Phishing remains the top entry point, often slipping past defenses through spoofed domains that lack proper SPF, DKIM, or DMARC controls. Once inside, attackers can steal credentials, spread malware, encrypt files, and expose protected health information, disrupting everything from patient communication to clinical operations. Human error makes the problem worse, with a single click sometimes leading to breaches that affect hundreds of thousands of records.
While HIPAA requires safeguards such as encryption and access controls, compliance alone does not stop these attacks. Even fully compliant organizations are frequently compromised through email. An example of this was seen recently when, in late 2025, Excellent Home Care Services in New York reported that an unauthorized party accessed an employee’s email account.
HIPAA compliance comes down to how well messages containing protected health information (PHI) are secured, controlled, and tracked. At a minimum, this means encrypting emails in transit and at rest so patient data cannot be read if it’s intercepted. It also requires strict access controls, ensuring only authorized users can view sensitive messages, along with authentication measures that verify the identity of both senders and recipients.
As one health informatics Biomedical Informatics Inisghts review puts it, “Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule.” HIPAA compliant email systems must also maintain audit logs that show when messages are sent, received, accessed, or altered, creating accountability and supporting breach investigations if something goes wrong.
Infrastructure attacks target the central systems that keep hospitals running, networks, devices, and digital platforms that support patient care, to disrupt operations. Ransomware is a common example, locking down electronic health records, imaging systems, and hospital IT. The WannaCry attack showed just how serious this can be, forcing parts of the UK’s NHS to cancel surgeries, reroute ambulances, and shut down equipment because outdated systems hadn’t been patched.
What makes these attacks especially dangerous is how interconnected healthcare has become. A single compromised device can open the door to wider failures, delayed treatments, canceled procedures, and millions of dollars in losses from downtime and legal fallout. The attacks exploit healthcare’s reliance on aging technology and its urgency to restore operations quickly. Even the strongest data protections mean little if the systems that deliver care are brought to a standstill.
In a lot of healthcare cyberattacks, everything begins with a single email. Phishing messages are often the first step attackers use to break into a hospital’s systems. They’re designed to look harmless, so when someone clicks a link or opens an attachment, malware slips in quietly. From there, it doesn’t just stay in the inbox. As one study ‘Cloud-based email phishing attack using machine and deep learning algorithm’ explains, “Phishing is a fraudster’s technique used to get sensitive data from users by seeming to come from trusted sources.” Once that happens, the threat doesn’t stay in the inbox; it spreads to email servers, patient records, and the digital tools staff depend on every day.
Once attackers gain that foothold, the situation can escalate fast. Ransomware can shut down entire networks, sensitive patient information can be stolen, and stolen passwords can open the door to even more needed systems. Many major healthcare incidents have followed this exact pattern, starting with a phishing email and ending with disrupted care, delayed treatments, or systems taken offline for days. The same research captures the scale of the problem plainly, noting that “the main problem is email phishing attacks while sending and receiving the email.”
Even well-trained employees can be caught off guard by a convincing message, and it only takes one mistake to give attackers ongoing access. Cloud-based email hasn’t changed that reality. Attackers now use smarter tactics to make their messages harder to spot, blending in with everyday communication until it’s too late.
At its best, it’s one of the ways healthcare organizations protect themselves from very real cyber threats. The Security Rule pushes hospitals and clinics to think seriously about how they handle patient data, from training staff to spot phishing emails to making sure outside vendors follow the same security standards. One Applied Clinical Informatics study found, “More than half (56%) reported a breach involving a third party in the last 12 months.” In other words, the risks don’t just come from inside the organization; they often come through partners and vendors that need access to systems and data.
Since so many healthcare breaches begin with a single phishing email, smarter tools are needed at the inbox level. Generative AI systems can scan messages in real time, looking at everything from sender behavior to suspicious links and unusual language patterns. These tools adapt as attackers change tactics. They can spot threats that would otherwise slip through, quarantine risky messages automatically.
When combined with HIPAA’s security requirements, AI-driven email protection turns compliance into something more than a checklist. It becomes an active defense strategy. Email is often the front door for attackers, and strengthening it helps prevent problems from spreading to patient records, internal systems, and even medical devices.
AI looks at patterns in language, sender behavior, and message history to spot signs that an email isn’t what it claims to be.
Most systems quarantine the email so IT teams can quickly review and release it if needed.
No, AI supports security teams by handling routine threats so people can focus on complex investigations.
AI is especially effective at stopping spear-phishing by learning who executives normally communicate with and flagging impostors.