Doesn’t matter if their Epic servers are up to date if the attacker got a domain admin account somewhere else and can just log in normally to run the ransomware.
Yup just spearfish one of the employees with a password reset email. People including educated developers and MDs are in general very lax about security. But also you have windows 7 legacy systems running specialized equipment that has been validated for that OS and software version number. There is really no way around this, if a country wants to kill Americans right now IMO it is most effective to disable EPIC servers in ND/SD/WI/MT that would cause way too much chaos and people would die.
But also what are we doing running life-critical software on Microsoft-made OS? This is idiotic, it is great for gaming and excel but not hospitals. Microsoft could make another OS based on Linux or BSD and it could not be hot garbage. But that would eat into profits and take...effort. Linux and ChromeOS + 2FA is much better although not perfect.