Healthcare Cybersecurity

Cl0p Mass Exploiting Zero-day Vulnerability in Oracle E-Business Suite

A zero-day vulnerability in Oracle E-Business Suite is under active exploitation by the Cl0p ransomware group. The vulnerability is tracked as CVE-2025-61882 and has a CVSS base score of 9.8 out of 10. The flaw is present in the BI Publisher Integration component of Oracle’s Concurrent Processing product within the Oracle E-Business suite, and can be exploited remotely by an unauthenticated attacker, leading to remote code execution. The vulnerability can be exploited by an unauthenticated attacker with network access via HTTP and will allow Oracle Concurrent Processing to be compromised.

Google’s Threat Intelligence Group and Mandiant first warned about attacks exploiting the vulnerability on October 2, 2025, when organizations started reporting that they had received demands for payment from the Cl0p threat group. Oracle published a security advisory about the vulnerability on October 4, 2025, and released a patch to fix the flaw. CrowdStrike believes with moderate confidence that a threat group tracked as Graceful Spider is mass exploiting the vulnerability.

Graceful Spider is a Russia-linked threat group known to conduct attacks with the Cl0p group. The vulnerability has been exploited in the wild since at least August 9, 2025, and a proof-of-concept exploit for the vulnerability has been published by the threat group Scattered LAPSUS$ Hunters. The threat intelligence firm WatchTowr has confirmed that the PoC exploit is real. Since valid exploit code is in the public domain, it is possible that multiple threat groups are now exploiting the vulnerability. WatchTowr reports that the exploit chain involves five separate bugs to achieve pre-authentication remote code execution, including some that were patched by Oracle in its July 2025 Critical Patch Update. WatchTowr explained that the exploit demonstrates a high level of skill and effort.

The vulnerability affects Oracle E-Business Suite versions 12.2.3 to 12.2.14, and may also exist in older, unsupported versions. Any organization that has Oracle E-Business Suite exposed to the internet is at risk, and given that the mass exploitation attempts have been ongoing for more than a month, there is a risk that the vulnerability has already been exploited and that the Cl0p group has yet to reach out to demand payment. According to the cybersecurity firm Resecurity, Cl0p has been reaching out to victims via compromised business email accounts and newly registered accounts.

Users of Oracle E-Business Suite should follow the advice in the Oracle security alert and ensure that they upgrade to a supported version and install the latest update. The update requires Oracle’s October 2023 Critical Patch Update to be applied before the patch for the CVE-2025-61882 vulnerability is applied. After applying the patch, Oracle E-Business Suite users should look for indicators of compromise to determine if the vulnerability has already been exploited. The IoCs have been shared in the above-linked Oracle security alert.

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Critical GoAnywhere Vulnerability Exploited in Medusa Ransomware Attacks

A critical vulnerability in Fortra’s GoAnywhere MFT secure web-based file transfer tool is being actively exploited in Medusa ransomware attacks. According to Microsoft’s Threat Intelligence Team, the vulnerability is being exploited by a threat group it tracks as Storm-1175, which is known for deploying Medusa ransomware after exploiting vulnerabilities in public-facing applications.

The zero-day deserialization vulnerability is tracked as CVE-2025-10035 and has a maximum CVSS base score of 10. According to Fortra, a threat actor with a validly forged license response signature could deserialize an arbitrary actor-controlled object. Successful exploitation of the flaw can result in command injection without authorization, which can potentially lead to remote code execution. Fortra issued a security advisory about the flaw on September 18, 2025, and explained that the vulnerability affects the GoAnywhere MFT’s License Servlet Admin Console version 7.8.3 and prior versions. The vulnerability has been fixed in version 7.8.4 and the Sustain release 7.6.3.

Microsoft detected attacks exploiting the vulnerability at multiple organizations on September 11, 2025, although the threat intelligence company watchTowr believes that attacks started on September 10, 2025, more than a week before Fortra issued its security alert. Microsoft has observed Storm-1175 dropping remote monitoring and management (RMM) tools such as SimpleHelp and MeshAgent for persistence, and in some cases, creating .jsp files within GoAnywhere MFT directories.

The group establishes persistence, sets up secure C2 communications, and deploys additional tools and malware payloads to facilitate network discovery and lateral movement. The latter is achieved using mstsc.exe. The group identifies and exfiltrates sensitive data and has used Rclone for data exfiltration in at least one attack. After data exfiltration, the group deploys Medusa ransomware to encrypt files.

All users are advised to immediately ensure that the GoAnywhere Admin Console is not exposed to the Internet and to update GoAnywhere to the latest version. Since the vulnerability has been exploited since at least September 11, 2025, patching alone is not sufficient. After updating the software, users should investigate for signs of compromise. “Customers are advised to monitor their Admin Audit logs for suspicious activity and the log files for errors containing SignedObject.getObject: If this string is present in an exception stack trace (similar to the following), then the instance was likely affected by this vulnerability,” explained Fortra in its security alert.

