HOSPITALS · HEALTH SYSTEMS · INSURERS · HEALTHCARE TECHNOLOGY

Govern Every Workforce Session. Protect Every Patient.

Keystrike is a continuous remote access governance platform. It governs what happens after access is granted — providing live visibility into every remote session, blocking unauthorised commands before they execute through deterministic enforcement, and generating continuous audit-ready proof of control. Built for healthcare environments where every remote session carries operational and patient safety risk.

Keystrike does not record keystrokes, credentials, or personally identifiable information. Session verification is cryptographic — not behavioural — eliminating false positives and privacy exposure.

THE PROBLEM

The Governance Gap Healthcare Cannot Ignore

70%

of healthcare breaches involved compromised credentials

Verizon DBIR 2024, Healthcare subset

Healthcare organisations have invested heavily in MFA, IAM, PAM, SIEM, and EDR. These tools do their jobs. MFA validates identity at login. PAM controls who can start a privileged session. SIEM collects and stores event logs.

But once a session begins, those tools stop governing it.

There is a persistent Governance Gap between access intent — who you authorised — and access reality — what actually happens inside the session. That gap is where ransomware deploys, where credentials get abused, and where lateral movement unfolds. It is where no tool in your current stack operates.

Keystrike closes that gap.

Healthcare Faces a Security Gap No Perimeter Tool Can Close

Attackers don't break in. They operate inside legitimate sessions after access is granted.

CONTROL

Ransomware and Operational Shutdown

A single compromised session can encrypt EHRs, pharmacy systems, billing infrastructure, and imaging simultaneously — disrupting care before any alert fires. HIPAA, HITECH, and CMS requirements demand continuous controls, not post-incident logs.

  • · EHR and clinical system protection
  • · Blocks ransomware deployment commands inside active sessions
  • · Operational continuity during active threats
SEE + CONTROL

Third-Party and Vendor Access

Healthcare organisations depend on a broad ecosystem of vendors, labs, and service providers — every external connection via VPN, RDP, or remote management tools is a potential entry point. Keystrike governs every vendor session without disrupting clinical workflows.

  • · Vendor session governance
  • · PHI exchange verification
  • · Blocks commands from compromised vendor sessions
CONTROL

Medical Device and Lateral Movement

Attackers who compromise a workforce session can pivot into imaging, pharmacy, and infusion pump networks — even with segmentation in place. Keystrike validates every session crossing into device networks, blocking lateral movement at the command level.

  • · Device network boundary enforcement
  • · Lateral movement containment
  • · Patient safety continuity
$872M+
from governance failure post-authentication in the Change Healthcare breach (UnitedHealth Group SEC Filing, Congressional Testimony, 2024)
70%
of healthcare breaches involved compromised credentials (Verizon DBIR 2024, Healthcare subset)
$10.93M
the average cost of a healthcare data breach (IBM Cost of a Data Breach Report 2025)
73%
increase in healthcare ransomware attacks year-over-year in 2024 (HHS/HC3 Threat Brief, 2024)
WHERE EXISTING CONTROLS FALL SHORT

Three Attack Paths That Bypass MFA, IAM, and EDR in Healthcare Environments

Ransomware Deployed Through Legitimate Sessions

Modern ransomware attacks don't breach the perimeter — they unfold inside authenticated sessions. Once inside, attackers encrypt EHRs, pharmacy dispensers, billing systems, and imaging platforms simultaneously. By the time detection tools fire, critical clinical operations are already offline.

Keystrike closes this gap by continuously verifying that every command inside the session originates from verified physical input on an authorised device — interrupting ransomware deployment commands and blocking lateral spread before they reach clinical systems.

Incident: The 2024 Change Healthcare ransomware attack disrupted billing, pharmacy, and EHR systems across the U.S. — 74% of hospitals reported direct patient care impact and 94% experienced financial consequences. Keystrike would have stopped the impact by blocking unauthorised remote commands mid-session before systems were encrypted.

Third-Party Vendor Compromise and PHI Exfiltration

Healthcare organisations depend on external vendors, labs, transcription services, and claims processors that connect via VPN, RDP, SSH, and remote management tools. Weak credentials, outdated endpoints, or inherited sessions create direct pathways to protected health information and internal infrastructure.

