As cyber incidents surge and breach costs climb, healthcare providers face a new wave of AI-driven threats that require health IT teams to rethink security assumptions and bolster defenses.
Healthcare organizations faced more reported cyberthreats in 2024 than any other U.S. critical infrastructure sector, with 444 incidents—238 ransomware attacks and 206 data breaches—according to the FBI’s Internet Crime Report. Moreover, data breaches in healthcare now cost an average of $10.9 million per incident, the highest across any industry.
The good news is that sharing threat intelligence and defensive measures across organizations has increased, and clinical continuity protocols can help minimize the impact on patient care. Even so, traditional security measures are struggling to keep pace with adversaries using advanced tools like generative AI.
For healthcare providers handling sensitive patient information under HIPAA, the question is no longer whether they will be targeted, but whether their defenses can withstand the attack when it comes.
The evolution of the phishing threat
Five years ago, most phishing emails were relatively easy to spot. Grammatical errors, generic greetings, and suspicious sender addresses often alerted security teams and staff in time to act. Today’s AI-powered attacks are becoming far more sophisticated.
Large language models (LLMs) can now create contextually appropriate emails that mirror legitimate business communications with unsettling accuracy. Attackers feed these systems publicly available information scraped from LinkedIn profiles, hospital websites, and even vendor directories to create highly targeted attacks.
And healthcare organizations are a prime target. Patient records sell for multiples of the value of credit card data on dark web markets. Organizations coordinate with dozens of vendors, payors, and partner organizations, creating a sprawling attack surface. Many also run legacy systems that weren’t designed with modern threat actors in mind.
The identity-first imperative
The traditional security model was built around the concept of a fortress: high walls, strong gates, and the assumption that once you’re inside, you belong there. Today’s attacks don’t just breach firewalls, they exploit stolen credentials to log in as trusted users.
Instead of focusing resources primarily on keeping intruders out, you need systems that constantly ask: “Should this person be accessing this resource right now?” Every login should be considered a possible risk, with access restricted to only what the user needs in the moment. It’s more friction than the old model, but with AI-enhanced phishing climbing, stronger habits need to become standard practice.
Email security as the first line of defense
Email remains the primary delivery mechanism for phishing attacks, which means your email security infrastructure needs to be sophisticated. Many advanced threat protection platforms incorporate their own machine learning models to detect anomalies that traditional spam filters miss, analyzing sender behavior patterns, link destinations, and message content for subtle inconsistencies.
But technology implementation requires the right configuration. Start by enforcing DMARC, SPF, and DKIM authentication protocols across your domain. These technical standards verify that emails claiming to come from your organization actually originate from authorized servers, making it harder for attackers to spoof your leadership or IT department in internal phishing campaigns.
Enable sandboxing features that detonate suspicious attachments in isolated virtual environments before they reach end users. Configure your system to add clear visual warnings to emails originating outside your organization. A simple banner can interrupt the automatic trust users place in their inbox. And don’t just flag high-risk messages; quarantine them entirely, requiring security review before delivery.
Authentication is your safety net when phishing succeeds
Here’s an uncomfortable truth: some percentage of phishing attempts will succeed. Someone will click the link. Someone will enter credentials. Your security strategy must account for this inevitability, which is where multi-factor authentication (MFA) becomes non-negotiable.
MFA adds a second verification step beyond passwords, typically requiring a code from a mobile device, biometric scan, or physical security key. Microsoft reports that MFA can block 99.9% of account compromise attacks, even when credentials have been phished. For healthcare organizations, this means implementing MFA everywhere that matters: EHR systems, email accounts, VPN access, administrative portals, and any system touching patient data.
Not all MFA is created equal, however. SMS-based codes can be intercepted through SIM-swapping attacks. Push notification fatigue can lead to inadvertent approvals. The gold standard is phishing-resistant MFA using FIDO2 security keys or platform-based biometric authentication. These methods verify the destination URL cryptographically and prevent attackers from completing authentication even when credentials are stolen.