The U.S. Cybersecurity and Infrastructure Security Agency (CISA) added the vulnerability to its Known Exploited Vulnerability Catalog on September 29, 2025, and requires all federal civilian agencies to implement Fortra’s mitigations by October 20, 2025.

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Healthcare Cyberattacks Costing $200K+ Rise 400% in a Year

Over the 12 months from March 2024 to March 2025, almost half of healthcare organizations experienced at least one data incident, such as a ransomware attack, hacking incident, or phishing attack, according to the cybersecurity firm Netwrix. For its 2025 Cybersecurity Trends Report, Netwrix surveyed 2,150 IT professionals from 121 countries in March 2025 and compared the findings to previous surveys conducted in 2024, 2023, and 2020.

Healthcare has long been targeted by threat actors due to the high value of patient records, and the fact that healthcare organizations cannot tolerate disruption, as it puts patient safety at risk. The sector is extensively targeted by ransomware groups as there is a higher probability that the ransom will be paid to prevent the publication of stolen data and ensure a fast recovery. In the past 12 months, 48% of healthcare organizations experienced at least one security incident that required a dedicated response from the security team.

Across all sectors, the number of organizations reporting no impact from security incidents is rapidly reducing. In 2023, 45% of respondents said there was no impact from security incidents, whereas in 2025 the percentage had fallen to just 36%. In 2024, 60% of organizations reported suffering financial damage due to cyberattacks, and the percentage jumped to 75% in 2025. Across all sectors, the number of organizations reporting financial damage of at least $200,000 almost doubled from 7% in 2024 to 13% in 2025.

Netwrix reports that four times as many healthcare organizations suffered financial losses of at least $200,000 in 2025 as in 2024. In 2024, only 2% of healthcare organizations experienced cyberattack-related losses of more than $500,000, compared to 12% in 2025. The report confirms that healthcare faces the biggest financial impact from cyberattacks. In 2025, 6% of all industries suffered cyberattack-related financial losses of more than $500,000, compared to 12% in healthcare.

The Netwrix survey revealed that almost one-third of healthcare organizations experienced security incidents involving compromised user/admin accounts. Phishing remains the most prevalent threat, and attacks are becoming harder to identify due to attackers’ use of AI tools for their phishing and social engineering campaigns. 37% of healthcare respondents said AI-driven threats require stronger defenses.

“Research strongly suggests that attackers are ahead in AI adoption, which is pushing defenders into a reactive posture. Indeed, 37% of survey respondents say AI-driven threats forced them to adjust — that’s a direct reaction to the offensive use of AI by adversaries, “ explained Jeff Warren, Chief Product Officer, Netwrix. “At the same time, 30% haven’t even started AI implementation and are in “considering” mode, indicating a significant lag in adoption. It’s fair to say that attackers are moving faster with AI, and defenders are scrambling to catch up. This asymmetry is not new in cybersecurity, but AI appears to be accelerating it.”

In 2025, the top three threats in the cloud and on-premises were the same. Phishing was the most common cause of security incidents (76% cloud; 69% on-premises), followed by user/admin account compromise (46% cloud; 45% on-premises), and ransomware and other malware attacks (30% cloud; 31% on-premises).

“Ransomware attacks on premises are becoming less frequent, while the rate for cloud infrastructure remains steady,” explained Warren. “As businesses shift critical operations and sensitive data to the cloud, attackers increasingly see cloud workloads as high-value targets worth encrypting or exfiltrating for ransom. And it’s a numbers game, too. Some attackers don’t target the cloud per se; they target everything. As more infrastructure moves to the cloud, the odds of hitting a cloud tenant go up.”

The main challenges for security teams are understaffed IT and security departments, a lack of budget for data security initiatives, mistakes/negligence by business users, and a lack of cybersecurity expertise within the IT and security teams.  Unsurprisingly, given the staffing problems at many organizations, one of the main priorities is the automation of manual IT processes, and while AI tools can help in this regard, it is important to ensure that the tools are not granted excessive privileges and that there is proper governance.

As AI adoption by cybercriminals accelerates, organizations need to respond. Warren suggests that organizations should double down on the basics of zero-trust networking and ensure they are adequately protecting their identity infrastructure, improving resilience by adopting an identity-first approach to protect accounts and the sensitive data they can access.

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Cybersecurity Awareness Month 2025: Building a Cyber Strong America

October is Cybersecurity Awareness Month – a global initiative that aims to educate the public and businesses about the importance of cybersecurity and protecting against cyber threats to systems and data.  The initiative is led by the Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency (CISA), and this year’s theme is “Building a Cyber Strong America. The main focus this year is improving cybersecurity at the government entities and small and medium-sized businesses that operate and maintain the nation’s critical infrastructure, as well as the myriad of vendors and suppliers that support or are connected to critical infrastructure.