Keystrike closes this gap by requiring every remote action to be tied to verified physical input from an authorised device — preventing attackers from using stolen credentials, inherited sessions, or compromised vendor access to reach PHI.

Incident: The 2025 Yale New Haven Health breach exposed 5.56 million patient records through compromised third-party access to secondary servers. Keystrike would have stopped the impact — session-level enforcement ensures only verified human actions can execute, blocking misuse of vendor sessions regardless of credential validity.

Lateral Movement into Medical Device Networks

MRI machines, infusion pumps, pharmacy dispensers, and imaging systems often run legacy operating systems and remain connected to clinical networks. Attackers who compromise a single workforce session can pivot into these device networks — even through segmented environments — putting patient safety at direct risk.

Keystrike closes this gap by validating every workforce session crossing network segment boundaries, blocking credential replay, RDP hijacks, and inherited sessions before lateral movement can reach connected medical devices.

Incident: The 2025 Frederick Health breach exposed approximately 934,000 patient records through widespread use of stolen credentials across connected systems. Keystrike would have stopped the impact — continuous session verification prevents attackers from issuing malicious commands even when login credentials are fully compromised.

POST-AUTHENTICATION SECURITY GAP

Why Perimeter Controls Cannot Secure Privileged Sessions in Healthcare Environments

Security ToolWhat It ProtectsPost-Authentication Gap
Firewalls / IDS/IPS / MFAPerimeter and identity at loginSession activity after access is granted
PAM — Privileged Access ManagementWho can start a session / vault accessActivity inside the session once it starts
SIEM — Security Information and Event ManagementCentralised alerts and compliance reportingReactive — alerts after damage is done
NDR — Network Detection and ResponseNetwork traffic anomalies and lateral movementBlind to encrypted or legitimate-looking session traffic
EDR — Endpoint Detection and ResponseMalware detection and endpoint telemetryBlind to valid credential theft and session misuse
KeystrikeEvery command in every privileged sessionNone. Unauthorised commands blocked before execution.

Keystrike does not replace any of these tools. It completes them — governing the session layer that no other control reaches.

Keystrike does not record keystrokes, credentials, or personally identifiable information. Session verification is cryptographic — not behavioural — eliminating false positives and privacy exposure.

THE KEYSTRIKE PLATFORM

Three Capabilities. One Governance Layer.

Every remote session is visible, enforceable, and provable — from login to logout.

SEE

Live Visibility

A live map of every remote session across RDP, SSH, PowerShell Remoting, WinRM, WMI, SMB, TeamViewer, NinjaOne, and more — including unknown connections and unmanaged pathways that no other tool surfaces.

One map replaces raw, noisy logs with live intelligence.

CONTROL

Deterministic Enforcement

Every command inside every session must be tied to verified physical human input via cryptographic attestation. Commands without attestation are blocked before execution. No behavioural scoring. No false positives.

We move you from assuming your policies work to knowing they do.

PROVE

Audit-Ready Governance

Continuous, tamper-evident evidence of every governed session. HIPAA, HITECH, HITRUST, and NIST audit requirements satisfied as a direct output of governance — not assembled after the fact.

We eliminate the Audit Fire Drill.

HOW KEYSTRIKE FITS YOUR STACK

Keystrike Completes Your Stack. It Does Not Replace It.

IAM / PAM

Okta, CyberArk, BeyondTrust

Defines who can access which systems and controls session initiation. Once the session starts, their visibility ends.

SIEM / SOAR / XDR

Splunk, Microsoft Sentinel, CrowdStrike

Stores event records and fires alerts when patterns match threat signatures. Reactive — by the time detection fires, the damage is already done.

Keystrike

Continuous Remote Access Governance

Governs every action inside the session — in real time, from login to logout. Closes the Governance Gap that IAM, PAM, and SIEM were never designed to cover. Does not replace any of them.

You don't need to replace your multi-million dollar stack. Keystrike is the essential final piece that makes your Okta, your CyberArk, and your Splunk work together to deliver Continuous Remote Access Governance.
COMPLIANCE AND GOVERNANCE

Continuous Remote Access Governance That Satisfies HIPAA, HITECH, HITRUST, and NIST Requirements

Every privileged session produces continuous, tamper-evident audit records that satisfy healthcare regulatory requirements as a direct output of governance — not as a separate compliance process.

