Key Takeaways
- 82 % of European hospital cybersecurity buyers rate their 2026 attack concern as very high or extreme, and 74 % believe a major cyber event is likely this year.
- Buying priorities have shifted from breach prevention to clinical continuity, emphasizing identity resilience, ransomware recovery, immutable backup, read‑only clinical access, and supplier‑risk protection.
- The highest‑demand solution categories are identity/IAM/PAM/SSO failover (64 %), managed detection and response/SOC modernization (62 %), and ransomware recovery/immutable backup/read‑only access (57 %).
- Confidence in maintaining operations without core EHR access drops sharply: 59 % at 24 hours, 32 % at 48 hours, and only 14 % at 72 hours, revealing a significant operational‑resilience gap.
- The Cyber Resilience Continuity Index for respondents scores 44/100, indicating that urgency outpaces validated continuity capability.
- Board engagement is uneven: 78 % receive general cyber updates, but only 31 % get resilience metrics tied to clinical continuity, and just 25 % have fully tiered critical suppliers by clinical impact.
- Vendors will be judged less on generic detection claims and more on demonstrable proof that their technologies keep hospitals clinically operational during real‑world outages.
Survey Overview and Respondent Profile
The Pre‑HIMSS26 Europe Copenhagen Cybersecurity Demand Pulse Survey, conducted by Black Book Research in May 2026, gathered responses from 284 self‑identified attendees of HIMSS26 Europe. Participants spanned hospitals, health systems, health‑IT vendors, clinical‑digital teams, cybersecurity units, procurement, risk management, and executive leadership across Europe. The sample represents a broad cross‑section of stakeholders who are actively evaluating or purchasing cybersecurity solutions around the HIMSS26 event, providing a timely snapshot of current buying intentions and perceived risk levels.
Level of Concern and Anticipated Likelihood of Attack
A striking 82 % of respondents characterize their 2026 cyberattack concern as very high or extreme, underscoring a pervasive sense of vulnerability. Complementing this, 74 % believe their organization is likely or highly likely to experience a major cyber incident within the year. These figures illustrate that European hospitals are no longer viewing cyber threats as abstract privacy or compliance issues; they are anticipating tangible disruptions to patient care and operational stability.
Shift in Buying Priorities: From Breach Prevention to Clinical Continuity
Traditional cybersecurity spending focused on preventing data breaches is giving way to a new emphasis on clinical continuity. Surveyed buyers now prioritize capabilities that ensure care delivery persists despite an attack, such as identity resilience (ensuring authenticated access when primary systems fail), ransomware recovery, immutable backup, read‑only clinical data access, and supplier‑risk management. This shift reflects an understanding that attackers increasingly target authentication mechanisms, availability windows, third‑party dependencies, and the digital workflows that move patients through emergency departments, labs, imaging, pharmacy, theatres, ICUs, and discharge processes.
Highest‑Demand Solution Categories
When asked to identify the cybersecurity areas receiving the most investment focus, respondents highlighted the following:
- Identity, IAM, PAM, SSO failover, and break‑glass access – 64 %
- Managed detection and response (MDR) / SOC modernization – 62 %
- Ransomware recovery, immutable backup, and read‑only clinical access – 57 %
- Network segmentation, zero‑trust architecture, and ZTNA – 51 %
- Incident‑response retainers and crisis‑response services – 46 %
- Third‑party supplier and vendor cyber‑risk management – 45 %
- Medical device / IoMT security – 37 %
- Cyber range, downtime simulation, and resilience exercise services – 29 %
These percentages reveal a clear appetite for technologies that protect identity continuity, enable rapid recovery from ransomware, enforce least‑privilege access, and segment critical clinical networks to limit lateral movement.
Operational Resilience Gap: Confidence Across Time Horizons
Confidence in maintaining safe operations without core EHR access erodes rapidly over time. While 59 % of respondents feel their hospitals could operate safely for 24 hours during an outage, that confidence falls to 32 % at 48 hours and plummets to only 14 % at 72 hours. This steep decline signals a critical resilience gap: hospitals may improvise through the first day, but by day two and three, medication reconciliation, laboratory turnaround, radiology workflow, pharmacy verification, transfer coordination, discharge planning, and backlog reconciliation become patient‑safety risks. The findings reinforce the notion that cyber resilience is now an operational medicine issue rather than a purely IT concern.
Board Engagement, Supplier Management, and Preparedness Metrics
Board‑level oversight shows mixed maturity. Although 78 % report that their board receives general cybersecurity risk updates, only 31 % receive cyber‑resilience metrics explicitly tied to clinical continuity. Supplier risk management also lags: just 25 % say critical suppliers have been fully tiered by clinical impact and incident‑response obligation, and only 26 % have conducted a full clinical downtime simulation in the past 12 months. Conversely, 32 % admit they have never performed a full simulation, relying instead on tabletop exercises or lacking knowledge of the last activity date. These gaps highlight the need for more rigorous, clinically focused resilience testing and supplier accountability frameworks.
Cyber Resilience Continuity Index and Market Maturity
Black Book’s Cyber Resilience Continuity Index assigned the aggregated European hospital respondent group a score of 44 out of 100. This intermediate score indicates that while concern and spending intent are high, validated capabilities to sustain clinical operations during cyber disruptions remain limited. The survey concludes that the European hospital cybersecurity market is entering a new maturity stage: buyers are moving beyond generic detection promises and demanding concrete evidence that technologies can preserve care continuity under realistic outage conditions.
Vendor Expectations and Recommendations for Buyers
To succeed in this evolving landscape, vendors must shift their messaging from “we reduce cyber risk” to “we help keep hospitals clinically operational when attackers succeed.” Buyers are advised to require suppliers to demonstrate measurable support for 24/48/72‑hour clinical continuity, including:
- EHR downtime workflows and alternative documentation processes
- Identity break‑glass and failover mechanisms
- Proven ransomware recovery with immutable backup integrity
- Read‑only access to critical clinical data during encryption events
- Laboratory, pharmacy, and imaging continuity plans
- Supplier escalation procedures and third‑party breach containment
- Post‑outage reconciliation and data integrity validation
Additionally, hospitals should institutionalize regular, full‑scale clinical downtime simulations, integrate resilience metrics into board reporting, and enforce rigorous supplier tiering based on clinical impact.
Conclusion
The Pre‑HIMSS26 Copenhagen survey paints a vivid picture of European hospitals operating in a high‑stakes cyber‑risk environment where attacks threaten not just data but the very ability to deliver care. With over four‑fifths of buyers expressing extreme concern and a clear pivot toward clinical continuity solutions, the market is demanding proof‑based, resilience‑focused technologies. Addressing the identified gaps—particularly in board‑level resilience metrics, supplier risk tiering, and regular downtime simulations—will be essential for hospitals to achieve true cyber resilience and safeguard patient safety in the face of increasingly sophisticated threats.