Regional Hospital System Adds Air-Gapped Vault to Veeam Infrastructure 

Organization

A US regional hospital system operating a 1,200-bed acute care facility across multiple campuses. The organization runs an integrated EHR platform, a PACS system for radiology and imaging, and critical clinical applications requiring continuous availability.

Industry

Healthcare — Acute Care Hospital System

Challenges

The organization had a mature Veeam Backup & Replication environment with reliable daily backup coverage across its core clinical workloads. The gap the security team identified was architectural: the Veeam repository sat inside the same flat network segment as the EHR, PACS, and clinical scheduling systems. A ransomware event that encrypted production would reach the repository in the same propagation window — leaving nothing to recover from.

HIPAA compliance added a second pressure. The organization’s covered entity obligations required a demonstrable, documented recovery capability with a tested RTO. Backup jobs running to an exposed repository did not satisfy that requirement.

“Our Veeam environment was solid. The problem wasn’t the software — it was where the repository lived. It was on the same network as everything else. If ransomware got into production, it would get to our backups at the same time. We needed a copy it couldn’t reach.” — Marcus, VP of IT Infrastructure

Solution

The organization deployed the StoneFly DR365V — a Veeam Ready air-gapped and immutable backup and disaster recovery appliance with integrated threat detection — as the vault tier for its existing Veeam environment. Veeam backup jobs were redirected to write to the DR365V through a policy-driven replication window: the appliance opens on a defined schedule, accepts the backup data, then closes — severing all network access until the next cycle. WORM volumes enforce immutability on every committed copy. The integrated threat detection engine scans incoming backup streams for ransomware indicators before committing to the vault. The existing Veeam configuration required no changes.

“We pointed Veeam at the DR365V, configured the replication window, and it was running the same day. The architecture we should have had from the start was in place in hours.” — Marcus, VP of IT Infrastructure

Results

Several months after the DR365V deployment, a ransomware payload entered through a phishing attachment on a nursing station workstation and encrypted production storage across the EHR, PACS, and clinical scheduling systems. The DR365V vault — logically isolated from the production network — was unreachable from the attack. When the incident response team turned to recovery, the vault held intact, immutable copies timestamped to 58 minutes before the payload executed. Full clinical system availability was restored in under four hours. No ransom was paid. No patient data was lost.

4-Hour Full Clinical Recovery — No Ransom Paid

Recovery was initiated directly from the DR365V vault without any dependency on the compromised production network or the encrypted Veeam repository. Veeam instant VM recovery, paired with the DR365V’s NVMe storage tier, brought the EHR online first, followed by PACS and clinical scheduling within the same window. The organization’s four-hour RTO was met with margin to spare.

Zero Data Loss Past the Last Vault Cycle

The vault replication window had closed 58 minutes before the attack executed. Every backup committed in that cycle was intact and unmodified. The recovery point covered nearly all active patient records, radiology orders, and scheduled procedures from the day of the incident. The remaining gap was covered by standard clinical downtime procedures — no data reconstruction required.

Intact HIPAA Chain-of-Custody Audit Trail

The DR365V’s vault copies carry immutable metadata including backup timestamps, data integrity hashes, and access event logs. The audit trail was continuous and unmodified through the incident, satisfying the organization’s post-incident HIPAA reporting requirements without gaps.

Air-Gapped Architecture Validated in Production

The incident provided real-world confirmation that the DR365V performed exactly as designed: production fully compromised, primary repository encrypted, vault copy unreachable and fully recoverable. The organization has since standardized the DR365V architecture across two additional campuses.

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