Keystrike is a continuous remote access governance platform for healthcare environments. It governs what happens after access is granted, providing live visibility into every remote session, blocking unauthorized commands before execution through deterministic enforcement, and generating continuous audit-ready evidence of governance. Every remote session in a healthcare environment carries operational risk and patient safety risk. Keystrike ensures each one is visible, policy-enforced, and provably governed.
Healthcare organizations 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, none of them govern what happens inside it.
There is a persistent governance gap between access intent — who was authorized — and access reality — what happens inside the live session. That gap is where ransomware deploys, where stolen credentials get abused, and where lateral movement unfolds. No tool in the current healthcare security stack operates inside that space.
Once access is granted, no tool in the traditional healthcare security stack governs what happens inside the live session. That is where credentials are abused, ransomware deploys, and lateral movement reaches clinical systems and patient data.
A single compromised session can encrypt EHRs, pharmacy systems, billing infrastructure, and imaging simultaneously, thus disrupting patient care before any alert fires. HIPAA, HITECH, and CMS requirements demand continuous session-level controls, not post-incident logs.
Healthcare organizations depend on a broad ecosystem of vendors, labs, and service providers. Every external connection through VPN, RDP, or remote management tools is a potential entry point. Keystrike governs every vendor session without disrupting clinical workflows.
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.
Modern healthcare ransomware attacks don't breach the perimeter. They unfold inside authenticated sessions using valid credentials. Once inside, attackers encrypt EHRs, pharmacy dispensers, billing systems, and imaging platforms simultaneously. By the time detection tools alert, critical clinical operations are already offline.
Ransomware Deployment Through Authenticated Clinical Sessions
Modern healthcare ransomware attacks don't breach the perimeter. They unfold inside authenticated sessions using valid credentials. Once inside, attackers encrypt EHRs, pharmacy dispensers, billing systems, and imaging platforms simultaneously. By the time detection tools alert, critical clinical operations are already offline.
The 2024 Change Healthcare ransomware attack disrupted billing, pharmacy, and EHR systems across the United States, 74% of hospitals reported direct patient care impact and 94% experienced financial consequences exceeding $872M in total costs. Keystrike blocks unauthorized remote commands mid-session before systems are encrypted.
— UnitedHealth Group SEC Filing, Congressional Testimony, 2024
Keystrike closes this gap by continuously verifying that every command inside the session originates from verified physical input on an authorized device, interrupting ransomware deployment and blocking lateral spread before they reach clinical systems.
Third-Party Vendor Compromise and PHI Exfiltration Through Remote Sessions
Healthcare organizations depend on external vendors, labs, transcription services, and claims processors that connect through VPN, RDP, SSH, and remote management tools. Compromised credentials, outdated endpoints, or inherited sessions create direct pathways to protected health information and internal clinical infrastructure.
The 2025 Yale New Haven Health breach exposed 5.56 million patient records through compromised third-party access to secondary servers. Keystrike blocks this attack path: session-level enforcement ensures only verified physical human input on an authorized device can execute commands, preventing misuse of vendor sessions regardless of credential validity.
Keystrike closes this gap by requiring every remote action to be cryptographically attested to verified physical input, preventing attackers from using stolen credentials, inherited sessions, or compromised vendor access to reach PHI and clinical systems.
Lateral Movement from Compromised Sessions 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.
The 2025 Frederick Health breach exposed approximately 934,000 patient records through widespread use of stolen credentials across connected clinical systems. Keystrike prevents this attack path through continuous session verification that blocks attackers from issuing commands even when login credentials are fully compromised.
Keystrike closes this gap by validating every session crossing network segment boundaries, blocking credential replay, RDP hijacking, and inherited sessions before lateral movement reaches connected medical devices.
IAM and PAM control who gets access. SIEM and SOAR record what happened. No tool in the stack governs what happens during the live session.
Keystrike operates in that gap. It strengthens every tool in your healthcare security stack by governing the session layer none of them were built to reach. For PAM and ZTNA, Keystrike delivers the continuous session-level enforcement those tools promise but cannot sustain after authentication.
Keystrike does not capture keystrokes, credentials, or session content. Verification is cryptographic and deterministic — not behavioral — eliminating false positives and privacy concerns.
