Red Team | MEDSHIELD: Threat Modeling for Medical IoT

Red Team | MEDSHIELD: Proactive Threat Modeling Framework for Connected IoT Care 🎙️ Dr. Jennifer Schieferle Uhlenbrock, Healthcare Cybersecurity Consultant, Provisio Insights, LLC 🎙️ Dr. Deepti Gupta, Assistant Professor, Texas A&M University-Central Texas 📍 Presented at SANS Hack & Defend Summit 2025 Adversarial exploitation of medical devices, robotics, and smart hospital systems has emerged as a critical challenge as healthcare environments embrace interconnected, IoT enabled equipment. Recent empirical analyses reveal that, on average, medical devices harbor multiple unpatched vulnerabilities for over three years post-purchase, leaving systems exposed to remote compromise. These flaws span firmware defects, insecure network configurations, supply chain vulnerabilities, inadequate use of cryptographic controls, all of which have been demonstrably exploited in red team engagements. In this session, we present a MEDSHIELD methodology for threat modeling of medical devices. We review methods for discovering hidden attack surfaces, such as reverse-engineering proprietary protocols and leveraging IoT firmware analysis, to emulate real-world exploits. Attendees will learn the nine-step MEDSHIELD framework, Mapping their medical IoT landscape, Enumerating and Decomposing device ecosystems, applying STRIDE for threat coverage, Hunting vulnerabilities, Indexing and prioritizing risks, Establishing mitigations, Launching coordinated purple-team validations, and Documenting for continuous improvement. Using this framework, they'll build an enriched medical device inventory with threat intelligence to pinpoint high-risk internals and attack paths, conduct joint offense/defense tests to refine detection and controls, and translate findings into a prioritized defense plan, featuring firmware integrity checks, network micro-segmentation, and ongoing monitoring, that shrinks their attack surface and accelerates response. By integrating these adversarial insights into pr