Observability refers to an IT system’s ability to reveal its internal state based on external outputs. Logs, metrics, traces, user-behavior analytics, system dependencies, etc., all play a role in helping make the invisible visible! In a hospital environment, observability means having visibility into how devices (including IoT/digital medical devices), applications (e.g., electronic health records), networks, third-party services, and users behave and respond to issues when they occur. According to the India Cyber Threat Report 2025, in 2025, the healthcare sector in India became the number one target for cyber-attacks and represented 21.82 percent of all cyber incidents in the country.
Simultaneously, a larger analysis suggested that globally, healthcare organisations are being faced with rapidly increasing threat surfaces, particularly ransomware, third-party breaches, and IoT/medical device vulnerabilities. These figures are not grisly numbers; they are a call to action for hospitals, where patient safety, compliance, and digital operations meet. In this environment, traditional monitoring becomes insufficient.
Why is this important to hospitals, specifically? Hospitals are unique and experience a convergence of risk:
– Hospitals hold large amounts of sensitive personal and medical information, which makes them high-value targets.
– Hospitals operate a mixture of legacy systems with newer digital solutions, including telemedicine, IoT devices, and cloud services, creating a wide attack surface.
– Any disruption (e.g., ransomware) affects not just data, but also patient lives and the institution’s integrity.
– Accompanying regulatory and compliance expectations (data privacy, audit trails, incident disclosure) are increasing.
– Observability gives hospitals a distinct advantage by enabling organizations to detect anomalies early, establish what happened, assist in root-cause analysis, and reduce mean time to detect (MTTD) and mean time to recover (MTTR). In summary, more observability means quicker, more accurate responses.
Enhancing Cybersecurity: Anticipating Threats Before They Manifest
Cybersecurity has traditionally relied on specific tools like firewalls, antivirus software, and intrusion detection systems. However, attackers accelerate their approaches using ransomware, supply-chain assaults, and the compromise of IoT devices. In this new paradigm, observability adds a strength multiplier.
With full-stack visibility, hospitals can:
– Identify anomalistic traffic, lateral movement, or device behaviours that could indicate an incident.
– Track a compromised IoT medical device back to its originating network and the methods it communicates with the core systems.
– Correlate user login behaviours, changes in systems, and configuration drifts to identify insider threats, misconfigurations, or exploitation of vulnerabilities.
– Associate system failures or performance degradation with some form of malicious action (i.e., a performance degradation caused by data extraction instead of the result of high loads on the system).
In its simplest form, observability changes the conversation from responding post-breach to predicting and containing a breach before it escalates.
Compliance and Audit: Creating Evidence, Not Guesswork
Hospitals are forced to meet a growing set of regulatory obligations, and not only do they have to maintain audit trails for patient data, but they also have to alert others to breaches promptly and manage vendor/third-party risk and data integrity. Observability can play an enabling role here, too.
With solid observability frameworks, a hospital can:
– Capture searchable logs and traces across systems – ensuring a document trail of who, did what, when, and where.
– Provide dashboards and reports to internal compliance teams and external auditors, establishing system health, access patterns, and response readiness to incidents.
– Support forensic investigations by providing extensive context – not just that something happened, but how it happened and/or why.
– Support supplier/third-party risk reviews, providing access logs and monitoring of external integrations, vendor access, and data flows.
When hospitals embed observability into governance, risk, and compliance programmes, they can move from “we hope we’re compliant” to “we can demonstrate we are compliant.”
IT Resilience: Operating the Hospital When A Crisis Occurs
When working in a hospital, downtime means cancelled surgeries, delayed diagnostics, risks to patient safety, and reputational damage. Resilience is not a “nice to have”; it is a must-have. Observability fits into this framework.
Think about what happens when there is an unplanned outage: a network outage, an overloaded system, a ransomware attack, or an IoT device failure. With observability:
A hospital can detect and react promptly (due to alerts on anomalous behaviours) and isolate components that are causing failure.
An engineer can conduct end-to-end tracing to identify dependencies, bottlenecks, and points where the system/ network has failed, which can help speed up recovery.
An engineer can experiment with the impact of the outage on critical pathways (patient records, lab systems, diagnostic imaging, or emergency department) and prioritize the impact of recovery in the critical path based on the understanding of the effect of the outage.
Data generated as part of the observability function can provide opportunities for continuous improvement. Understanding of incidents to avoid recurring incidents in the future.
In essence, observability would help move the posture of hospitals from a precarious and reactive state to a robust and proactive one
Challenges and Potential Solutions
Implementing observability in the hospital setting is not plug-and-play. There are true challenges:
Legacy systems and siloed architecture: Many hospitals have utilized older equipment or systems fragmented across the enterprise. These systems might not have been designed to offer visibility. Solution: take a phased approach to observability, begin with critical systems and grow outwards, retrofitting agents or APIs where you can.
Resource constraints: There may be budget constraints or a limitation of skilled personnel who understand each system, as well as observability implementation. Solution: position observability as a risk against patient safety, compliance, and an investment, rather than a cost centre. If you need development capabilities, follow along with a managed service or cloud solution instead of your in-house team.
Data overload/alert fatigue: More logs, more noise to sort through. Solution: define your meaningful metrics, and alert by priority, or have machine learning & analytics work for you by shielding out the noise, while identifying relevant signals at the same time.
Integration with clinical workflows: You want technology to support clinical teams, not sabotage their work. Solution: make sure that you have engaged clinical stakeholders early in the process, define dependencies, and ensure that observability does not add more fatigue to their workflow.
A hospital that looks at observability as a strategic enabler, rather than another IT project, will benefit the most.
A Vision of the Future of Hospitals
Picture a hospital in which every connected device, every system interaction, and every network transaction is visible in near-real time. A hospital where:
- In the case of a spike in anomalous device communications, an alert is triggered prior to the patient’s data being exfiltrated.
- A change in user login patterns triggers a pause in the workflow and prompts an administrator to review.
- A vendor integration fails the defined health check and triggers the system to fall back while automatically logging the event or forwarding logs to the compliance dashboard. After the incident, the hospital does not just restore functionality but also learns, adapts, and improves the model. This is the power of observability. For hospitals in India and around the world, increasing cyber-risk, regulations, and operational pressures – observability doesn’t just become optional, it becomes foundational.
Conclusion
Hospitals operate at a crossroads of healthcare delivery, data security and protection, regulatory compliance, and mission-critical operations. In this era of escalating cyber threats, the weakest link may not be the front-door firewall for hospitals, but rather the hidden pathways that exist. Observability shines a light on those pathways. Through visibility, rapid detection, compliance, and resilience, observability moves hospitals from passive defenders to active protectors of health and data. Thousands of attacks per week, critical data at risk, and legacy systems at risk. To hospital leadership, CIOs or IT Directors, the message is clear: consider observability not as a nice-to-have, but as imperative. Because when lives and data are on the line, knowing what you cannot see can literally save lives.
