The Ultimate Guide to IT, OT, IoMT and SOC Team Alignment: Best Practices

In today's interconnected enterprise environment, the traditional boundaries between information technology (IT), operational technology (OT), and Internet of Medical Things (IoMT) are rapidly dissolving. According to Gartner, organizations with effective integration between these domains achieve significantly better security outcomes and operational efficiency. This convergence, coupled with new regulatory requirements like the 2025 HIPAA Security Rule changes and evolving IEC 62443 standards, demands a fresh approach to security operations center (SOC) management and team alignment.

The Evolving Security Landscape

The security landscape for manufacturing and healthcare organizations has transformed dramatically. Manufacturing facilities now connect traditional OT systems directly to enterprise networks, while hospitals manage complex ecosystems of connected medical devices. According to recent research, 90% of manufacturing organizations experienced production impacts from cyber incidents in 2023, while healthcare facilities saw a 123% increase in ransomware attacks targeting connected medical devices.

Traditional security approaches, with separate teams managing IT and OT environments, no longer suffice. Modern threats move laterally across these environments, exploiting the gaps between siloed security operations. This reality demands a unified approach to security operations, bringing together traditionally separate domains under coordinated leadership and shared objectives.

Unique Security Requirements by Sector

Manufacturing and OT Security

Manufacturing facilities must protect critical industrial control systems (ICS) while maintaining continuous operations. The manufacturing sector's migration toward smart factories expands the attack surface through IoT sensors and connected equipment. Production downtime from security incidents averaged 3.5 days in 2024, costing organizations millions in lost revenue. Critical systems like PLCs and SCADA networks require specialized protection that accounts for legacy protocols and 24/7 operational requirements.

Healthcare and IoMT Security

Healthcare organizations manage increasingly complex ecosystems of connected medical devices that directly impact patient safety. IoMT devices range from patient monitors to imaging systems, creating a security environment where privacy and safety are paramount. The 2025 HIPAA Security Rule changes mandate specific network segmentation controls, requiring sophisticated security measures that can adapt to dynamic clinical workflows while protecting sensitive patient data. Healthcare security teams must balance rapid incident response with maintaining continuity of care.

Building an Integrated Security Strategy

OT Integration Requirements

Manufacturing operations require security controls that respect production schedules and maintenance windows. OT security integration must account for legacy systems, proprietary protocols, and air-gapped networks. According to Gartner, successful OT security integration requires specialized expertise in industrial protocols and deep understanding of operational impacts. Security teams need visibility into both IT and OT environments to prevent lateral movement while maintaining operational efficiency.

IoMT Integration Considerations

Healthcare security integration demands careful attention to clinical workflows and patient safety requirements. IoMT security must account for device mobility, varying risk levels, and complex regulatory requirements. Integration platforms must support automated device discovery and classification while enabling granular access controls based on device identity and clinical context. Successful integration requires close collaboration between security, clinical engineering, and healthcare IT teams.

Unified Security Operations

Modern SOCs must evolve beyond traditional IT security monitoring to incorporate specialized OT and IoMT expertise. This evolution requires security teams to develop cross-domain knowledge and establish clear procedures for incidents spanning multiple environments. Organizations implementing integrated SOCs demonstrate 60% faster incident response times across all environments. Success requires platforms that provide comprehensive visibility while respecting the unique requirements of each domain.

Security architects must work closely with operational teams to implement controls that enhance security without disrupting essential functions. This collaboration extends to vendor relationships, where platforms from providers like Elisity, Armis, Claroty, and CrowdStrike can be integrated to provide comprehensive discovery, control and management of least privilege access policies for all users, workloads and devices. The key is selecting solutions that can be implemented without significant downtime or operational impact.

Implementation Framework

Successful implementation of an integrated security program requires careful attention to three core elements:

People and Organization

Create dedicated roles for OT/IoMT security specialists within the SOC team. These specialists should understand both security principles and operational requirements specific to their domains. Invest in cross-training programs that help IT security professionals understand OT/IoMT environments and vice versa. Regular joint training exercises and tabletop scenarios help build mutual understanding and effective incident response procedures.

Process Integration

Establish unified security workflows that accommodate the unique requirements of each environment. Manufacturing operations require careful change control procedures that respect production schedules, while healthcare environments need processes that prioritize patient safety and care delivery. Document clear escalation paths and decision-making frameworks for security incidents that impact multiple domains.

Technology Enablement

Modern security platforms enable unified visibility and control across IT, OT, and IoMT environments. Integration between security tools provides essential context for effective decision-making. For example, combining device metadata from specialized platforms like Armis or Claroty with microsegmentation capabilities from Elisity enables precise access control policies based on device identity and risk level.

Summary: Best Practices for Integrated IT/OT/IoMT Security Operations

The Path Forward

Organizations should approach security integration as a journey rather than a destination. Begin with a comprehensive assessment of current security operations, identifying gaps in visibility and control across IT, OT, and IoMT environments. Develop a roadmap that prioritizes critical risks while building toward comprehensive coverage.

Start with foundational capabilities like asset discovery and visibility across all environments. Modern platforms can automate this process, providing continuous updates as new devices join the network. Build on this foundation by implementing granular access controls through microsegmentation, ensuring that critical systems are protected without disrupting legitimate operations.

Measure progress through meaningful metrics that reflect both security and operational objectives. Track metrics like mean time to detect (MTTD) and respond (MTTR) across all environments, while monitoring operational indicators to ensure security controls don't impact critical processes. Regular reviews with stakeholders from IT, OT, and clinical medical device teams help maintain alignment and drive continuous improvement.

The convergence of IT, OT, and IoMT security operations represents both a challenge and an opportunity for modern enterprises. Organizations that successfully integrate these domains position themselves to better protect critical assets while enabling digital transformation initiatives. By establishing clear governance frameworks, investing in cross-functional capabilities, and leveraging modern security platforms, organizations can build resilient security operations that span all environments.

Success requires commitment from leadership, investment in people and technology, and patience to build effective cross-functional relationships. The result is a more resilient organization better equipped to protect critical assets and respond effectively to emerging threats across all domains.

Remember that integration doesn't mean standardization – each environment maintains unique characteristics that must be respected. The goal is to create unified visibility and control while preserving the specialized procedures and considerations essential for each domain. Through careful planning and execution, organizations can achieve this balance, establishing security operations that effectively protect all assets while enabling continued innovation and growth.

Next Steps With Elisity

As organizations tackle the complex challenge of securing converged IT, OT, and IoMT environments, success depends on implementing unified security operations that respect the unique requirements of each domain while enabling comprehensive visibility and control. Through proper team alignment, integrated platforms, and risk-based approaches, enterprises can strengthen their security posture while maintaining operational excellence.

Elisity's identity-based microsegmentation platform enables organizations to accelerate this journey by providing automated device discovery, rich contextual awareness through integration with specialized platforms like Claroty and Armis, and granular access controls that can be implemented without disrupting critical operations. 

A notable comment was published in the Forrester Wave™ Microsegmentation Solutions, Q3, 2024  "Network infrastructure vendors have long had microsegmentation solutions on the market, but they were prone to project failure, usually due to complexity. Elisity makes this old idea work by removing the complexity, compressing the policy, and leveraging multiple vendors’ switch fabrics to enable microsegmentation.”  Download your copy of the Forrester Wave™ Microsegmentation Solutions, Q3, 2024 

Elisity solution engineers are happy to discuss your goals for enabling a stronger cyber resilience program and preventing widespread damage from ransomware and other attacks; schedule a conversation or demo with Elisity today.