HIPAA Security RuleHITECH / HICPHITRUST CSFNIST 800-53NIST 800-207OCR GuidanceSOC 2 Type 2

Keystrike supports compliance with HIPAA Security and Privacy Rules, HITECH, NIST Cybersecurity Framework (800-53) and Zero Trust Architecture (800-207), OCR Enforcement Guidance, CMS Requirements, HITRUST CSF, ISO 27799, and applicable state privacy laws — through continuous authentication, policy-driven access controls, and auditable session records for every remote workforce interaction.

Keystrike is a governance platform. With governance working as designed, compliance evidence is produced continuously, not assembled under audit pressure.

HOW KEYSTRIKE WORKS

Deterministic Session Enforcement — Not Probabilistic Detection

1

Workstation Agent

A lightweight agent on the user's device recognises legitimate physical keystrokes and mouse clicks, and submits cryptographic attestations confirming their legitimacy to the central Keystrike service.

2

Server-Side Terminator

A second lightweight agent on the destination server withholds all input until it receives proof of legitimacy. Attested input is processed. Unattested input — from scripts, injected commands, or compromised sessions — is blocked and an alert is generated in real time.

3

Live Session Map

The Keystrike SEE module maps all remote protocols across your environment — RDP, SSH, PowerShell Remoting, WinRM, WMI, SMB, and more — surfacing which sessions are governed and where policy gaps remain.

Keystrike completes your existing IAM, PAM, and SIEM stack. No rip-and-replace. Deploys in 20 minutes. Clinicians and staff experience no workflow changes.

FREQUENTLY ASKED QUESTIONS

Questions Buyers Ask Before Implementing Keystrike

How is Keystrike different from PAM?
PAM controls who can start a privileged session and secures the vault. Keystrike governs every action inside the session once it starts. They address different layers of the access lifecycle and are complementary — PAM secures the vault, Keystrike secures the session. Keystrike does not replace PAM.
How is Keystrike different from SIEM?
SIEM collects logs and fires alerts after events occur. Keystrike enforces policy inside live sessions — before damage occurs. SIEM is reactive. Keystrike is real-time. They complement each other: Keystrike generates high-fidelity, session-level intelligence that enriches SIEM data.
Does Keystrike replace our existing MFA or IAM?
No. Keystrike assumes your identity tools are doing their job. It adds the governance layer they were never designed to provide — controlling what happens inside the session after authentication succeeds.
Does Keystrike record or store keystrokes?
No. Keystrike does not record keystrokes, credentials, or personally identifiable information. Session verification is cryptographic — the platform verifies that commands originated from legitimate physical human input on an approved device. It does not store what was typed.
What is the Governance Gap?
The Governance Gap is the space between access intent — who you authorized to access a system — and access reality — what actually happens inside their session. IAM grants access. PAM controls session initiation. SIEM logs events after the fact. None of these tools govern what happens inside the live session. That is the Governance Gap. Keystrike closes it.
How long does deployment take?
Keystrike deploys in 20 minutes. It integrates with existing MFA, IAM, and SIEM infrastructure without workflow disruption to clinicians or staff.
What remote protocols does Keystrike govern?
Keystrike governs RDP, SSH, PowerShell Remoting, WinRM, WMI, SMB, TeamViewer, NinjaOne, and other remote access protocols. It also surfaces unknown and unmanaged remote access paths as part of the SEE capability.
What compliance frameworks does Keystrike support for healthcare?
Keystrike supports compliance with HIPAA Security Rule, HITECH, HITRUST CSF, NIST 800-53, NIST 800-207, OCR Enforcement Guidance, CMS Requirements, SOC 2 Type 2, ISO 27799, and applicable state privacy laws — through continuous session governance that produces audit-ready evidence as a direct output, not a separate compliance process.

More questions? See the full FAQ or explore the Keystrike platform.

HOSPITALS · HEALTH SYSTEMS · INSURERS · HEALTHCARE TECHNOLOGY

Close the Governance Gap Before the Next Incident Reaches Clinical Operations

Ransomware, vendor compromise, and credential abuse all exploit the same blind spot: the gap between who you authorised and what actually happens inside their session. Keystrike makes every remote session in your healthcare environment visible, verifiable, and governed — without replacing your existing stack or disrupting clinical operations.

To speak with a Keystrike engineer: connect@keystrike.com