By Zac Amos, Features Editor, ReHack
LinkedIn: Zachary Amos
LinkedIn: ReHack Magazine
Healthcare IT leaders already understand that attackers have them in their sights, but the gulf between knowing and acting remains wide. Penetration testing — or pen testing — closes that gap by providing proof of how systems can be breached and data exfiltrated.
Why Pen Testing Cannot Wait
In 2024, an average of 61 significant healthcare data breaches occurred every month, and in March 2025, 1,754,097 people had their private health information stolen, exposed or disclosed without authorization due to data breaches.
These numbers illustrate what every compliance team sees in audit logs — electronic protected health information (ePHI) is lucrative, and attackers move stealthily and fast. Pen testing turns passive risk registers into actionable findings.
7 Proven Practices for a More Secure Program
An effective pen testing program gives healthcare security teams tangible evidence of where defenses can fail and what that failure would mean for patients and clinicians. Implementing the program begins with clear ground rules and ends with verification that fixes are in place. These best practices keep the process practical and realistically aligned with hospital operations.
1. Choose Testers Fluent in Healthcare Standards
Pen testers familiar with DICOM, HL7, FHIR and FDA guidance can uncover device-specific flaws that generalists miss. Vendors should demonstrate sector experience and sign business associate and non-disclosure agreements before any data is touched.
2. Align Scope with Business and Clinical Workflows
Healthcare IT professionals should target the applications and devices that keep care moving — such as electronic health record sessions, patient-facing portals and infusion pumps on the network — so risk scores translate directly into safety, downtime and revenue metrics. Focusing on real-world impact secures executive support and budget.
3. Include Social Engineering and Impersonation Scenarios
Attackers may impersonate senior clinicians or executives to coerce staff into handing over credentials. Some hacks exploit authority and forge documents to bypass technical controls. Testing for these scenarios reveals weak approval paths and sharpens employee awareness. Implement phishing, vishing and pretexting training modules to reflect modern, blended tactics.
4. Follow the Cadence in the Draft HIPAA Security Rule
The December 27, 2024 Notice of Proposed Rulemaking calls for enterprise-wide penetration tests at least every 12 months and vulnerability scans every six months. Scheduling to this rhythm shows auditors and cyber-insurers that the organization is preparing for the rule’s final form.
5. Report in Plain Language and Map Findings to HIPAA Controls
The HIPAA §164.308(a)(8) security policy requires ongoing technical evaluations. Translating each exploit into the exact implementation specification it violates helps IT, compliance and clinical leaders prioritize remediation and track progress.
6. Retest and Validate After Fixes
IT professionals should conduct a focused retest after patching critical issues. A clean retest report gives boards, regulators and insurers proof that the company does not leave gaps open for another audit cycle.
7. Go Beyond a Pure Risk-Mitigation Mindset
A culture built solely around risk mitigation is reactive, limited in scope and resource-intensive — often burning out staff with constant firefighting. Embedding pen testing into a more extensive, proactive safety program allows teams to prevent issues rather than chase them.
Pen testing satisfies HIPAA’s technical evaluation standards. The proposed Security Rule refresh adds explicit testing intervals, multi-factor authentication and network segmentation rules. Implementing these best practices produces artifacts — such as scope documents, retest reports and exploit evidence — that map directly onto these controls and reduce audit preparation time.
Bad actors target the least-trained employee with convincing spoofs of authority. Impersonation testing exposes weak approval paths in ePHI and educates staff under realistic pressure, reinforcing that security is everyone’s job.
Turning Tests into Trust
Pen testing delivers value only when every finding becomes an action item with an owner and a deadline. Healthcare systems that fold those actions into their regular cadence can see breach probability fall, insurance terms improve, and incident response costs shrink. The message to boards, clinicians and patients is the same — security investments pay operational dividends