Reconceptualizing Zero-Trust Security for Clinical Workstations: Integrating AI-Driven Architectures, Legacy Medical Devices, and Operating System Modernization in Healthcare Environments

Abstract

The accelerating digitization of healthcare infrastructures has intensified the exposure of clinical environments to sophisticated cyber threats, particularly as hospitals increasingly depend on interconnected clinical workstations, legacy medical devices, and heterogeneous operating systems. Traditional perimeter-based cybersecurity models have proven inadequate in addressing the complex risk landscape of modern healthcare systems, where implicit trust, static access controls, and outdated endpoint protections create systemic vulnerabilities. Zero Trust Architecture (ZTA) has emerged as a transformative cybersecurity paradigm that challenges legacy assumptions by enforcing continuous verification, least-privilege access, and dynamic risk assessment. Within this evolving discourse, the adoption of modern operating systems, notably Windows 11, has been positioned as both a technical enabler and a governance challenge for implementing Zero Trust principles in hospital clinical workstations. This article develops a comprehensive, theory-driven, and empirically grounded examination of Zero Trust security in healthcare, with a particular focus on bridging AI-driven ZTA frameworks, legacy medical device constraints, and operating system modernization strategies.