Rural America is no stranger to infrastructural challenges. Comprising over 70% of the country’s landmass yet only 14-20% of its population (depending on how one defines “rural”), many of these regions are home to deteriorating roads and railways, relatively limited broadband access, as well as understaffed and overstretched emergency services.
The healthcare facilities sitting at the heart of rural communities are affected by those challenges and others: With higher rates of chronic illness, drug addiction, and disproportionately older patients, rural hospitals often have to do more with fewer resources than their urban counterparts.
While rural health clinics, critical access hospitals, and other facilities serving rural areas may be separated from supporting health networks and other critical infrastructure by vast distances—their patients may travel more than twice as far as urban patients to the nearest hospital—they’re typically still connected to the world via the internet.
Like any other hospital, healthcare facilities in rural communities rely on electronic health records (EHRs), computer-assisted medical imaging, and other digital technologies to deliver care. Network access and software tools are overwhelmingly a benefit for these facilities, but they also present vulnerabilities that can be exploited by criminals or inadvertently exacerbated by staff misuse.
Why is cyber risk mitigation more important for rural hospitals?
Hacks, cyberattacks, and data breaches are growing more common across industries, but healthcare organizations are among the top targets, according to the FBI’s 2024 Internet Crime Report. In 2024, more than 276 million people had their protected health information exposed or stolen. That’s more than double the number of victims from the prior year.
With outdated IT systems and limited budgets to address these risks, rural hospitals may be considerably more vulnerable to cybersecurity threats than facilities in urban areas.
In many facilities, small or predominantly part-time IT teams may be responsible for everything from EHR maintenance to printer troubleshooting, leaving security on the backburner. Add in aging legacy systems, unsupported software and devices, and smaller training budgets, and you have a recipe for security breaches.
Not only are rural hospitals often the only care providers within an hour’s drive for ‘nearby’ residents, they’re also intrinsically linked to local economies, supporting roughly one in every 12 rural jobs, according to the American Hospital Association. This means cyberattack-related service disruptions can have a seriously outsized impact for rural patients and communities at large.
Rural hospital cybersecurity concerns
For the reasons listed above, cybersecurity should be a top priority for rural and critical-access hospitals. Before we examine how these facilities can become more resilient to cyberattacks, let’s take a quick look at the kinds of threats they should be prepared for:
Ransomware
Simply opening the wrong email attachment or visiting an infected website can result in the inadvertent installation of malicious software known as ransomware. This software encrypts and locks files within an infected system, after which the attacker demands a ransom in exchange for a decryption key. In some cases, the attacker may threaten to leak or sell the locked data if their demands aren’t met.
One 2024 survey found that while the number of organizations reporting ransomware attacks across industries fell from 66% to 59% over the previous 12 months, healthcare organizations saw a jump in ransomware attacks from 60% to 67% in the same period.
Phishing
Named the number one concern by 90% of IT professionals in a 2021 survey, phishing attacks are also on the rise—and they’re alarmingly easy for untrained users to fall for. Usually performed via email or SMS, phishing attacks involve compelling a user to share sensitive and/or valuable information, often through a legitimate-looking portal or website.
If attackers can get the username and password of even one employee, the entire facility’s network infrastructure could be vulnerable to exploitation.
Compromised devices and systems
At an industry-wide scale, cybersecurity is an endless chess match between software and hardware developers and the malicious parties looking to exploit their products: Hackers find vulnerabilities in a system, developers address those vulnerabilities and force the hackers to find new vectors of attack, prompting the devs to respond with patches, and so on and so on.
Medical device and healthcare IT systems developers often employ round-the-clock teams that can identify these exploits, fix the problematic code, and push patches to their users rapidly—sometimes within 24 hours of an initial attack. Put into optimistic terms, a very bad day for one facility can ultimately result in improved security for every other user of the software or device.