Cybersecurity Awareness Month 2025 - CISA

CISA is issuing a call to action to all critical infrastructure entities and vendors that support those entities to take steps to improve cybersecurity, starting with four essential steps to improve baseline security:

  • Avoid phishing
  • Use strong passwords
  • Require multifactor authentication
  • Update business software

Phishing is the initial access vector in many cyberattacks, providing threat actors with the credentials they need to access internal systems and data and conduct a comprehensive attack on the organization.  According to the cybersecurity firm SentinelOne, phishing attacks have increased by 1,265%, with that increase driven by the growth of GenAI. These attacks target employees and trick them into disclosing credentials, opening malicious email attachments, or clicking links that direct them to malicious sites where malware is downloaded. While technical defenses such as spam filters can reduce the number of threats that reach employees, it is vital to train the workforce on how to recognize and report suspicious emails.

A system is only as secure as the password used to protect it, so it is essential that passwords are used that are difficult to guess and are resistant to automated brute force attempts. According to Hive Systems, even a password consisting of 10 random numbers could be cracked in less than a day, compared to 803,000 years for a 10-character password consisting of numbers, upper and lower case letters, and special characters. Strong passwords should be mandatory for all users.

Even strong passwords are not sufficient by themselves, as while they may be difficult to brute force, they can be obtained by threat actors through phishing, for example. Multifactor authentication adds an additional layer of protection, ensuring that a password alone is not sufficient to access accounts, systems, and devices. Implementing multifactor authentication will significantly improve security, and where possible, phishing-resistant multifactor authentication should be implemented.

Threat actors target vulnerabilities in software and operating systems and exploit them to gain access to the networks of critical infrastructure entities and their vendors.  All business software and operating systems should be kept up to date, with patches and security updates applied promptly to fix vulnerabilities before they can be exploited. After completing these four essential steps to improve baseline security, the next step is to level up defenses through additional actions, such as implementing logging on all systems. Logs should be monitored for anomalous activity, including hacking incidents and insider threats.

Ransomware is one of the biggest threats, especially in healthcare. These attacks lock victims out of systems and prevent access to critical data, causing massive disruption to business operations. It is therefore essential to ensure that all critical information is backed up securely, as this will allow a fast recovery in the event of an attack. In addition to making multiple backups and securing one copy off-site, backups should be checked to ensure that file recovery is possible. A backup plan should also be developed to reach the recovery point in the shortest possible time frame.

Data encryption is another key protection to safeguard data at rest and in transit. If a threat actor gains access to files, the data cannot be viewed. Threat information sharing is also a key part of building a strong cyber America. By informing CISA about cyberattacks and sharing pertinent information, CISA can take steps to warn others and help them avoid similar threats.

Healthcare organizations should also consider implementing the cybersecurity performance goals (CPGs) developed by the Department of Health and Human Services in collaboration with CISA. The CPGs set a floor of safeguards that will help prevent successful cyberattacks, and the enhanced CPGs help healthcare organizations mature their cybersecurity capabilities. The 2025 HIPAA Journal Annual Survey indicated a lack of awareness of these important CPGs.

“Critical infrastructure – whether in the hands of state and local entities, private businesses, or supply chain partners – is the backbone of our daily lives,” said Acting CISA Director Madhu Gottumukkala. “Whenever it’s disrupted, the effects ripple through communities across America. That’s why this year CISA is prioritizing the security and resilience of small and medium businesses, and state, local, tribal, and territorial government (SLTT) that facilitate the systems and services [that] sustain us every day. This includes things like clean water, secure transportation, quality healthcare, secure financial transactions, rapid communications, and more. Together, we must make resilience routine so America stays safe, strong, and secure.”

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Cyber Insurance Claims Fall But Ransomware Losses Increase

There’s good and bad news on the ransomware front. Attacks are down year-over-year; however, successful attacks are proving even costlier to mitigate, according to the Mid-Year Risk Report from the cyber risk management company Resilience. The company saw a 53% reduction in cyber insurance claims in the first half of the year, which indicates organizations are getting better at preventing attacks; however, when ransomware attacks succeed, they have been causing increased financial harm, with losses 17% year-over-year. While ransomware accounted for just 9.6% of claims in H1, 2025, ransomware attacks accounted for 91% of incurred losses.

On average, a successful ransomware attack causes $1.18 million in damages, up from $1.01 million in 2024, and the cost is even higher in healthcare. Resilience’s healthcare clients suffered average losses of $1.3 million in 2024, and in the first half of 2025, some healthcare providers faced extortion demands as high as $4 million. While it is too early to tell what the severity of claims will be in 2025 until claims are settled, Resilience said there are indications that the average severity of incurred losses for healthcare ransomware attacks this year could be $2 million, up from an average of $705,000 in 2024 and $1.6 million in 2023.

One of the most active ransomware groups this year has been Interlock, which has attacked many healthcare organizations. In a concerning development, Interlock has been observed stealing cyber insurance policies and using them to benchmark and set higher ransom demands. In at least two ransomware attacks, the threat actor referenced the victim’s cyber insurance policy in the ransom demands, and in at least one case, set the ransom demand to just below the policy payout limit.

