Securing the Internet of Medical Things (IoMT): Why Medical-grade OTA Updates are Essential

May 20, 2026

Blog

The Internet of Medical Things (IoMT) is a connected infrastructure of medical devices, applications, health systems, and services. Its global market size, valued at $47.32 billion in 2023, is projected to reach $814.28 billion by 2032, reflecting an impressive annual growth rate of 38.5%.

The exponential growth of IoMT is fueled by the adoption of connected devices across healthcare, from patient monitoring systems and diagnostic equipment to infusion pumps and imaging technologies. Each of these innovations aims to enhance patient outcomes, improve operational efficiency, reduce costs, and strengthen safety standards.

Cybersecurity Threats in a Connected Ecosystem

However, rapid innovation is not without risks. As IoMT adoption accelerates, so do cybersecurity threats that endanger patient data, clinical operations, and even lives. Healthcare is one of the most targeted industries, receiving 100 - 200% more cyberattacks annually than any other sector.

The May 2024 ransomware attack on Ascension affected 140 hospitals and exposed 5.6 million patient and insurance records while disrupting critical operations; it serves as a stark reminder of the vulnerabilities facing the healthcare industry today. The immense value of protected health information (PHI), coupled with the safety-critical nature of medical devices, makes healthcare a prime target for cybercriminals.

Why Modernizing Legacy Systems is a Necessity

Despite the innovation and technological advances of IoMT, many healthcare providers still rely on legacy systems. Replacing these systems is often prohibitively expensive for underfunded organizations, and the risks in transitioning to new systems entirely include system-wide outages or data loss. Yet, healthcare providers must also modernize legacy systems to meet compliance and safety standards.

Similarly, traditional update mechanisms, once relied on within legacy systems, prove inadequate for today’s connected healthcare environments. Healthcare providers expose themselves to escalating risks to patient safety, regulatory compliance, and operational continuity as traditional update methods are error-prone and result in inconsistent deployments across device fleets.

The solution lies in implementing robust, secure over-the-air (OTA) updates across entire medical device fleets, regardless of connectivity challenges or device complexity.

Why OTA Updates are a Game-changer

To fully embrace IoMT while minimizing risks, healthcare organizations and device OEMs must implement secure over-the-air (OTA) updates across their entire fleets of connected devices. Unlike traditional update methods, OTA updates enable continuous, reliable, and secure deployment of fixes and improvements, ensuring:

• Patient safety remains uncompromised
• Regulatory compliance is consistently upheld
• Operational continuity is maintained even as threats evolve

Building a Medical-grade OTA Update Framework

Medical-grade OTA updates must account for the unique requirements of healthcare environments, maintaining the highest standards of security, reliability, and compliance. In the development of Internet of Medical Things (IoMT) devices, applying secure-by-design principles from the beginning is essential.  Because IoMT systems can be safety-critical, handle sensitive patient information, and are deeply embedded in healthcare operations, security should never be treated as an afterthought at any stage of the process.

A zero trust security architecture is particularly important in this context, as healthcare environments involve multiple stakeholders who must access and interact with connected devices. By assuming that no user or device is inherently trustworthy, zero trust models help protect critical patient data from unauthorized access, reduce the risk of breaches, and reinforce the overall resilience of healthcare networks. Similarly, IoMT devices should not assume trustworthiness. Implementing multiple checkpoints and verification methods throughout the device creation, activation, and usage stages ensures device security and safety.

Core device security elements examples:

• Code signing provides a cryptographic assurance that the updates come from a trusted source and remain unaltered during transmission.
• Secure first boot is a firmware security feature that verifies the digital signature of software loaded during the initial boot process and bridges any security gaps or fixes between manufacturing and device activation.
• Public key encryption protects updates and device communications from external interference, ensuring the data remains secure.

As the number of connected medical devices continues to grow, hospitals and device OEMs can no longer rely on traditional IT security practices or one-time safeguards. These organizations operate in highly dynamic security environments, where there is a constant influx of patients, data,  and stakeholder access. To address these challenges, both healthcare providers and manufacturers must adjust their processes to embed security and resilience into the ongoing management of devices.

Key elements for operational safeguards:

• Real-time fleet monitoring gives healthcare organizations full visibility into their connected devices, enabling quick detection of security threats, operational issues, or malfunctions. Advanced systems track device health, connectivity, updates, and security events, presenting them in dashboards that support rapid response.
• Remote troubleshooting allows the stakeholders to quickly diagnose and repair any anomaly without the need for physical access to the devices.
• Detailed audit logging records all device activities, security events, and system changes, creating audit trails essential for compliance and incident response. Logs capture OTA updates, configuration changes, alerts, and user actions, offering a complete view of system behavior and supporting regulatory requirements in healthcare.

Device security best practices combined with elevated operational capabilities ensure organizations can manage, monitor, and troubleshoot devices at scale without compromising compliance or patient trust.

Securing the Future of Connected Healthcare

As IoMT continues its rapid expansion, robust and secure OTA updates become essential. Only by deploying trusted, medical-grade OTA update solutions can healthcare organizations and device manufacturers protect patients, safeguard data, and unlock the full potential of connected medical devices.

Choosing a battle-tested, market-leading OTA solution is the key to future-proofing connected healthcare while leading the charge in one of the industry’s fastest-growing verticals.