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OT and IoMT network segmentation reduces unnecessary communication by separating systems into zones and controlling the traffic allowed between them. To make it effective, organizations need to map operational dependencies, define permitted connections, and filter and monitor traffic at zone boundaries. A generic network diagram or firewall alone cannot establish a safe design for a particular industrial process or clinical environment.

What network segmentation does in OT

Network segmentation divides a network into separate physical or logical areas and restricts communication between them. In operational technology (OT), the goal is to limit which systems can reach control and other operational assets. If an endpoint is compromised, fewer permitted routes can make it harder for an attacker to move laterally into other parts of the environment.

Segmentation is a boundary-and-rules approach, not simply a matter of drawing zones on a diagram. The rules determine which communication may cross each boundary, and controls at that boundary enforce and observe those rules. CISA’s January 2022 infographic, Layering Network Security Through Segmentation, emphasizes that “Segmentation is not the only tool to secure a network.” It also cautions that its illustration is not a production engineering design.

Where OT segmentation breaks down

A flat or weakly bounded network can give a compromised endpoint more routes to other systems. CISA and NSA’s October 2023 cybersecurity misconfiguration guidance warns that insufficient segmentation can enable lateral movement; CISA’s January 2022 critical-infrastructure guidance specifically warns that a lack of separation between IT and OT puts OT environments at risk.

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  • Unregulated IT/OT connections: When business IT and operational systems can communicate without a controlled intermediary, a compromise in one environment may expose the other.
  • Zones without defined rules: A boundary is ineffective if the organization has not specified which communications are necessary and permitted across it.
  • Traffic that is not filtered or monitored: A boundary that does not enforce and observe its intended rules cannot reliably limit or reveal unwanted cross-zone communication.
  • Policy non-adherence or bridging devices: CISA’s StopRansomware guidance describes how segmentation can be undermined when policy is not followed or a device bridges multiple segments.

These are design and operation failures, not proof that one specific technology is inherently inadequate. A firewall, VLAN, gateway, or other control only helps when it is placed, configured, maintained, and validated against the actual communication requirements.

How to plan zones and conduits

CISA’s guidance points to risk-based zones: group OT assets with attention to their criticality, the consequences of disruption, and operational necessity. A conduit is an allowed communication path between zones. Define those paths deliberately, then apply controls to filter and monitor traffic as it crosses boundaries.

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  1. Inventory the assets. Build and maintain an inventory that captures each asset’s role, exposure, and support status. CISA’s May 2025 advisory, Primary Mitigations to Reduce Cyber Threats to Operational Technology, identifies asset inventory as a foundational practice.
  2. Map dependencies before changing access. Identify which systems communicate, why they do so, and what operational function depends on each connection. Use this map to assess criticality, consequence, and operational need before assigning zones or tightening rules.
  3. Separate IT and OT, and control necessary crossings. CISA recommends separating IT from OT and using a demilitarized zone (DMZ) to avoid unregulated communication. Place required intermediary services so that connections can be controlled rather than allowing unrestricted direct communication.
  4. Define and enforce permitted conduits. Document the traffic each cross-zone path is intended to carry. CISA’s guidance identifies firewalls, gateways, and proxies as possible controls; its OT advisory also discusses multiple Purdue-style levels and zones. These are approaches to consider, not a universal architecture or prescribed product selection.
  5. Review remote access and exposed connections. Examine remote-access routes, including vendor pathways. CISA’s December 2024 advisory on attacks involving programmable logic controllers calls for device control lists when possible and regular inventory of internet-accessible devices.
  6. Validate changes with operational stakeholders. Confirm that the proposed rules preserve required operations and that boundary controls behave as intended. Security guidance cannot determine the safe configuration for a site-specific process; operational review is necessary before and after changes.

Choosing physical or logical boundaries

Physical and logical segmentation can both create boundaries, and CISA recognizes both approaches. The available guidance does not prescribe one as the universal winner. Compare options against the enforcement boundary, required granularity, operational impact, visibility, resilience needs, and the organization’s ability to manage and validate the controls.

Logical approaches discussed in CISA’s segmentation material include VLANs and access control lists (ACLs); other guidance identifies DMZs, firewalls, and gateways. The right combination depends on the environment and the traffic that must remain available. Do not assume that a particular technology, by itself, guarantees isolation or safe operation.

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Macrosegmentation and microsegmentation

Macrosegmentation establishes broader boundaries between zones, such as separating IT from OT. Microsegmentation applies more granular controls to smaller groups of resources. Finer divisions may help restrict communication more narrowly, but they also require an accurate understanding of dependencies and the capacity to manage and validate the resulting rules.

CISA’s July 2025 release of part one of its zero-trust microsegmentation guidance is planning-oriented and aimed at federal zero-trust implementation; CISA says its principles are applicable more broadly. It should not be read as a ready-made OT design or as evidence that every facility should implement the same degree of granularity.

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Applying segmentation to healthcare and IoMT

For healthcare, the baseline principle is to place IT and OT devices on different network segments and control communication between those segments. CISA’s Healthcare and Public Health Sector Mitigation Guide supports that approach. It does not establish a single VLAN pattern or universal architecture for every Internet of Medical Things (IoMT) device.

Medical-device segmentation needs to account for the clinical workflow and the device’s actual communication requirements. The cited guidance does not resolve device-specific clinical, manufacturer-support, or safety constraints, so avoid blanket rules such as placing every connected medical device into one isolated segment without assessing its dependencies. Define the necessary paths and have the relevant clinical, technical, and security stakeholders review proposed controls.

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What segmentation can—and cannot—provide

Segmentation can reduce unnecessary access and constrain possible lateral movement when zone boundaries are enforced and their permitted conduits are controlled. It does not replace inventory, operational review, traffic visibility, or other security layers. Procurement of an industrial firewall or OT security gateway should follow an assessment of the specific process, protocols, performance, safety, and support requirements; CISA’s identification of these control categories is not an endorsement of a vendor or model.

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