Zero Successful Ransomware Installations in 24 Months
How a regional hospital system protected legacy medical systems, secured patient data, and achieved 600% ROI with FileSure.
Regional Hospital System — Mid-Atlantic US
The Situation
A 500-bed regional hospital system serving a large metropolitan area faced a security challenge common across healthcare: their medical infrastructure depended on legacy Windows systems that modern endpoint security tools simply wouldn't run on.
Approximately 25% of their medical devices — including imaging systems, laboratory equipment, pharmacy management systems, and patient monitoring stations — ran on Windows versions that mainstream security vendors had stopped supporting. These weren't neglected systems; they were mission-critical equipment locked to specific operating systems because the specialized software wouldn't run on anything newer.
The IT department was caught between two impossible choices: leave critical systems unprotected, or spend millions replacing equipment that still worked perfectly well — money they didn't have and couldn't justify to the board.
The Problem
What They Were Trying to Protect
Electronic health records, medical imaging archives, laboratory information systems, pharmacy dispensing systems, and patient monitoring data — all containing protected health information (PHI) subject to HIPAA requirements.
Compliance Requirements
HIPAA Security Rule technical safeguards including access controls, audit trails, integrity controls, and transmission security for all systems containing PHI.
What Existing Security Couldn't Do
Their enterprise antivirus solution wouldn't install on 25% of their Windows systems. EDR tools required minimum OS versions their medical equipment couldn't meet. Signature-based detection couldn't stop zero-day ransomware — and healthcare is the most targeted sector.
Why Legacy Systems Made It Harder
Medical device manufacturers often lock equipment to specific Windows versions. Upgrading the OS would void warranties, break FDA-certified configurations, and potentially render equipment unusable. The hospital couldn't simply "upgrade everything."
Why FileSure
FileSure was the only solution that checked every box:
- Runs on all Windows versions — from their oldest medical systems through Windows Server 2022
- Stops ransomware by behavior, not signature — no waiting for vendor updates when new variants emerge
- Creates HIPAA-ready audit trails — every file access logged with user, program, timestamp, and operation
- Lightweight and invisible — less than 2% CPU impact, no disruption to medical workflows
- Works offline — protection continues even when systems are disconnected from the network
The deciding factor: FileSure doesn't try to recognize ransomware. It controls what programs are allowed to do to files. An unauthorized program can't write an executable to disk, can't encrypt files, can't cause damage — because it simply isn't allowed to. This approach works on ransomware variants that don't exist yet.
The Implementation
Assessment & Planning
Installed FileSure management server. Catalogued protected systems including legacy medical devices. Designed initial rule set focused on ransomware prevention and PHI access logging.
Pilot Deployment
Deployed agents to representative sample of 50 systems including legacy medical devices. Tested rules in audit-only mode. Refined rules based on observed application behavior. Zero disruption to clinical workflows.
Full Deployment
Rolled out to all 500+ endpoints. Enabled enforcement mode for ransomware prevention rules. Configured HIPAA audit trail logging. Established alert thresholds and reporting schedules.
The Results
Multiple attempts detected and blocked before any damage occurred
Continuous protection across legacy and modern systems
Based on estimated avoided recovery costs from ransomware attacks
"We had systems that modern security tools simply wouldn't run on. FileSure was the only solution that protected everything we had."
— IT Director, Regional Hospital System
Compliance Requirements Addressed
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Details in this case study have been anonymized to protect customer confidentiality.