Penetration Testing for Healthcare | HIPAA-Aligned Security Assessments

Healthcare Cybersecurity → Penetration Testing

Find Vulnerabilities Before Attackers Do

Healthcare penetration testing identifies weaknesses in your EHRs, medical devices, and networks—so you can fix them before they're exploited.

In 2024, healthcare organizations suffered 276 million breached records—a 64% increase from 2023. Every vulnerability is an entry point. Every unpatched system is a risk. And with the proposed HIPAA Security Rule updates requiring annual penetration testing by December 2024, hospitals can't afford to wait.

Regular penetration testing helps you:

  • Identify exploitable weaknesses before threat actors find them
  • Validate that security controls actually stop attacks
  • Meet insurer expectations and prepare for regulatory audits
  • Protect patient care systems from ransomware and disruption

New HIPAA Requirement

HHS proposed on December 27, 2024 that all covered entities and business associates conduct penetration testing at least once every 12 months by qualified professionals.

This is currently a proposed rule under review, but signals where compliance is headed.

What Gets Tested in a Healthcare Penetration Test

Healthcare environments aren't like corporate networks. You have clinical systems that can't go offline, medical devices that can't be patched, and legacy infrastructure supporting patient care. Our testing accounts for all of it.

Healthcare attack surface diagram

Electronic Medical Records (EMRs/EHRs)

  • Authentication and access controls
  • SQL injection and XSS vulnerabilities
  • API security for integrations
  • Session management flaws
  • PHI exposure risks

Medical Devices (IoMT)

  • Weak or hardcoded credentials
  • Unencrypted data transmission
  • Outdated firmware vulnerabilities
  • Network segmentation gaps
  • Unauthorized access paths

Network Infrastructure

  • Firewall misconfigurations
  • VPN and remote access security
  • Lateral movement potential
  • Privilege escalation paths
  • Internal vs. external attack surface

Third-Party Integrations

  • Vendor portal access controls
  • Supply chain vulnerabilities
  • API authentication weaknesses
  • Data sharing security
  • Billing system connections

Cloud & Web Applications

  • Patient portal vulnerabilities
  • Cloud storage misconfigurations
  • Telehealth platform security
  • Mobile app weaknesses
  • SaaS integration risks

Physical & Social Engineering

  • Badge access system testing
  • Tailgating and physical access
  • Phishing simulation results
  • Staff security awareness
  • Insider threat scenarios

How Penetration Testing Supports HIPAA Compliance

The HIPAA Security Rule doesn't explicitly require penetration testing—but auditors, insurers, and regulators increasingly expect it as evidence of a proactive security program.

HIPAA Technical Safeguards

Penetration testing directly addresses these Security Rule requirements:

  • §164.308(a)(1)(ii)(A) – Risk Analysis: Identify threats to ePHI
  • §164.308(a)(1)(ii)(B) – Risk Management: Implement measures to reduce risks
  • §164.308(a)(8) – Evaluation: Regular testing and monitoring of security effectiveness
  • §164.312(a)(1) – Access Control: Validate that only authorized users can access ePHI
  • §164.312(e)(1) – Transmission Security: Test encryption and data protection

What Auditors & Insurers Want

During HIPAA audits and cyber insurance reviews, you'll need to demonstrate:

  • Regular security testing beyond vulnerability scans
  • Evidence of remediation for identified issues
  • Documented testing methodology and scope
  • Qualified testers with healthcare expertise
  • Testing that doesn't disrupt patient care

Penetration testing provides audit-ready evidence that you're not just checking compliance boxes—you're actively defending patient data.

Why Healthcare Testing Is Different

Testing a hospital network isn't like testing a bank or a retailer. You're dealing with life-supporting systems, 24/7 operations, and devices that were never designed with security in mind.

Healthcare penetration testing challenges

Medical Device Constraints

Many IoMT devices can't be patched, rebooted, or taken offline for testing. Manufacturers often void warranties if you modify firmware or run aggressive scans.

Our approach: Non-disruptive testing that assesses vulnerabilities without risking device functionality. We identify attack paths to medical devices without directly exploiting them.

24/7 Operations

Hospitals don't have maintenance windows. Emergency departments, ICUs, and surgical suites can't tolerate downtime—even for security testing.

Our approach: Scheduled testing during low-activity periods, phased rollouts across departments, and continuous coordination with your IT and clinical teams.

Legacy Systems

Windows Server 2003 running lab interfaces. Unpatched radiology PACS from 2010. Systems that are too expensive to replace and too critical to take offline.

Our approach: Document risks, identify compensating controls (network segmentation, access restrictions), and provide realistic remediation roadmaps.

