare organizations foster better collaboration between departments to strengthen cybersecurity and resilience?

Healthcare organizations aiming to strengthen their cybersecurity and resilience should prioritize teamwork across all departments. Start by creating a cohesive strategy that ties cybersecurity initiatives directly to IT and clinical operations, ensuring that patient care remains at the forefront. Clear and efficient communication protocols are equally important to keep staff, patients, and regulatory bodies in the loop during any security incidents.

It's also crucial to form dedicated response teams with clearly defined roles for IT personnel, clinical staff, and leadership. These teams can act swiftly and effectively when faced with security events. Regular training sessions for employees on identifying potential threats, adhering to security best practices, and promptly reporting issues can significantly bolster the organization's defenses. When departments collaborate seamlessly, they can create a safer and more resilient healthcare environment.

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