An insider threat, whether deliberate or accidental, can cause long-lasting harm to a healthcare organization. These threats can circumvent an organization’s perimeter security measures to gain access to sensitive information, such as a patient’s protected health information (PHI). As a growing cyber issue, an insider threat nowadays could cost a healthcare provider as much as $16.2 million.
See also: HIPAA compliant email: The definitive guide
The Health Insurance Portability and Accountability Act (HIPAA) sets the rules and regulations surrounding access to and disclosure of PHI. The HIPAA Privacy Rule establishes the national standards to protect PHI, while the Security Rule creates a framework for the defense of electronic PHI (ePHI). To enhance data confidentiality, healthcare organizations must prioritize HIPAA compliance by using strong security measures.
HIPAA compliance promotes strong security, especially as data breaches in the healthcare industry increase. According to reports, the total number of individuals affected by healthcare data breaches from 2005 to 2019 was 249.09 million. Of these, 157.4 million individuals were impacted in the last five years alone. New data also shows that healthcare data breaches exposed 170 million records in 2024.
Common examples of breaches that result in exposed PHI include accidental disclosures, theft, lost, or stolen devices, hacking incidents, and phishing/ransomware attacks. The two most widespread types of healthcare breaches are hacking/IT incidents and unauthorized internal disclosures or insider threats. No matter the type, a data breach can have far-reaching consequences and can cause serious accountability and responsibility issues for an organization.
An insider threat in healthcare refers to the risks posed by individuals who have access to a healthcare organization’s information and systems, including employees, contractors, and third parties. The numerous ways for an insider to harm a healthcare provider fall into two main categories: intentional (i.e., malicious) and unintentional (i.e., non-malicious). Generally, insider breaches in healthcare can be caused by a lack of security awareness, weak access controls, and/or employee dissatisfaction.
Intentional insider threats occur when someone with knowledge inappropriately accesses or discloses PHI with malicious intent for espionage, fraud, violence, exposure, or even money. Unintentional insider threats occur when someone discloses PHI without malicious intent. That person might lack awareness about cybersecurity, be too tired to follow guidelines properly, or fail to recognize potential dangers (e.g., a phishing email).
Both types of insider threats are dangerous, becoming more common in healthcare with:
With such threats come privilege abuse, unauthenticated PHI access or disclosure, improper device disposal, and unintentional/intentional sharing with unauthorized parties.
Learn about: 3 insider threats you need to plan for
The longer a threat goes undetected, the more damage it can cause to a healthcare organization.
Read more: Human factors in electronic health records cybersecurity breach: An exploratory analysis
Boston-based Mass General Brigham terminated two employees after discovering a data breach in April 2024. The organization determined that the employees had allowed an unauthorized individual to access patient data within its system for more than a year. The PHI exposed included patients’ names, addresses, medical record numbers, birthdates, email addresses, phone numbers, health insurance policy numbers, and clinical records.
Since the incident, the healthcare organization has said that it has strengthened its cyber safeguards, enhanced employee training, and refined its security alert system.
The Cancer Care Center of North Florida recently disclosed that it was the victim of an email phishing incident in December 2024, as well as a network hacking incident in March/April 2025. Both were due to a careless employee. Exposed PHI from the two breaches included patients’ names, addresses, birthdates, financial account details, diagnoses and lab results, medications, treatment information, health insurance and claims records, provider names, and dates of treatment.
As the information was just disclosed to the Office for Civil Rights (OCR) in July/August 2025, the repercussions are still unfolding.
The consequences of insider threat breaches are severe. Compromised medical records can lead to identity theft, financial losses, and reputational harm for patients. Organizations can face hefty fines and penalties for HIPAA violations and reputational damage that can affect patient trust and long-term viability. Insider threats prove to be costly to resolve, with an average price tag of $676,517 in 2024 for negligence and $715,366 in 2025 for malicious intent.
Insider threats not only harm individual healthcare organizations but can have ripple effects on the entire healthcare ecosystem. For example, insider threats influence insurance premiums for healthcare organizations, making it more expensive for them to protect themselves against such risks. They can erode trust in the healthcare sector, as the public can become more wary of sharing their sensitive health information.
In turn, this can hinder data-sharing initiatives, research collaborations, and the development of patient-centric healthcare solutions.
Related: What are the consequences of not complying with HIPAA?
The reality is that an insider data breach can occur; if they do, healthcare organizations must know what to do to mitigate the situation. Healthcare providers need to continuously monitor their systems after a breach for any anomalies and/or strange behavior. If an organization suspects that its system has been breached, it should identify and confirm the situation, then take steps to stop the leak of PHI.
Healthcare organizations can begin to reduce the impact of an inside breach by updating and then implementing more rigorous security measures. Organizations must also employ measures to halt potential harm, such as retrieving sensitive information from the affected system and providing emergency training to staff. They should also conduct thorough security audits and compliance reviews to identify vulnerabilities further.
After detection and investigation, organizations must also follow the Breach Notification Rule and notify affected individuals, OCR, and the media. Swift and transparent communication helps lessen the fallout and indicates an organization’s commitment to rectifying a breach and ensuring it does not occur again.
Proper mitigation after a breach can keep more patient data from being exposed and protect a healthcare organization from committing a HIPAA violation.
HIPAA compliance involves continuously updating security measures to protect sensitive health information and to avoid breaches like insider threats. One of the first steps toward HIPAA compliance is conducting a risk assessment. This assessment helps identify vulnerabilities and develop strategies to address them. Other steps to avoid insider threats include:
HIPAA compliance regulations aim to protect patient and employee health information. Adhering to HIPAA standards helps providers protect patient privacy, leading to strengthened relationships and better patient outcomes.
Insider threats are security risks that come from within an organization, involving employees or contractors who misuse access to harm the organization, either intentionally or accidentally.
A data breach occurs when sensitive, protected, or confidential data is accessed, disclosed, or stolen without authorization.
Signs of a potential insider threat include employees accessing patient records they don’t typically handle, unusual activity during nonworking hours, or excessive data downloads without clear justification.
Implementing role-based access controls ensures that employees only have access to the information necessary for their job functions, minimizing the risk of misuse while maintaining operational efficiency.
HIPAA's breach notification requirements mandate that healthcare providers, insurers, and their business associates must notify affected individuals, the Department of Health and Human Services, and sometimes the media, within 60 days of discovering a data breach involving PHI.