Patient Safety

A misconfigured test could delay lab results, disrupt medication orders, or take down clinical communication systems. Patient safety is non-negotiable.

Our approach: Pre-testing validation in isolated environments, real-time monitoring during active tests, and immediate rollback procedures if issues arise.

Our Healthcare Penetration Testing Methodology

We follow industry-standard frameworks (PTES, OWASP, NIST) adapted for healthcare environments, with additional considerations for patient safety and operational continuity.

Step 1: Scoping & Planning

Define What Gets Tested and When

We work with your IT, clinical, and compliance teams to:

  • Identify critical systems, off-limits devices, and testing windows
  • Document emergency stop procedures and communication protocols
  • Set rules of engagement that prioritize patient safety
  • Establish reporting timelines and escalation paths
Step 2: Reconnaissance

Map Your Attack Surface

Using both passive and active techniques, we identify:

  • Publicly exposed systems, domains, and services
  • Network topology, device inventory, and segmentation
  • User accounts, privileges, and access patterns
  • Third-party integrations and vendor connections
Step 3: Vulnerability Assessment

Identify Weaknesses

We scan for known vulnerabilities, misconfigurations, and security gaps using:

  • Automated testing
  • Manual testing
  • IoMT-specific assessments for medical devices
  • Configuration audits for firewalls, VPNs, and access controls
Step 4: Exploitation

Prove the Risk

We attempt to exploit vulnerabilities to demonstrate real-world impact:

  • Gain unauthorized access to EHR records
  • Escalate privileges to domain admin
  • Move laterally from workstations to servers
  • Access medical devices through network paths

Note: All exploitation is carefully controlled, monitored in real time, and immediately stopped if any risk to patient care is detected.

Step 5: Reporting & Remediation

Deliver Actionable Findings

You'll receive:

  • Executive summary for leadership and board reporting
  • Technical report with detailed findings, evidence, and CVSS scores
  • Prioritized remediation roadmap based on risk to patient care and PHI
  • Compliance mapping to HIPAA Security Rule requirements
  • Follow-up retest validation after you've fixed critical issues
Healthcare penetration testing methodology

What Penetration Testing Finds in Real Healthcare Environments

These are anonymized findings from recent hospital penetration tests—issues that vulnerability scans missed, but attackers would exploit:

Unpatched EMR Vulnerability

Finding: Critical SQL injection flaw in patient portal allowed unauthorized access to 50,000+ patient records. Vendor patch was available for 6 months but hadn't been applied because of fear of breaking integrations.

Impact: HIPAA breach notification, potential $1M+ fine, patient trust erosion.

Firewall Misconfiguration

Finding: Firewall rules allowed direct internet access to internal medical imaging PACS system. No VPN required, no MFA enforced. Anyone with the IP address could connect.

Impact: Entire radiology database exposed. Fixed within 24 hours of discovery.

Weak Vendor Access Controls

Finding: Third-party billing vendor had VPN access with domain admin credentials. No MFA, password unchanged for 3 years, and no activity monitoring.

Impact: Lateral movement to entire network. Single compromised vendor account = hospital-wide access.

IoMT Device Exposure

Finding: Infusion pumps and patient monitors on same VLAN as guest WiFi. Hardcoded admin credentials found in device manuals published online. No network segmentation.

Impact: Ransomware could spread from compromised workstation to medical devices within minutes.

Every hospital we test has critical findings. The question isn't "if" you have vulnerabilities—it's whether you find them before attackers do.

Beyond Annual Penetration Testing

Annual penetration tests are valuable—but they're a snapshot in time. Your attack surface changes constantly: new devices connect, software gets updated, configurations drift, and attackers discover new techniques.

That's why leading healthcare organizations are moving toward continuous threat exposure management (CTEM)—ongoing assessment that finds vulnerabilities as they emerge, not months after they appear.

Annual Penetration Testing

  • Point-in-time assessment
  • Meets minimum compliance requirements
  • Findings may be outdated by the time they're fixed
  • Gaps between tests leave exposure windows

Continuous Threat Exposure Management

  • Ongoing monitoring and testing
  • Detects new vulnerabilities as they emerge
  • Validates fixes and tracks risk over time
  • Combines automated scanning with human expertise

We offer both approaches—and can help you determine which is right for your organization based on your risk profile, compliance requirements, and budget.

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Schedule Your Healthcare Penetration Test

Our security team has conducted penetration tests across hospitals, clinics, and healthcare systems nationwide. We understand HIPAA requirements, medical device constraints, and what it takes to test without disrupting patient care.

30-minute call to discuss your environment, compliance requirements, and testing approach. We'll provide a detailed proposal with scope, timeline, and pricing.