Hospital IT support for nights, weekends, and the systems past your EHR.
Your EHR team owns the EHR. We’re the firm you bring in for the systems, network, and people around it. IT and cybersecurity designed for critical access, community health, and specialty hospitals across Montana.
A protection plan shouldn’t come with a second bill.
For certified hospitals on an eligible plan, we do the response work ourselves, and a separate written warranty backs our services.
Containment, forensics, eradication, recovery, and rebuilding if needed, at no additional cost, within defined service limits.
The Big Sky Guarantee is not an insurance policy. It’s our commitment to do the response work ourselves.
Eligible payments made directly to the organization, up to $500,000 per covered incident, depending on plan.
The Big Sky Service Warranty is not an insurance policy and does not replace cyber insurance.
For certified clients on Professional, Enterprise, or co-managed plans, with required controls in place. Eligibility requirements, service limits, and exclusions apply. Full terms are provided for your review before you sign. See which plans qualify
Hospitals reach us three ways
Some have one IT director and an EHR vendor. Some have a strong team covering nights on a phone tree. Some just want a number that answers at 4am, already under a BAA. We do all three.
Your IT is one director and an EHR vendor
We run the whole estate, for critical access, specialty, and multisite outpatient facilities.
Your team is strong, but nights run on a phone tree
Your team keeps the clinical side. We take infrastructure, nights, weekends, and holidays.
You want a number that answers at 4am, under a BAA
Signed and ready before an incident. Available on its own, without a managed contract.
Running a clinic or practice rather than a hospital? See managed IT for medical and dental practices
Where your vendor’s support agreement stops
Your EHR vendor supports the application, whether that’s Epic, MEDITECH Expanse, Oracle Health, athenahealth, or a Community Connect instance. What stops working most often lives just past that line.
Badge tap at shift change
Authentication stalls, staff stay logged in on shared workstations, and it becomes a chart access problem.
Wireless at the far end
Carts drop at the end of the med surg floor, where nobody tests because the server room is fine.
The lab label printer
Unglamorous until it fails, and then specimen processing stops until someone gets it printing again.
Undocumented devices
The devices your interfaces feed, which nobody has drawn on a current network diagram.
None of that is your EHR vendor’s ticket and all of it can stop patient care. That’s the line we take responsibility for.
The clinic assumed one public IP meant low risk. A manual external test found two vendors had left equipment exposed, putting grant funding at risk.
Read the case studyFind out what sits past your EHR boundary before an incident does.
The assessment is free. 30 to 45 minutes onsite with a security engineer, at a time you pick, and the findings are yours either way.
Two ways to run it, written down before we start.
Fully managed when you need the estate run. Co-managed when you have a team and need the nights, infrastructure, and the backlog taken off it.
The same regulatory load on a fraction of the headcount
Critical access, specialty, and behavioral facilities, inpatient rehab, and FQHCs answer to the same Security Rule as an academic medical center. The person answering is usually also being paged about a printer in registration.
Imaging, the workstation fleet, and shared clinical logins.
Including the far end of the floor where carts drop.
A real maintenance window, agreed against your schedule.
Backup and restore testing you can show a surveyor.
Endpoint detection, identity, and privileged access.
Clinical staff reach us without submitting a ticket first.
What that changes: your IT director stops being tier one helpdesk support and gets back to strategy and the hospital roadmap.
For hospitals with an IT team and an on call schedule
We don’t come in and reorganize your department. Co-managed works when the split is written down, so escalation paths and the 5pm and 7am handovers are documented in the first two weeks.
Signed before you need it. Available on its own.
You don’t have to be a managed client. What the retainer buys you before anything happens:
Paperwork already signed
An MSA and BAA in place, so hour zero isn’t spent in procurement.
Response times in writing
Defined response times, committed contractually before anything happens.
Engineers who know you
Named engineers who’ve already seen your network, EDR console, and backups.
Rates fixed in advance
Not negotiated during a ransomware event.
If your log retention is shorter than an attacker’s dwell time, an investigation can’t rule out that ePHI was accessed, and an inconclusive finding is treated like a breach. Retainer setup checks your retention first.
If you carry cyber insurance, check the approved vendor panel before signing any IR retainer, including ours. If you should retain a panel firm as primary, we’ll work under them.
Downtime procedures come out, electives get cancelled, and transfers may go elsewhere. Containment is a clinical decision as much as a technical one, so we make it with your incident commander in the room.
Already a certified managed client? Incident response comes under The Big Sky Guarantee, within defined service limits, so the retainer is for hospitals that aren’t.
Attached to an engagement, or bought on their own
HIPAA Security Risk Analysis
Not a controls questionnaire with a maturity score. Risk analysis remains the most frequently cited deficiency in OCR investigations, so the version that matters is the one that shows your working.
Scoped with clinical engineering, not around them
Passive discovery on segments carrying infusion pumps, monitors, and imaging, active testing in agreed windows against the OR schedule, and a named person on your side who can stop us.
Times you should call someone else
We’d rather tell you before procurement than after. We’re probably not the right primary firm if:
Your insurer requires a panel firm
Retain the panel firm as primary. We can hold the environment knowledge and work under them.
You only need a retainer
If you have a full team, we’ll scope a DFIR retainer and won’t try to sell managed services.
You need someone embedded daily
Contract clients get same day onsite across Great Falls, Helena, and Billings, but we’re not staffed at a desk every morning.
Inside your change control, not around it
What working inside your environment looks like, written as what we do.
So we secure your systems the way attackers probe them.
Frequently asked questions
Do you replace our IT team?
No. Most hospital engagements are co-managed. Your team keeps the clinical systems and department relationships, and we take infrastructure, after hours support, and the project backlog.
Which EHRs do you work around?
Epic, MEDITECH Expanse, Oracle Health, athenahealth, and Community Connect instances hosted off a larger system. The vendor supports the application; we take what sits past it.
Can we security review you before signing?
You should, and we’re set up for it: questionnaire responses, our insurance and subcontractor position, evidence of internal controls, and where any data touching your environment resides.
Our approvals go through a board committee. Can you work with that?
Yes. The BAA goes to your privacy and compliance officers, and larger spend may wait for a monthly finance committee. Tell us your cycle and we’ll build the proposal, and its evidence, to survive it.
Will a penetration test disrupt clinical devices?
It shouldn’t. We use passive discovery on segments with infusion pumps, monitors, and imaging, test actively only in agreed windows, and a named person on your side can stop us at any time.
Do we have to buy managed services to get a retainer?
No. The DFIR retainer is available on its own, with a signed MSA and BAA, defined response times, and fixed rates in place before anything happens.
Our cyber insurer has an approved vendor panel. Does that matter?
Yes. Insurers often dispute costs from off panel firms. Check the panel before signing any retainer. If you should retain a panel firm as primary, we’ll say so and can work under them.
Do we need to act on the proposed Security Rule update now?
As of September 2026 the rule is still proposed, with final action shown as July 2027. Do the underlying work anyway: segmentation around ePHI, MFA, asset inventory, and annual testing. Your insurer is already asking.
What should we check before an incident?
Your log retention. If EDR, VPN, and authentication logs roll over before an attacker’s dwell time, an investigation can’t prove what wasn’t accessed. We check this during onboarding.
Tell us what you run and who audits you.
Twenty minutes, a straight answer, and nothing to sign. You get a written scope for managed, co-managed, or a retainer, with the evidence your privacy officer and CFO will ask for.
“Great company to work with. Any issues we have had they have addressed quickly.”
5.0 on Google and Birdeye.
Serving critical access, community, and specialty hospitals from Great Falls, Helena, Billings, and the corridors in between.Read the reviews