Future-proofing connected healthcare: Ensuring security in medical IoT devices

The rise of the Internet of Things (IoT) has revolutionized the medical landscape, bringing unprecedented advancements in diagnostics, real-time monitoring, and patient care. However, as medical IoT devices become more interconnected, the threat landscape expands drastically, posing serious concerns around data integrity, patient safety, and operational reliability.

In the age of connected healthcare or the Internet of Medical Things (IoMT), medical IoT devices have transformed how patient care is delivered. From wearable heart monitors to infusion pumps and implantable devices, these innovations improve patient outcomes and streamline hospital operations.

However, with greater connectivity comes greater risk. The security of medical IoT devices is no longer just a technical concern — it’s a patient safety issue and a business-critical priority.

Medical IoT pentesting (penetration testing) goes beyond traditional network security. It dives deep into the firmware, hardware, communication protocols, and gateways that make these devices work — and sometimes, make them vulnerable.

Recently, our security team completed a comprehensive penetration testing engagement for a major medical device manufacturer. This project revealed critical vulnerabilities and the growing complexity of securing embedded systems in a high-stakes, regulated environment. Drawing from that experience, this blog dives deep into the importance of IoT security in healthcare and why it's no longer optional. We explore the risks associated with medical IoT devices, the challenges in securing them, and a practical roadmap for building a secure IoMT environment.

We will also build a pentesting roadmap specifically for medical IoT devices, with deep focus on the core technical layers:

• Firmware testing
• Protocol testing
• Gateway testing
• Hardware testing

What is IoT security?
IoT security encompasses the strategies, protocols, and tools used to protect IoT devices and networks. These devices – ranging from smart infusion pumps to wearable monitors – collect and transmit sensitive data, often over wireless networks and with minimal human interaction.

Securing IoT involves protecting:

• Device firmware and hardware
• Data in transit and at rest
• Communication protocols
• Cloud and mobile integrations
• User and administrative interfaces

What are medical IoT devices?
Medical IoT devices (or IoMT) refer to network-connected healthcare technologies that collect, transmit, and sometimes analyze patient data. Examples include:

• Remote patient monitoring devices (e.g., ECG monitors)
• Wearables (e.g., glucose monitors, smart inhalers)
• Imaging machines (e.g., MRI, CT scanners)
• Infusion pumps
• Implantable devices (e.g., pacemakers, neurostimulators)
• Hospital equipment (e.g., smart beds, connected ventilators)

Their interconnectivity allows real-time monitoring, diagnosis, and even remote treatments – also exposing them to cyber threats.

Why IoT security is crucial in the medical industry
In healthcare, the stakes are exponentially higher. Unlike consumer electronics, medical IoT devices interact directly with patient health and hospital systems. A compromised device can lead not just to data breaches, but also to loss of life.

Key drivers for strong IoT security in healthcare:

• Patient safety: Any unauthorized control of a device (e.g., infusion pumps, pacemakers) can cause physical harm or death.
• Data privacy compliance: HIPAA, GDPR, US FDA, and other regulations mandate rigorous protection of patient data.
• Operational integrity: Downtime or manipulation of systems due to an attack can paralyze hospital operations.
• Brand and legal risk: Medical data breaches cost millions in fines, lawsuits, and reputational damage.

Key risks for medical IoT devices
During a recent penetration testing project, we identified several vulnerabilities prevalent across medical IoT ecosystems:

1. Hardcoded credentials: Devices often ship with factory default usernames and passwords, which attackers can easily exploit if not changed.

2. Unsecured firmware updates: Lack of code signing and encryption allows attackers to install malicious firmware during updates.

3. Weak authentication mechanisms: Limited use of MFA (multi-factor authentication) in device management interfaces increases the risk of unauthorized access.

4. Unsecured APIs and cloud integration: Poorly secured APIs can serve as open backdoors into sensitive systems.

5. Limited logging and monitoring: Many devices lack sufficient logging, hampering real-time detection and response to breaches.
5.1 Lack of trusted certificates: Many devices lack trusted certificates, which attackers can easily exploit.
5.2  Interoperability and network risks: Medical IoT devices often need to connect with older, unsecured systems. If IoT devices are not isolated on the network, an attacker could pivot from a weak device to critical hospital systems.
5.3 Ransomware: Hospitals are prime ransomware targets. Disabling medical IoT devices could directly endanger patients.

6. Exploitable vulnerabilities: Many medical devices operate for years without firmware updates, making them susceptible to known vulnerabilities.

Challenges in securing medical IoT devices
Medical IoT devices face unique constraints:

 

Real-world attacks and lessons learned
One of the most infamous attacks was the 2017 WannaCry ransomware attack, which disrupted over 2,00,000 systems globally, including the UK’s National Health Service (NHS). Many diagnostic machines and imaging systems were rendered unusable.

Another attack in 2019 involved researchers exploiting vulnerabilities in Medtronic insulin pumps, showing how attackers could potentially alter dosage remotely – a chilling scenario that could seriously affect patients.

Key lessons:

• Security-by-design is essential, not optional.
• Post-market surveillance of vulnerabilities should be continuous.
• Regular penetration testing must be part of the product life cycle.

Future-proofing medical IoT devices
With cyber threats evolving daily, securing medical IoT is a dynamic, ongoing process – not a one-time fix. It requires a proactive, adaptive, and comprehensive approach.

Recommendations:

• Embed security into device development from day one.
• Implement secure boot, encrypted communications, and authenticated updates.
• Conduct regular vulnerability assessments and penetration testing.
• Establish incident response playbooks specific to IoT attacks.
• Engage with a security partner who understands both the tech and the compliance landscape.

As healthcare embraces digital transformation, securing the devices that power it is non-negotiable. From patient safety to data privacy, the implications of weak IoT security are too grave to ignore.

Zensar is committed to empowering healthcare organizations with robust, scalable, and regulatory-aligned IoT security solutions. Let’s make connected care safe – for everyone.