[snlnspc]

The hospital's IT staff downloading and preparing update media, which would be the same process for every other device up until connectivity became their solution..

[Kalium]

It may be worth bearing in mind that historically, this often meant updates not going out at all.

[adrianN]

Which is not that big of a deal if the updates aren't there to fix wormable holes. And in the area of safety, you can encourage people to update their machines by imposing dramatic fines for non-compliance.