Resilience warns that cyberattacks are increasing in sophistication and that AI is increasingly being leveraged for social engineering and phishing campaigns. Social engineering and phishing attacks were linked to 88% of incurred losses in H1, 2025. AI-assisted phishing campaigns are more difficult for users to identify and for organizations to block. The success rate of traditional phishing and social engineering attempts is 12%, compared to 54% for AI-assisted attacks. Resilience reports that 1.8 billion credentials were compromised in H1, 2025 alone, an increase of 800% since January 2025. Social engineering and phishing stood out as leading causes of attacks, along with the inadvertent disclosure of sensitive data due to errors made using tracking technologies.

HIPAA Security Rule Compliance May Not Sufficiently Reduce Risk

Resilience cited one example of a healthcare provider that had invested significantly in cybersecurity yet still fell victim to an attack. The investigation revealed that while reasonable decisions had been made concerning cybersecurity, there were naturally trade-offs due to budgetary constraints. Those tradeoffs meant vulnerabilities were created that were ultimately exploited. Despite investing in cybersecurity, the organization’s risk assessments had not been updated in around four years, which is an aspect of compliance that the HHS’ Office for Civil Rights is actively enforcing due to its importance on security posture.

While the organization initially tested its endpoint protection to ensure it was effective, there was no routine testing after implementation to ensure those measures continued to provide adequate protection. Vendor risk management largely consisted of checks of security policy documents, rather than active monitoring, which only occurred for a few vendors. Incident response plans and disaster recovery exercises failed to consistently meet the organization’s recovery objectives, but the issue was not addressed due to limited resources and competing priorities. Gaps were identified in its backup procedures, as the threat actor was able to encrypt clinical images that had been missed from backups. That gave the threat actor significant leverage in ransom negotiations. The organization found that its assumed security posture bore little resemblance to its actual defensive capabilities.

Cybersecurity Recommendations for Healthcare Organizations

Naturally, there will be cybersecurity tradeoffs with budgetary restrictions, but the security gaps identified in that case study are all too common in healthcare. Resilience suggests that these security gaps are often a consequence of a focus on HIPAA compliance. The problem is that HIPAA only sets baseline standards for security, and the HIPAA Security Rule is more than 2 decades old.  A focus on compliance may help avoid regulatory penalties, but may not effectively reduce risks or adequately protect against modern threats.

“Organizations deploying disconnected security tools without strategic coordination create gaps between systems, while annual assessments become check-box exercises using outdated measures of effectiveness,” suggests Resilience. “Effective healthcare cybersecurity requires quantifying cyber risks in financial terms rather than relying on subjective ratings. Loss exceedance curves model potential impacts based on organization-specific factors, enabling leaders to understand exactly what risks could cost in business disruption, recovery expenses, and regulatory fines. When expressed financially, security discussions shift from technical justifications to strategic investment decisions.”

Based on its analysis of the current threat landscape, Resilience recommends healthcare organizations prioritize the following areas to improve their cybersecurity posture and limit the harm of a successful attack

  • Implement a comprehensive backup strategy with particular attention to imaging files, databases, and system configurations
  • Ensure regular tests are conducted to validate recovery capabilities and timeframes under realistic attack scenarios
  • Treat your cyber insurance policy as part of your crown jewels, and ensure it is properly secured
  • Implement robust training programs that address phishing, social engineering, and proper data handling procedures
  • Ensure there is continuous monitoring of third-party vendors’ security postures
  • Adopt methodologies that translate cyber risks into financial terms to allow leadership to make informed investment decisions based on actual risk reduction potential rather than compliance
  • Implement and regularly test your incident response plan, including patient safety considerations and regulatory notification requirements

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Microsoft Seizes Sites Used by Popular Phishing Operation to Attack Healthcare Orgs

Microsoft has announced the seizure of hundreds of websites used by a popular phishing-as-a-service (PhaaS) operation that targets Microsoft 365 credentials. The operation’s phishing kits have been used to steal at least 5,000 usernames and passwords, including the Microsoft 365 credentials of at least 20 U.S. healthcare organizations.

According to the Microsoft Digital Crimes Unit (DCU), RaccoonO365 is the fastest-growing tool used by cybercriminals to steal Microsoft 365 usernames and passwords. The PhaaS operation provides subscription-based phishing kits, which generate phishing emails mimicking official communications from Microsoft. The emails direct victims to websites that trick victims into disclosing their Microsoft 365 credentials. The phishing kits lower the barrier to conducting phishing campaigns and can be used by even low-skilled individuals to steal credentials.

RaccoonO365 has been offering phishing kits to cybercriminals since at least July 2024. Subscribers are able to use the infrastructure to send up to 9,000 phishing emails per day. A 30-day subscription costs less than $12 per day, and under $10 per day for a 60-day subscription. The phishing kits utilize sophisticated techniques to steal credentials and bypass multi-factor authentication. Recently, RaccoonO365 added a new service that utilizes AI to scale operations and increase the sophistication and effectiveness of phishing campaigns.