Endpoint protection and zero trust architecture
The moment a user clicks a malicious link or downloads a compromised attachment, the playing field shifts to the endpoint: the laptop, workstation, or mobile device they’re using. Modern endpoint detection and response (EDR) solutions provide real-time monitoring for suspicious behavior that traditional antivirus misses.
These platforms watch for unusual patterns: a Word document spawning unexpected processes, credential dumping attempts, lateral movement across your network, or connections to known command-and-control servers. When detected, they can automatically isolate the compromised device, preventing the infection from spreading to your EHR database or file servers.
Pair this with zero trust principles, or “never trust, always verify,” and you create defense in depth. Zero trust means that even authenticated users on your network don’t automatically get access to everything. Segment your network so that a compromised workstation in billing can’t reach your imaging servers. Enforce least-privilege access so users only see the systems and data they absolutely need. This containment strategy turns what might have been a catastrophic breach into a manageable incident.
The human firewall: Training that actually works
Technology alone won’t solve this problem. Your staff, from clinicians to administrators to billing specialists, are both your greatest vulnerability and your most powerful defense. The difference lies in training quality and frequency.
Ditch the annual 90-minute compliance video. Instead, implement continuous security awareness programs that deliver bite-sized training monthly and run realistic phishing simulations using AI-generated scenarios tailored to healthcare contexts. These simulations should mimic the actual threats you face like fake vendor communications about EHR updates, spoofed insurance verification requests, or fraudulent patient portal notifications.
Track your metrics continually. What’s your click-through rate on simulated phishing? How many users report suspicious emails? Most importantly, how are these numbers trending over time? Organizations that run consistent simulations can see click rates drop significantly over time.
Create a culture where reporting suspicious emails is rewarded, not punished. Make it easy with a dedicated security email address or a “report phishing” button integrated into your email client. And when someone does fall for a simulation, use it as a learning moment with immediate, constructive feedback rather than disciplinary action that breeds silence.
Technical controls: Hardening the attack surface
Beyond the foundational defenses, several technical controls can reduce your risk exposure. URL rewriting services scan and rewrite links in emails, checking their actual destination at the moment of click rather than when the email arrives, catching attacks that weaponize legitimate but compromised websites or use time-delayed redirects.
Disable macros by default in Microsoft Office documents across your organization. While some legitimate workflows require macros, the vast majority don’t, and macro-enabled documents remain a favorite delivery mechanism for malware. For departments that genuinely need this functionality, implement application whitelisting that only allows approved, digitally signed macros to execute.
Consider restricting file types on email attachments. Does your organization really need to receive executable files, script files, or compressed archives via email? For most healthcare organizations, the answer is no. Block them at the gateway.
Browser isolation technology takes a different approach: when users click potentially risky links, the web page renders in a remote cloud environment, with only a safe visual stream sent to the user’s browser. Even if the site is malicious, it can’t infect the endpoint because the code never actually executes locally.
When prevention fails: Incident response
Despite your best efforts, assume compromise will eventually occur. Your incident response plan should detail exactly what happens when an employee reports a suspected phishing attempt or, worse, realizes they’ve provided credentials to an attacker.
Establish clear reporting channels like a dedicated security hotline or email that’s monitored 24/7. Create playbooks that outline immediate actions: forced password resets for affected accounts, termination of active sessions, activation of network segmentation protocols to contain potential spread. Your response team needs to quickly determine whether protected health information (PHI) was accessed or exfiltrated, which triggers HIPAA breach notification requirements with strict timelines.
Post-incident, conduct thorough analysis. How did the attack bypass your filters? What made it convincing? What would have stopped it? Use each incident to refine your defenses and update your training scenarios.
Building resilience in an AI-powered threat landscape
AI-generated phishing represents a shift in the cybersecurity landscape. Your response must be equally sophisticated, layering technical controls, authentication requirements, endpoint protection, and human awareness into a defense strategy where no single point of failure brings down the entire system.
The organizations with the best defenses aren’t those that prevent every attack (an impossible standard) but those that detect and contain breaches before they become catastrophic, that maintain operational resilience under pressure, and that foster security-conscious cultures from the C-suite to the front desk.
With the right data, you can find the facilities most in need of stronger digital defenses. Sign up for a demo today to see technology insights in action.
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