Why Security is Non-negotiable in Healthcare
Healthcare is among the most targeted sectors in cybersecurity. Attackers target patients’ private health information, financial records, and even the systems that keep hospitals running.
The repercussions of these attacks are serious: delayed surgeries, stolen patient data, hefty penalties, and, most importantly, loss of trust that can take years to rebuild.
Globally, healthcare-targeted cyberattacks have a 68% attack rate, just behind central and federal governments.
In 2024, 67% of healthcare organizations were hit by cyberattacks, costing an average of $10.93 million per breach, nearly triple the cost for other industries.
Such attacks may disrupt care, forcing hospitals to cancel surgeries, turn away ambulances, and even go back to using paper records. For health insurers, breaches expose sensitive member data, leading to identity theft and fraudulent claims.
- A 2024 ransomware attack on a Midwest hospital system halted chemotherapy treatments for 1,200 cancer patients for 72 hours.
- A breach at Change Healthcare of the United Health Group exposed data for 100 million people, causing months of chaos in billing and patient care, even after a $22 million ransom was paid.
What is Penetration Testing (Pen Testing)?
Penetration testing, or pen testing, is an authorized simulated attack performed on a computer system to evaluate its security. Penetration testers use the same tools, techniques, and processes as attackers to find and demonstrate weaknesses in a system. Penetration tests usually simulate a variety of attacks that could threaten a business. They can examine whether a system is robust enough to withstand attacks from authenticated and unauthenticated positions.
Types of Pentesting Techniques
Testers are provided with different levels of access to the target system, depending on the objectives of the pen test. Sometimes, the pen testing team adopts either a single strategy or a binary strategy, depending on the system’s level of understanding.
There are three types of Pen tests:
Black Box Testing
The ethical hacker receives little to no advance knowledge about the company’s IT infrastructure or security through black box testing, also known as external penetration testing. To replicate a real cyberattack, black box tests are frequently employed.
Tests begin outside the network, with the tester having no knowledge of local network architecture or installed security systems. These tests may be the most time-consuming due to the blind simulated attack.
White Box Testing
White box testing involves the tester having complete knowledge of the security and network infrastructure. Even though these tests don’t replicate the appearance of an actual external attack, they are among the most comprehensive types of tests you may get done.
White box tests can also mimic the appearance of an inside attack as the tester enters the network with insider knowledge of its architecture. Since white box testing is transparent, it can be completed quickly, but organizations that need to test an array of applications might still have to wait months to obtain all the results.
Gray Box Testing
Gray box Testing (a combination of Black box and white box testing) gives the tester some knowledge or access to the company network. A common technique for testing a particular public-facing application with a private server backend. Using all this data, the tester can try to use specific features to access different parts of the network without authorization.
Typically, a gray box test takes longer than a white box test but less time than a black box test due to the testers’ limited network knowledge.
Common Weak Spots in Healthcare Systems
Since healthcare IT systems store enormous volumes of Protected Health Information (PHI) and Personally Identifiable Information (PII), they are often the target of cybercriminals. The following are some of the most prevalent vulnerabilities:
Insecure APIs: Inadequately secured APIs can act as gateways for hackers to obtain system data and patient records.
Unpatched Software: Systems that run outdated applications and don’t have security patches installed are vulnerable to intrusion.
Weak Access Controls: Inadequate password policies and a deficiency in multi-factor authentication (MFA) can allow unwanted access to sensitive information.
Misconfigured Cloud Environments: Inaccuracies in cloud security setups may allow unauthorized users to access private data.
Phishing and Social Engineering Attacks: To obtain system access, cybercriminals frequently use phishing emails to deceive employees.
Why Penetration Testing Matters for Healthcare Providers
A proactive approach to cybersecurity, penetration testing, assists healthcare organizations in locating and fixing IT system flaws before attackers can take advantage of them. Through the simulation of actual cyberattacks, pen-testing helps healthcare providers identify their weaknesses and determine how to address them.
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Identifying Vulnerabilities in Medical Equipment
Medical devices like pacemakers, MRI scanners, and infusion pumps that are connected to the internet are used by many healthcare providers. These devices may run outdated applications or have insufficient encryption, making them common vulnerabilities in a company’s security setup. Pen testing can be used to find these devices’ weaknesses and recommend security fixes.
Real-World Example: In 2017, significant flaws in St. Jude Medical’s cardiac devices were discovered. Hackers could utilize these flaws to alter the device’s settings, compromising the lives of patients. Later, the FDA in the United States released a warning to medical professionals to patch the devices right away.