The stolen credentials can provide access to accounts and sensitive data; however, they are commonly used to gain a foothold to launch more comprehensive attacks on victims, often leading to malware and ransomware downloads. The attacks have resulted in significant financial losses for healthcare providers and have disrupted critical patient care, putting patients at risk of harm. In addition to the attacks on healthcare organizations, RaccoonO365’s phishing kits were used for an extensive tax-themed phishing campaign that targeted more than 2,300 U.S. organizations worldwide.

MCU identified the leader of the operation, Joshua Ogundipe, who resides in Benin City in Nigeria. Ogundipe has a background in computer programming and is believed to have authored the bulk of the code for the phishing kits. Ogundipe was identified following a security lapse, which allowed MCU to identify a secret cryptocurrency wallet used by Ogundipe. Ogundipe, along with his associates, marketed and sold the RaccoonO365 phishing kits on Telegram and collected more than $100,000 in subscription payments. MCU estimates that between 100 and 200 subscriptions were sold, although that range is likely to be underestimated. Based on that range, subscribers could send between 900,000 and 1.8 million phishing emails per day. MCU’s intelligence has been shared with international law enforcement

Microsoft and Health-ISAC filed a lawsuit in the U.S. District Court for the Southern District of New York against Ogundipe and four John Doe conspirators seeking recovery of damages and the seizure of domains used by the operation. The allegations against the defendants include violations of the Computer Fraud and Abuse Act, Racketeer Influenced and Corrupt Organizations (RICO) Act, and the Electronic Communications Privacy Act.

The DCU investigation identified 338 sites used by the operation, which were seized after a court order was granted. Cloudflare assisted with the seizure of the domains. The domain seizures have caused considerable disruption to RaccoonO365’s operation. “To counter RaccoonO365, we acted swiftly to protect our customers and prevent further harm. But criminals constantly evolve, so Microsoft is evolving too,” explained Steven Masada, Assistant General Counsel and Director of Microsoft’s Digital Crimes Unit. “For instance, we are integrating blockchain analysis tools like Chainalysis Reactor into our investigations. These help us trace criminals’ cryptocurrency transactions, linking online activity to real identities for stronger evidence.

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GAO: HHS Yet to Implement 82 Cybersecurity and IT Management Recommendations

The U.S. Government Accountability Office has written to Clark Minor, Chief Information Officer (CIO) of the U.S. Department of Health and Human Services, advising him about the current open cybersecurity and IT management recommendations that require his attention.

GAO is a non-partisan agency that works for Congress and provides support to ensure it meets its constitutional responsibilities and helps improve the performance and ensure the accountability of the federal government. GAO makes recommendations for improving the government’s performance in IT and related IT management functions, including recommendations for the HHS, yet many of those recommendations have yet to be implemented. In the letter, GAO explained that the HHS currently has 82 open recommendations involving high-risk cybersecurity and IT management issues.

GAO made the recommendations over several years, each relating to a GAO High-Risk area: Ensuring the Cybersecurity of the Nation or Improving IT Acquisitions and Management. Out of the 82 recommendations, at least 37 are considered sensitive, and one has been designated as a priority recommendation. GAO explained in the report that in order to secure the cybersecurity of the nation, the HHS needs to take additional steps to secure the records and information systems it uses to carry out its mission.

GAO had recommended that HHS establish a reasonable time frame for when it will be able to digitally accept access and consent forms from properly identity-proofed and authenticated individuals and post those forms on the department’s privacy program website. GAO has warned that until the recommendation is implemented, the HHS will not be able to adequately protect records from improper disclosure.

HHS’ Office for Civil Rights investigations into potential HIPAA violations have resulted in financial penalties for organizations that have failed to maintain logs of activity in information systems containing ePHI, yet it hasn’t fully implemented effective logging of its own systems, as directed by the Office of Management and Budget. “Until HHS implements this recommendation, there is increased risk that the department will not have complete information from logs on its systems to detect, investigate, and remediate cyber threats,” warned GAO. HHS has also not yet implemented the recommendation that it should improve its incident response guidance, implementation, and oversight.

In the Improving IT Acquisitions and Management category, GAO has recommended that HHS improve its management and tracking of IT resources. For instance, the HHS had previously provided a revised time frame for completing its covered Internet of Things (IoT) inventory, but has still not completed the inventory. GAO warned that there is an enormous array of disparate devices that may be considered part of IoT, and those devices connect to HHS information systems. Until HHS has a complete inventory, it lacks visibility into the IoT devices within its environment, which will hamper its ability to mitigate IoT cybersecurity risks.

HHS had made little progress developing a work plan that includes specific actions to show progress in developing a public health situational awareness and biosurveillance network. Doing so will help to ensure that the HHS has comprehensive capabilities to allow a rapid and efficient response to an infectious disease outbreak. GAO also stressed to the HHS CIO that there are also outstanding recommendations from the HHS Office of Inspector General in the areas of cybersecurity and IT acquisitions and management, including requirements under the Federal Information Security Modernization Act of 2014, which must also be resolved.