Facilities relying on outdated, unsupported, or unpatched systems, however, don’t benefit from this sort of systematic immune response. In the case of rural hospitals, a financially motivated decision to forgo updates or retain aging equipment could prove to be far more expensive than any initial savings accrued, if a successful cyberattack occurs.
4 practical ways to improve rural hospital cybersecurity
So how can rural healthcare facilities reduce their chances of becoming the victims of a cyberattack? Luckily, the strategies that apply to most healthcare facilities are just as useful to those in rural regions. Here are some strategies adapted in part from recommendations provided by the National Rural Health Resource Center:
1. Build organizational awareness around cybersecurity
Protecting a facility from a cyberattack starts with raising awareness that these attacks can and do occur. Every member of a rural health organization who engages with network-connected technology must be aware of their shared responsibility to reduce vulnerabilities and use IT systems safely.
From the earliest onboarding through annual trainings and as often as possible in between, care staff, IT teams, and executive leaders alike should be educated about ongoing risks, recent real-world cyberattacks, and basic cyber hygiene. Formal training sessions, take-home materials, and live demonstrations can help all stakeholders understand critical factors such as:
- The use of strong passwords and multi-factor authentication
- The importance of software patching and routine updates
- Safe storage of personal computing devices and work-related data
- Retirement of devices and systems at the end of their service life
2. Assess current risks and vulnerabilities
HHS requires all U.S. hospitals to undergo the HIPAA Privacy and Security Risk Assessment to identify possible vulnerabilities in systems that utilize PHI, but rural facilities shouldn’t stop at the bare minimum. Rural hospital IT teams can protect their facilities, patients, and colleagues by implementing an ongoing assessment of all systems within their IT infrastructures.
Ideally, these assessments will identify the highest-risk systems by vulnerability and/or potential value of data, and prioritize the greatest vulnerabilities for immediate mitigation. Bringing in an external consultant—or even a non-IT stakeholder from within the organization—can ensure potential blind spots aren’t missed.
Many state and local governments offer grants to fund assessments, or subsidize assessments directly through a variety of programs, such as the Microsoft Cybersecurity Program for Rural Hospitals.
3. Implement improvements and address vulnerabilities
As organizational awareness around cybersecurity grows and risks are formally assessed, rural hospitals can begin to implement improvements and remediate potential vulnerabilities. This may involve the establishment of new policies, processes, and/or technologies to protect private health information and reduce attack vectors.
In many cases, other providers, care networks, and trade organizations can be good sources of inspiration and guidance for best practices. Here are a few examples from the National Rural Health Resource Center:
- Assign an individual or team to monitor and install software updates
- Update HR policies to address employee sanctions related to data breaches
- Assess server activity and firewall logs daily
- Assign antivirus software management to a central team or stakeholder
- Establish an incident response team including IT, facility leaders, and appropriate vendors
- Update and maintain the HIPAA-required Incident Response Policy
4. Partner with trusted vendors
A third-party firewall management team or external cybersecurity consultants can help sparsely staffed rural health facilities craft policies, establish preventive measures, and maintain the systems that keep their data and devices safe. But nearly every vendor, whether they support an EHR, host a public-facing website, or process transactions at the facility’s cafeteria, has a role to play in cybersecurity.
All vendors should be vetted for their own incident response policies prior to partnership. If contracted, vendors should be kept informed of the facility’s own policies and included in relevant documentation, communication, and breach notification workflows.
What it all means
Cybersecurity resilience doesn’t require major budgets or massive IT departments. Rural hospitals, clinics, and other care sites can make meaningful progress toward safer data systems—and thus safer patients—by focusing on security fundamentals, prioritizing organizational awareness and training, and working with the right partners.
When it comes time to partner with a data vendor capable of providing insights into patient populations, growth opportunities, and prospective market conditions, you can count on Definitive Healthcare to not only work hand-in-hand with your security and IT teams, but also to integrate seamlessly into the workflows and systems your stakeholders rely on.
Sign up for a demo today and see how our data and analytics can support your facility, your staff, and your patients.
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