Once the session starts, their governance ends. Keystrike operates inside the live session, providing continuous enforcement, visibility, and cryptographically attested evidence where no other tool in the stack can reach.
| IAM / PAM | SIEM / SOAR / XDR | Keystrike | |
|---|---|---|---|
| Tools | Okta, CyberArk, BeyondTrust | Splunk, Microsoft Sentinel, CrowdStrike | Continuous Remote Access Governance |
| What it does | Verifies identity and controls who can initiate privileged sessions. Some solutions offer session recording for forensic review. | Collects event logs, correlates alerts, and triggers automated response workflows. Detection is reactive, based on events that have already occurred. | Governs every action inside the live session in real time, from authentication to logout. Deterministic enforcement blocks unauthorized commands before execution. |
| In-session enforcement | None — governance ends at session initiation | None — cannot block commands inside the live session | Cryptographic attestation proves governance was applied across every session |
Keystrike is not a replacement for your existing tools. It closes the governance gap that none of them address.
| Capability | Keystrike | CyberArk PAM | BeyondTrust PAM | Okta IAM | Splunk SIEM |
|---|---|---|---|---|---|
| Continuous in-session verification | Cryptographic | No | No | No | No |
| Blocks unverified commands in real time | Deterministic | No | Limited | No | No |
| Physical input attestation (patented) | Patented | No | No | No | No |
| Zero false positives | Cryptographic proof | N/A | N/A | N/A | No — probabilistic |
| Live session topology mapping | All protocols | Limited | Limited | No | Log-based |
| Deployment time | ~20 minutes | Weeks–months | Weeks–months | Days–weeks | Weeks–months |
| Requires rip-and-replace | No | Often | Often | May | May |
Every remote session is visible, policy-enforced, and provably governed from authentication to logout.
Keystrike provides live session visibility across every remote access protocol in your healthcare environment: RDP, SSH, PowerShell Remoting, WinRM, WMI, SMB, TeamViewer, NinjaOne, and more. It surfaces unmanaged assets, unknown connections, and ungoverned access pathways that no other tool in your security stack detects.
Every command inside a governed healthcare session must be cryptographically attested to verified physical human input on an authorized device. Commands without valid attestation are blocked before execution. Enforcement is deterministic — no behavioral models, no statistical baselines, no false positives.
Continuous, cryptographically attested evidence across every governed healthcare session. HIPAA, HITECH, HITRUST, and NIST CSF audit requirements satisfied as a direct output of enforcement, not assembled after the fact.
Keystrike produces continuous, cryptographically attested governance evidence across every privileged session, satisfying healthcare regulatory requirements as a direct output of enforcement, not assembled as a separate compliance process.
Keystrike supports compliance with HIPAA Security and Privacy Rules, HITECH, HITRUST CSF, NIST Cybersecurity Framework (800-53), NIST Zero Trust Architecture (800-207), OCR Enforcement Guidance, CMS requirements, ISO 27799, and applicable state privacy laws. Compliance evidence is generated through continuous session verification, deterministic policy enforcement, and audit-ready governance records across every privileged remote session.
A lightweight agent on the operator's device verifies legitimate physical keystrokes and mouse clicks, then submits cryptographic attestations to the central Keystrike service. Every command is either verified or blocked. There is no probabilistic model, no behavioral baseline, and no detection delay.
A lightweight agent on the operator's device verifies that input originates from legitimate physical keystrokes and mouse clicks, submitting cryptographic attestations to the central Keystrike service. No session content is captured or stored.
A second lightweight agent on the destination server withholds all input until proof of legitimacy is received. Attested input executes. Unattested input — from scripts, injected commands, or compromised sessions — is blocked before execution and an alert is generated in real time.
Keystrike maps all remote access protocols across your environment — RDP, SSH, PowerShell Remoting, WinRM, WMI, and SMB — surfacing which sessions are governed, which protocols are active, and where governance gaps remain.
Ransomware, vendor compromise, and credential abuse all exploit the same blind spot: the gap between who you authorized and what 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.
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.
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.
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.
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.
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.
Keystrike deploys in 20 minutes. It integrates with existing MFA, IAM, and SIEM infrastructure without workflow disruption to clinicians or staff.
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.
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.