Minor only joined the HHS in February and has served as CIO since May 2025. The HHS said in that short time, Minor has made steady progress toward ensuring the highest level of security and performance across its systems.

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What is the Best EMR for Small Practices in 2025?

Whether you are starting a new practice or looking to grow your existing business, choosing the right electronic medical record system (EMR) is key to improving revenues and profits. An EMR is more than a system for managing large data records. An EMR is an invaluable tool at the heart of your practice that facilitates many aspects of your practice’s operations, such as scheduling, payments, insurance billing, record requests, patient engagement, telehealth, patient follow-ups, and HIPAA compliance.

In addition to ensuring accurate patient records, an EMR is an invaluable tool for aiding decision-making, improving efficiency by streamlining documentation, and eliminating manual administrative tasks that inevitably impact revenue-generating activities and patient care. An EMR can significantly improve the patient experience by streamlining scheduling, providing patients with easy access to their health data to improve engagement, and facilitating communication, helping to improve satisfaction and attract new patients.

With an EMR that is the right fit for your practice, you can reduce the administration burden on clinicians and administrative staff and improve efficiency, allowing you to spend more time providing high-quality, personalized, value-based care.

An EMR Streamlines Operations and Improves Efficiency

An EMR improves efficiency, streamlines data management and billing processes, while helping ensure compliance with HIPAA and state laws, but it is vital to get the right EMR solution for your practice that meets your current needs and has the scalability to support your practice as it grows.

There is a myriad of EMRs to choose from, and while Epic and Oracle Cerner are the most commonly used enterprise EMRs, they require a significant investment and are not well-suited for solo providers and small independent practices, as they prioritize operational scale and standardization.

EMRs for small practices are more affordable, easier to use, and offer far greater flexibility, often providing scope for customization to support specialty-specific workflows and value-based individualized care. The best EMR for small practices will allow you to streamline practice operations while meeting your regulatory obligations under HIPAA, EPCS, and other federal and state regulations, allowing you to concentrate on providing the highest quality patient care.

With the right EMR, you will be able to significantly reduce time-consuming administrative tasks, improve clinical accuracy, and deliver a better patient experience, helping you to reduce the churn rate and win more business.

Choosing an EMR for Small Practices

Cost is naturally a key consideration for small practices. Setting up a new practice costs hundreds of thousands of dollars, after which there are likely to be considerable budgetary constraints. You naturally need to get good value for money and a significant return on your investment, but it is important to look past the cost of licenses and initial setup costs, which include data migration if you are changing EMRs. There are often ongoing monthly expenses, add-on costs for integrations and improving core EMR functionality, limited logins, and locked-in insurance billing partners and other vendors.

If you are starting out and have a handful of clients, what works initially may not be sustainable over time. Transitioning to a new EMR when you outgrow your current platform can be time-consuming and costly, with data migration headaches and a long learning curve, which will inevitably negatively impact operations until the staff gets up to speed.

It is therefore important to choose an EMR for small practices that has comprehensive features, supports extensive integrations, with workflow automation allowing for efficient practice management. The solution should incorporate business features, including billing and analytics, while supporting telehealth, electronic prescriptions, and compliance, with scalability to support the changing needs of your practice. The support options should not be overlooked, as if you experience any technical problems or require customizations, assistance should be provided quickly to allow you to rapidly resolve your issues.

A free EMR may seem like the best choice if you have a limited budget and competing priorities. While initially you could save hundreds or thousands of dollars, you may end up paying more in the long term due to limited functionality, a lack of live customer support.  You will generally only get basic features, and the core components generally do not extend to billing, comprehensive reporting, and analytics. Free EMRs are generally only free up to a point and often require an upgrade to a full or premium package to get more than the basic EMR functions. There are also security and compliance risks associated with free EMRs, many of which are open source.

If you have a clear vision for your practice and your area of specialization, a free EMR may be a good choice, but the lack of flexibility can be limiting, and the money saved on capital outlay could be lost – and more. There are, however, excellent low-cost EMRs for small practices with extensive functionality and comprehensive integrations to meet your current and future needs, that are easy to use and support individualized care.

Security and Compliance

Two areas that should not be overlooked are security and compliance. Security needs to be built into the core of the design, as the EMR contains the crown jewels of your business, and hackers are actively targeting small practices. Free EMRs are typically open source, which means the code is available to anyone to inspect, but that doesn’t mean that it has been thoroughly inspected, nor that there is an active community looking at the code to identify security weaknesses. Data leakage and security vulnerabilities can prove extremely costly.

While small practices were once able to fly under the radar, regulators are taking a keen interest in HIPAA compliance at small medical practices. The HHS’ Office for Civil Rights (OCR) has an enforcement initiative on patient access, and in recent years, many financial penalties have been imposed on small providers for noncompliance. The HHS is also cracking down on information blocking, so it is vital that your EMR provides an easy-to-use patient portal and supports seamless health data exchange.

