Healthcare Penetration Testing: Protecting Patient Data, EHRs, Medical Devices, and APIs

The healthcare sector is one of the most targeted industries for cyberattacks. According to the Indusface State of Application Security H1 2025, exploit attempts on EMRs, test result dashboards, and online consultation platforms grew by 247%, highlighting the sector’s rising exposure. APIs and third-party integrations further expand the attack surface, giving adversaries more entry points to access sensitive patient data.

These breaches are among the costliest, often taking months to detect and remediate as noted in the IBM Cost of a Data Breach Report.  This makes penetration testing essential, as it identifies vulnerabilities across legacy systems, EHRs, IoMT devices, and APIs before attackers can exploit them, safeguarding both patient safety and regulatory compliance.

Why Penetration Testing is Critical in Healthcare

Healthcare IT systems are inherently sensitive because they store highly personal information, including medical histories, insurance details, diagnostic images, and financial data. Beyond confidentiality, patient safety is at stake. Compromised systems can delay care, disrupt medical devices, or corrupt health records, leading to potentially life-threatening situations.

From EHR platforms and APIs to connected medical devices, every layer of this ecosystem presents new entry points for cybercriminals. Penetration testing is critical because it helps healthcare organizations discover and fix these vulnerabilities before attackers exploit them.

One major driver is regulatory compliance. The HIPAA Security Rule (45 CFR §164.308(a)(8)) explicitly requires ongoing technical evaluations, which include penetration testing, to ensure systems remain secure against evolving threats. Failing to meet these requirements not only exposes organizations to fines but also undermines patient trust.

Pen Testing helps identify weaknesses like broken authorization, misconfigured access controls, and unpatched systems all of which attackers frequently exploit to steal PHI or launch ransomware campaigns.

Ultimately, penetration testing builds a proactive security culture in healthcare. Instead of waiting for breaches to happen, organizations can validate defenses, strengthen response plans, and safeguard both patient safety and compliance.

Key Components of Effective Healthcare Penetration Testing

A robust penetration testing program for healthcare provides an active shield across critical digital assets, going far beyond vulnerability scanning. Here are the key components of effective healthcare penetration testing to look for when safeguarding critical systems and patient data:

1. Testing Electronic Health Records (EHRs) and Patient Portals

EHRs are the core of modern patient care, holding vast amounts of Protected Health Information (PHI). Testing should go beyond simply scanning the public-facing pages. It must simulate an authenticated user, such as a doctor, nurse, or patient, to uncover deep-seated vulnerabilities. This includes:

• Logic vulnerabilities: Testing to see if a low-privilege user can access or modify patient data they should not.
• Privilege Escalation: Simulating an attack where a user with limited access could elevate their permissions to view or alter sensitive records.
• Data Exposure: Ensuring that PHI is not exposed through misconfigurations, weak encryption, or insecure data handling.

Indusface certified experts strengthen patient portals and EHR interfaces through comprehensive penetration testing. The methodology covers frontend applications to backend databases, ensuring full vulnerability assessment. With access to continuous DAST scanning, patient portals, EHR systems, and healthcare APIs are actively tested for vulnerabilities, while authenticated testing simulates authorized user access to detect hidden logic vulnerabilities, privilege escalation paths, and sensitive data exposures.

2. Testing APIs and Interoperability

APIs are the backbone of modern healthcare, enabling interoperability between EHRs, mobile apps, and third-party services. Unsecured APIs are a primary attack vector for data exfiltration. Effective testing for healthcare APIs should:

• Cover OWASP API Top 10 and Beyond: Test for common vulnerabilities like injection, broken object-level authorization, and excessive data exposure, while also evaluating healthcare-specific business logic vulnerabilities, such as how patient records are transferred or how medical claims are processed.
• Discover Undocumented Endpoints: Many healthcare organizations have “shadow APIs” that are not officially managed. Testing must discover these hidden endpoints, which often lack security controls.
• Validate Authentication and Authorization: Ensure that APIs correctly validate user identity and enforce proper permissions, preventing unauthorized access to PHI.

Indusface API Pen Testing combines automated “API DAST Scanner” with manual assessments to detect OWASP API Top 10 vulnerabilities and healthcare-specific business logic vulnerabilities, while uncovering undocumented APIs and validating security controls to protect PHI.

3. Testing Internet of Medical Things (IoMT) Devices

IoMT devices, from infusion pumps to patient monitors, are not just IT assets; they are clinical devices where a security breach could directly impact patient safety. Specialized testing is required to ensure these devices are secure. This includes:

• Firmware and Software Security: Analyzing the device’s software bill of materials (SBOM) and firmware for known vulnerabilities and hardcoded credentials.
• Wireless Communication Security: Testing the security of Wi-Fi or Bluetooth connections used to transmit patient data.
• Lab-Based Simulations: Conducting tests in a controlled environment to simulate real-world attacks, such as attempting to disrupt or manipulate a device’s functions.

4. Testing Cloud and SaaS Healthcare Applications

Healthcare organizations are increasingly moving to the cloud, using platforms like Epic and Cerner or other SaaS solutions. Penetration testing of these environments must focus on:

• Configuration and Access Controls: Ensuring that cloud infrastructure and SaaS instances are correctly configured to prevent unauthorized access.
• Data Segregation: For multi-tenant SaaS platforms, testing to ensure that one client’s data cannot be accessed by another.
• Identity and Access Management (IAM): Thoroughly testing authentication protocols to ensure that only authorized personnel can access sensitive cloud resources.

5. Compliance and Reporting Built-In

Healthcare is one of the most regulated industries. For example, HIPAA-aligned schedules require vulnerability scanning at least every six months and penetration testing at least once every 12 months. HIPAA requires covered entities and business associates to conduct regular risk analyses to identify vulnerabilities and implement risk management processes to mitigate those risks, which implicitly includes vulnerability remediation.

A penetration testing program is only effective if its results can be used to demonstrate compliance. Testing should generate:

• Detailed, Evidence-Based Reports: Providing clear, actionable findings with proof of concept for each vulnerability.
• Prioritized Remediation Guidance: Providing a clear roadmap for your security team, focusing on the most critical risks that pose the greatest threat to patient safety and compliance.

Indusface penetration testing ensures comprehensive compliance with detailed reports that highlight vulnerabilities, prioritize risks, and provide actionable remediation guidance. Onboard applications to AppTrana WAAP to virtually patch critical, high, and medium-level vulnerabilities using SwyftComply, generating a clean vulnerability report that supports compliance.

Guarding Patient Data Across Digital Touchpoints

From EHRs to patient portals and APIs, every digital interaction in healthcare carries sensitive information. Indusface combines subscription-based PTaaS for ongoing security coverage with manual penetration testing to uncover deeper, real-world risks, helping healthcare providers protect patient data, maintain HIPAA compliance, and enhance overall digital resilience.

Leverage PTaaS for continuous protection and schedule manual penetration testing to uncover hidden risks before attackers do.

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