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Exposure Management: Healthcare’s Preventive Medicine

Posted by: Asaf Melamed
January 30, 2025
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Most people will agree that healthcare is pretty essential, and ergo, protecting it from threats should be top of any provider’s to do list. Today, understanding cyber threats isn’t just about checking boxes – it’s about recognizing how interconnected systems create opportunities and vulnerabilities at the same time. From electronic health records and connected medical devices to telehealth platforms and payment systems, each digital touchpoint can become a potential gateway for threats. 

What’s more, these exposures don’t exist in isolation; they form interconnected paths where an exposure in one area can cascade into systemic disruption, potentially compromising patient care, privacy, and though it may sound dramatic, even lives. As healthcare organizations continue to undergo digital transformation, having a comprehensive understanding of these cyber exposures and their interconnections is not just a security measure, but a fundamental component of providing safe and reliable healthcare services.

In this blog, we will look at the challenges and drivers in this complex industry, and the strategies these organizations can use to ensure they stay secure.

The Modern Healthcare Security Landscape

While security is important in any industry, healthcare is in a league of its own when it comes to the complexity and scope of challenges for protecting these all important (and potentially life-impacting) systems. Complicated challenges, like the need to march onward towards digital transformation, and the necessity of meeting strict compliance requirements – all while trying to prevent breaches borne from a myriad of attack methods like phishing and ransomware – make this a truly confounding landscape. And don’t forget that many of these organizations are dependent on legacy systems with multiple unpatched vulnerabilities, making them a lightning rod for attackers looking for easy entry. Moreover, the vast amount of data collected and stored at any given healthcare provider is a veritable treasure trove of PII just waiting to be scraped and sold on the dark web. 

Why Traditional Vulnerability Management Efforts Fall Short

Against this backdrop, it’s easy to see why and how traditional vulnerability management methods fail to prevent breaches. Traditional VM relies on periodic scans and inaccurate discovery methods, leading to false positives and a loss of trust. They also lack the business context needed to pinpoint where vulnerabilities reside or how they affect overall risk. Prioritizing CVEs based solely on quantity or severity fails to account for exploitability within a specific environment. And even in teams with ample resources, patching and testing can take an extended period of time, due to complex approval processes, and limited context as to which systems to patch first, and why.

The recent data breach at United Health Group’s subsidiary, Change Healthcare, illustrates the dangers of this siloed approach. The AlphV ransomware group exploited compromised credentials and a lack of multi-factor authentication on a Citrix portal to gain initial access. From there, they moved laterally through the network, exfiltrated data, and deployed ransomware, resulting in the compromise of over 190 million individuals’ data. This incident highlights how seemingly low-risk issues, like compromised credentials, can lead to major consequences when combined with other vulnerabilities and exploitation techniques.

6 Tips to Build a Strong Exposure Management Strategy

This is why building a strong exposure management program is essential for ensuring a living, breathing security ecosystem that changes as threats change. Let’s break down the core components of what this should entail:

  • Understand Your Attack Surface

Gone are the days when simply scanning your network periodically for vulnerabilities was enough. Healthcare providers need a comprehensive view of their attack surface that includes everything from IoT medical devices to cloud-based telehealth platforms. Analyzing hybrid attack vectors via attack graphs helps identify not just where vulnerabilities exist, but how they could be exploited and used in toxic combinations with other exposures to reach business-critical assets. As an example, a seemingly low-risk vulnerability in a patient portal could provide the foothold needed to access critical systems. Through attack path analysis, organizations can find vulnerabilities and exposures that traditional scans miss. 

  • Leverage Smart Prioritization

Healthcare organizations can’t chase every alert, considering the limited resources and countless exposures. Smart prioritization understands which alerts pose the greatest risk to the specific environment. This goes way beyond CVSS scores, and is all about understanding business context. An exposure in a critical care system should take precedence over the same exposure in a non-critical system.

Optimal prioritization helps security teams focus on what matters most. By incorporating factors like asset criticality, exposure to the internet, and potential impact on patient care, organizations can make more informed decisions about where to direct their resources.

  • Ensure Proper Configuration Management 

Healthcare environments are a lot more susceptible to configuration errors, owing to their complex mix of legacy systems, modern cloud applications, and specialized medical devices. Common misconfigurations include:

  • Improper network segmentation between clinical and administrative systems
  • Default credentials left unchanged on medical devices
  • Excessive permissions in cloud environments
  • Misconfigured remote access solutions

Automated detection and correction of misconfigurations is super important, as manual processes can’t keep up with the rate of change in today’s healthcare environments.

  • Set up Real-time Security Posture Management

In healthcare, system availability can literally be a matter of life and death so real-time security monitoring isn’t optional – it’s essential. In this case, we need to ensure:

  • Continuous monitoring of all assets, from MRI machines to mobile devices
  • Immediate detection of unauthorized changes or suspicious behavior
  • Automated response capabilities for known threats
  • Regular testing of backup and recovery procedures

  • Continually Reduce Risk

Today’s healthcare networks are increasingly complex, combining on-premises systems, cloud infrastructures, and SaaS applications. Any comprehensive exposure management strategy must provide comprehensive protection across this hybrid landscape, ensuring seamless security regardless of where assets reside. This means implementing unified controls and monitoring capabilities that can adapt to different environments while maintaining consistent protection levels, and protecting the entire IT ecosystem as one cohesive unit.

  • Invest in Compliance 

In the heavily regulated healthcare sector, compliance isn’t just a checkbox exercise – it’s a fundamental business requirement. An effective exposure management strategy must include automated reporting and continuous monitoring capabilities that align with frameworks like ISO, 27001, NIS2 or comply with the standards of HIPAA. This proactive approach helps organizations meet current regulatory requirements and adapt to new compliance mandates, to ensure legal and industry standards are continually met.

The Wrap-Up – Healthcare is Only Getting Sicker, Treat it Now

The diagnosis is in, and the treatment is clear – what health care orgs need to stay secure is a comprehensive exposure management program. As healthcare becomes increasingly digital, understanding cyber exposures and how they interconnect is essential. It’s not just about security; it’s about providing safe and reliable healthcare. 

 


Asaf Melamed

Asaf Melamed is a Customer Success Manager in the DACH team at XM Cyber, ensuring the success of enterprise organizations across the region, protecting their critical business system processes and assets.

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