The Best EMRs for Small Practices

The best EMRs for small practices strike a good balance between cost and functionality, providing the functions to meet your operational needs, scalability to grow with your practice, and support to resolve technical or usability issues quickly, without hidden costs.

The best EMRs for small practices streamline operations, allowing you to improve patient engagement, reduce the burden of compliance, and have flexibility and support customizations to meet your unique needs. To save you time in your search, the HIPAA Journal has assessed EMRs for small practices to help you find the best EMR to meet your practice’s needs.

OptiMantra is the Best EMR for Small Practices

In our opinion, OptiMantra is the best EMR for sole providers and small independent primary care, functional medicine, mental health, and aesthetics-focused practices due to a comprehensive range of features and integrations, excellent customer support, scalability, and scope for customization. The platform provides excellent value for money with one of the lowest monthly costs, and many features included with the license that other platforms provide only as paid add-on features.

OptiMantra is an all-in-one solution with a comprehensive suite of functions, including charting, scheduling, e-prescribing, billing, video chat for telehealth, and an integrated lab network for bloodwork and tests. The platform includes a HIPAA-compliant patient portal with email and text reminders to improve engagement and reduce no-shows, and an extensive library of forms, including MSQ, symptom surveys, mental health questionnaires, and email, text, and fax templates.

OptiMantra offers a full suite of clinical, billing, point of sale, digital, and cloud integrations, ensuring seamless integration with the most commonly used third-party service providers. The platform streamlines small practice operations, allows charting on the go through tablet and mobile-friendly interfaces, helping practices improve efficiency and concentrate on patient care. OptiMantra also reports that clinics see an average 37% increase in revenue in the first year of using the platform, and if you ever decide to change platforms, there is no tie-in other than a month’s notice.

OptiMantra is rated highly by users, with a 5/5 score on G2 and a 4.8/5 score on Capterra, and is universally praised for customer support, with responses typically received within an hour, earning OptiMantra a 2025 Best Customer Support software badge from Gartner-owned Software Advice.  OptiMantra is also highly responsive to suggestions and rapidly implements tweaks to improve usability in response to customer requests.

While we feel OptiMantra is the best EMR for small practices for features, flexibility, cost-effectiveness, and customer service, other platforms are worthy of consideration.

AdvancedMD is a Comprehensive All-in-one Solution with Strong Revenue Management Features

AdvancedMD is an all-in-one cloud-based EMR system aimed at small practices, although those at the larger end of the category. The platform includes a suite of features for independent medical practices, including mental health, physical therapy, and medical healthcare organizations, and has integrated scheduling, charting, billing, claims, e-prescribing, and telehealth capabilities, with a good patient portal and patient messaging feature for improving engagement.

The platform offers excellent stability and accessibility, and robust security for HIPAA Security Rule compliance, including multi-factor authentication. AdvancedMD has an excellent scheduling system, a good patient portal, and impressive revenue management features, making it an ideal choice for practices with their one in-house billing teams.

While the platform has extensive features to support single physicians and small practices, with excellent scalability to support practices as they grow, there are more cost-effective choices due to high set-up fees. Due to the high initial cost, users typically do not tend to see a return on their investment for 14 months, and the system generally takes around 2 months to fully implement. Once set up, the platform is easy to use and navigate, with well-functioning modules that are intuitive and a great choice for compliance, with a comprehensive audit trail with all actions time and date stamped.

AdvancedMD has a 3.6/5 rating on Capterra and a 3.6/5 rating on G2 and is praised for its customizable features and the ability to tailor workflows to specific practice needs, and while the platform is reliable with excellent uptime, it is prone to lag times during busy periods, and customer service and issue resolution are often subject to delays. Overall, the platform is a good choice for larger practices and medical groups.

Practice Fusion is a Good Low-Cost Choice Providing Basic EMR Functionality

Practice Fusion is a solid choice for practices with restrictive budgets, especially for new sole provider practices and small practices with 3 or fewer signing staff. Practice Fusion is an entry-level cloud-based EMR system that initially provided free-to-use basic functionality, although it has now moved to a subscription-only service with a 14-day free trial.

Set up is straightforward, and the platform is intuitive and easy to use, without a steep learning curve. The platform has basic reporting and scheduling capabilities, web-based charting and e-prescribing, and lab, imaging, and billing services, and a good patient portal.

Practice Fusion provides online and telephone support, although it has no dedicated customer service representatives for users, and response times can be slow, sometimes taking days rather than hours to resolve issues.

The platform has a 3.8/5 rating on G2 and a 3.7/5 rating on Capterra, with users praising the platform for ease of use, its lab and imaging integrations, and web-based charting and e-prescribing. There is a lack of integrations and interoperability, although improvements are continuously being made to integrate with other portals and improve patient record importing, and extend integrations with vendors. Users report some system stability issues, with occasional downtime due to crashes.