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Evaluating Application and Network Security
Numerous applications interact with other applications in healthcare networks, which are frequently expansive. If there are security flaws, this makes the environment vulnerable to exploitation. Pen testing checks the resilience of firewalls, encryption protocols, and other network defenses against cyberattacks.
Real-World Example: Nearly 80 million people’s personal information was compromised in the 2015 Anthem data breach. The attackers obtained unauthorized access to electronic Protected Health Information (ePHI) by taking advantage of a weakness in Anthem’s IT systems. A strong pentesting program might have found the vulnerability and prevented this disastrous hack.
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Ensuring Employee Awareness and Training
The weakest component of a healthcare organization’s security plan is frequently its workforce. Human error can result in breaches, whether it’s using weak passwords or falling for a phishing email. Social engineering techniques, in which ethical hackers try to trick employees into disclosing private information, are frequently used in pentesting.
How Penetration Testing Helped Companies Strengthen Security (Case Studies)
The DDoS Attack on Dyn
A significant Distributed Denial of Service (DDoS) attack was launched against DNS provider Dyn in 2016. Popular websites like Twitter, Amazon, and Netflix experienced significant disruptions as a result of the attack.
Following the attack, Dyn engaged a group of professionals to perform a penetration test on its systems. The group found an array of weaknesses that the attackers might have used to launch the DDoS attack.
Before any more attacks could take place, Dyn was able to find and fix these vulnerabilities due to the penetration test. Additionally, the test assisted Dyn in strengthening its cybersecurity stature and getting prepared to combat potential future breaches.
The Target Data Breach
Target, an established retail chain, experienced a data breach in 2013 that exposed 40 million customers’ financial and personal data. The company’s payment card processing system had a vulnerability that led to the breach.
Target performed a penetration test on its systems following the breach. The test found a number of weaknesses, such as weak passwords and an unprotected server. Target was able to strengthen its security and fix these flaws.
The Canadian Government Cybersecurity Breach
A cybersecurity breach that affected the Canadian government in 2019 exposed 9,041 people’s personal data. The government’s online job-search portal had a vulnerability that led to the breach.
To perform a penetration test on its systems, the Canadian government involved a group of professionals. Numerous flaws that an attacker could have used to obtain sensitive government data were found during the test.
The Canadian government was able to find and fix these vulnerabilities through the penetration test before any more attacks could take place.
The Ransomware Attack on Norsk Hydro
The operations of the Norwegian aluminum company Norsk Hydro were severely disrupted in 2019 by a ransomware attack. Norsk Hydro suffered large financial losses as a consequence of the attack, which forced the company to shut down multiple plants.
Following the attack, Norsk Hydro engaged a group of professionals to perform a penetration test on its systems. The test discovered several weaknesses that the attackers might have used to access Norsk Hydro’s systems.
Before any more attacks could take place, Norsk Hydro was able to find and fix these vulnerabilities due to the penetration test.
The Best Practices of Penetration Testing in the Healthcare Industry
1. Conduct Annual Evaluations
Pentesting every year assesses the organization’s current security protocols, cyber hygiene, and monitoring capabilities. Assign tests to priority lists based on known high-risk applications and areas.
2. Integrate External Testing
Third-party companies provide unbiased assessments. It is always preferable to hire them to obtain a thorough understanding of vulnerabilities, thorough pentest reports, and a healthcare security certificate.
3. Production Testing Apps
Real-world production apps are the best at mimicking real-world conditions and users, even though staging environments are helpful for certain types of testing. Additionally, it increases the reliability of results.
4. Transparency in Demand
To assist in fixing all vulnerabilities discovered, full disclosure of all testing activities and comprehensive reporting of results are essential.
5. Validation Re-test
Conduct follow-up penetration testing after implementing solutions to ensure risks have been sufficiently reduced or eliminated.
6. Increase Accountability
To guarantee that high-risk vulnerabilities are promptly fixed, ensure that IT security teams assume accountability for fully remediating discoveries under the direction of leadership.
7. Concentrate on High-Risk Areas First
Databases, cloud repositories, medical devices, EHR systems, and other assets that hold patient medical records should be the main focus of initial testing.
To have the greatest impact, healthcare penetration testing should be carried out as an ongoing program that addresses many risks rather than as a one-time event.
Summary
Penetration Testing in healthcare has become a mandatory practice. It assists in identifying security flaws, guarantees adherence, and safeguards private patient information before actual dangers materialize. Platforms providing Penetration Testing as a service, such as Astra’s PenTest Suite, enable healthcare organizations to lower risks, take a proactive approach, and strengthen their digital defenses, protecting patient trust and operations.
