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What does ransomware do to a hospital?
Ransomware is malicious software that blocks access to data, typically by encrypting it. The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) used that description in an April 23, 2026 announcement. Encryption is a common mechanism, not a guarantee that every incident works the same way.
In a hospital, the affected technology may include electronic health records, patient schedules, communication systems, and tools used to process or share test results and imaging. An attack may also involve data theft, which is distinct from making systems or records unavailable; some incidents involve both.
How can ransomware affect patient care?
When staff cannot access information or communicate through normal systems, the effects can move from IT operations into clinical work. CISA’s 2021 analysis of a hospital-system incident described inaccessible schedules and records, disrupted communication, and delays in processing and communicating test results. In that specific case, surgeries and cancer treatments were delayed or canceled, some COVID-19 test collection sites closed, radiology imaging could not be submitted, and care for high-risk patients was suspended.
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HHS’s incident briefing describes a separate case involving IT outages and electronic health record downtime, patient-care delays, cancellations, and ambulance diversion. It also reports data theft, disruption to payroll and a patient portal, and a temporary switch to paper records. These examples show possible consequences, not a fixed sequence that occurs in every attack.
What the historical attack data shows
A 2022 JAMA Health Forum cohort study examined publicly identified ransomware attacks on U.S. healthcare delivery organizations from January 2016 through December 2021. The researchers recorded 374 attacks, involving nearly 42 million patients’ protected health information. They found that 166 attacks (44.6%) disrupted care delivery.
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| Recorded disruption | Attacks in the 2016–2021 study |
|---|---|
| Electronic system downtime | 156 (41.7%) |
| Scheduled-care cancellation | 38 (10.2%) |
| Ambulance diversion | 16 (4.3%) |
These figures describe the study’s reported U.S. incidents, not a current attack rate or a complete count of every healthcare ransomware event worldwide. The authors’ results depend on publicly identified incidents and available information.
Do hospitals cancel surgeries after a ransomware attack?
They may. If records, test results, imaging, or communication are unavailable, a facility may delay or cancel procedures, particularly when it cannot safely complete the necessary checks or coordinate care. CISA’s incident analysis documented delayed or canceled surgeries and cancer treatments; HHS testimony on healthcare cybersecurity infrastructure also describes canceled appointments, services not rendered, and delayed procedures, particularly elective ones.
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Whether a particular procedure goes ahead depends on what systems are affected, what information clinicians can access, and the facility’s operational response. The available evidence supports that cancellations happen in documented incidents; it does not establish that every ransomware attack leads to surgery cancellations.
What happens to patient records during a hospital outage?
Electronic records may be inaccessible while systems are down, whether because data is encrypted or because the hospital has taken systems offline during its response. In documented incidents, hospitals have temporarily used paper records to keep track of care. Paper workflows are an institutional contingency, not a universal process: hospitals need locally designed procedures for documenting, communicating, securing, and later reconciling information. CISA and HHS document temporary paper record-keeping but do not endorse a particular consumer product or one-size-fits-all method.
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Can ransomware affect nearby hospitals?
Yes. When a hospital diverts ambulances or patients, nearby emergency departments may receive additional demand even if their own systems are unaffected. HHS testimony states that hospital cyberattacks can disrupt care and safety through multi-week outages, patient diversion, strain on acute-care capacity, cancellations, and delayed procedures.
A 2023 JAMA Network Open study examined one emergency department near a hospital affected by ransomware. The neighboring, unaffected ED experienced significant increases in patient volume, ambulance diversions, waiting time, and time-sensitive, resource-intensive conditions such as stroke. The study’s authors argued that the event should be considered a regional disaster. It is evidence of spillover in that setting, not a measure of what happens in every attack or region.
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What the evidence can—and cannot—establish
- Documented operational effects: electronic downtime, delayed test-result communication, cancellations or delays, ambulance diversion, and temporary paper workflows appear in incident reports and studies.
- Different kinds of evidence: the JAMA Health Forum figures count reported incidents over a historical period; CISA and HHS describe individual cases; the neighboring-ED study evaluates one spillover event. They answer different questions and should not be treated as interchangeable estimates.
- Patient harm and causation: disruption can create risks and reduce capacity, but evidence that systems were disrupted does not alone prove that a particular patient was injured or died because of the attack.
- Recent enforcement figures: on April 23, 2026, HHS OCR reported that four settlements affected over 427,000 individuals and that it had completed 19 ransomware breach investigations. Those are enforcement figures, not an estimate of all people affected by ransomware.
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