For single providers and practices with 3 or fewer signing staff, Practice Fusion is a good choice due to ease-of-use, solid core functions, a good patient portal, and lab, imaging, and billing capabilities. A free trial is strongly recommended, as there is a minimum tie-in of 12 months for subscriptions with no early cancellation.

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Sen. Wyden Urges FTC to Take Action Against Microsoft for “Gross Cybersecurity Negligence”

Senator Ron Wyden (D-OR) has written to Andrew Ferguson, Chair of the Federal Trade Commission (FTC), requesting the FTC investigate Microsoft and hold it responsible for “gross cybersecurity negligence,” which Sen. Wyden believes has contributed to the barrage of ransomware attacks on critical infrastructure entities.

In the letter, Sen. Wyden cites figures from a February 2025 report published by the Director of National Intelligence (DNI) indicating more than 5,000 ransomware attacks in 2024, a 15% increase from 2024, and a 103% increase from 2022. Around half of the victims of those attacks are located in the United States. Those attacks have caused enormous harm to healthcare providers, put patient care at risk, and pose a continuing threat to national security.

Sen. Wyden believes Microsoft is at fault for many of these attacks because of its de facto monopoly on operating systems, combined with dangerous software engineering decisions that have made the Windows operating system vulnerable to ransomware attacks. Sen. Wyden explained that Microsoft chooses the security measures enabled by default in the Windows operating system, and while any user can alter the settings, many do not, as they are unaware of the risks associated with the default security settings.

Cybersecurity Vulnerability Exploited in Ascension Ransomware Attack

Sen Wyden used the 2024 hack of Ascension, one of the largest health systems in the United States, as an example of how easy it is for ransomware groups to breach the networks of critical infrastructure entities. The ransomware group gained access to privileged accounts on Ascension’s Active Directory Server using a privilege escalation technique called kerberoasting, after an Ascension contractor clicked a malicious link in a Bing search result on an Ascension laptop and inadvertently downloaded malware.

The malware provided the attacker with initial access, they moved laterally, and gained administrative privileges to the Microsoft Active Directory Server. The attacker exfiltrated data, then used ransomware to encrypt files. The electronic protected health information of 5.6 million patients was compromised in the attack. The attack was made possible due to a long-standing post-exploitation vulnerability.

Kerberoasting is an attack technique that exploits Microsoft’s continued support for an insecure encryption technology – RC4 – from the 1980s. Microsoft is well aware of the risk from kerberoasting, and how it can be exploited to obtain Active Directory credentials. For more than a decade, cybersecurity experts have warned of the dangers of kerberoasting, yet no action has been taken by Microsoft to mitigate the threat, even though more secure methods of encryption are supported by Windows.

The Advanced Encryption Standard (AES) is vastly superior to RC4, is supported by Windows, and recommended by the U.S. government, yet Microsoft does not use AES by default in Windows. The result of that software engineering decision is that hackers with access to a corporate network can exploit the weaknesses in RC4 encryption technology to crack administrators’ privileged accounts.

Sen. Wyden said Microsoft has stated that the risk can be mitigated by setting long passwords of 14 or more characters, yet Microsoft does not require passwords of that length to be set for privileged accounts by default. Sen. Wyden wrote to Microsoft in July 2024, warning about the threat of kerberoasting, and in October 2024, Microsoft published a blog post warning about the vulnerability and how the threat can be mitigated. Microsoft also promised to issue a software update to fix the issue. Almost a year on, and no fix has been forthcoming. Also in October 2024, the Cybersecurity and Infrastructure Security Agency (CISA) issued a warning that Iranian hackers were using the kerberoasting technique to attack U.S. organizations.

Despite the technique being used by threat actors, the warning was added to an obscure part of its website and was not promoted. Rather than issue a prominent and easy-to-read warning as requested by Sen. Wyden, the blog post was highly technical in nature. As a result, many companies may not have seen the post or acted on the advice, leaving their crown jewels – Active Directory credentials – at risk.

FTC Action Required to Force Microsoft to Provide Secure Software by Default

Kerberoasting is just one technique that can be used to exploit vulnerabilities. Sen. Wyden provided further examples of Microsoft’s cybersecurity failures that have been exploited by nation-state actors to attack Microsoft customers, including attacks by China in 2023 and, more recently, the vulnerability in Microsoft SharePoint that was mass exploited by hackers linked to the Chinese government this year.

“There is one company benefiting from this status quo: Microsoft itself. Instead of delivering secure software to its customers, Microsoft has built a multibillion-dollar secondary business selling cybersecurity add-on services to those organizations that can afford it,” Sen. Wyden wrote in the letter. “At this point, Microsoft has become like an arsonist selling firefighting services to their victims. And yet government agencies, companies, and nonprofits like Ascension have no choice but to continue to use the company’s software, even after they are hacked, because of Microsoft’s near-monopoly over enterprise IT.”

Sen. Wyden believes that the FTC should take action to hold Microsoft to account, and if no action is taken, Microsoft is likely to continue to deliver dangerous, insecure software to critical infrastructure entities and the government, and further attacks are inevitable.

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