Healthcare organizations are relatively unlikely to have serious cybersecurity vulnerabilities compared to other industry sectors, as they are generally good at prevention; however, when vulnerabilities are identified, healthcare lags other sectors when it comes to remediation. These are the findings from a recent analysis of penetration testing data and a survey of 500 U.S. security leaders by the Pentest-as-a-service (PTaaS) firm Cobalt. The findings are published in its State of Pentesting in Healthcare 2025 report.
Serious cybersecurity vulnerabilities are relatively rare in healthcare, with the industry ranking 6th out of the 13 industries represented in the data, with only 13.3% vulnerabilities identified through pentesting qualifying as serious. When penetration tests identify serious vulnerabilities, they need to be remediated promptly. As long as a vulnerability remains unaddressed, it can potentially be exploited by a threat actor.
The standard for measuring the time to perform a security action is the median time to resolve (MTTR), which, for serious vulnerabilities in healthcare, was 58 days. Healthcare ranked 11th out of 13th industries on MTTR. Cobalt plotted the frequency of serious vulnerabilities against the resolution rate in a scatterplot chart. Healthcare was the only industry in the struggling sector, with low prevalence but low resolution. The ideal is low prevalence and high resolution.
While the MTTR is a standard measure in security, it can be somewhat misleading, as it is only based on the vulnerabilities that are actually resolved. Cobalt reports that 52% of pentest findings are never resolved. Therefore, to obtain a complete picture, it is also necessary to look at the survival half-life, which is the time taken to resolve 50% of identified vulnerabilities. Having an MTTR of 20 days is excellent, but much less so if half of all serious vulnerabilities are never resolved.
The data show healthcare to be the third-worst industry for half-life score, with a half-life of 244 days, compared to the leading sector, transportation, which has a half-life of 43 days. Education performed worst, with a half-life of 283 days, ahead of hospitality on 270 days. Cobalt notes that the healthcare sector is generally good at prioritizing vulnerability remediation, with the most critical issues usually fixed on time. Almost 40% of healthcare service level agreements (SLAs) require serious vulnerabilities in business-critical assets to be fully resolved within three days, while a further 40% of SLAs require those vulnerabilities to be resolved within 14 days.
Most practices meet the deadlines, with 43% resolving critical findings in one to three days, 37% resolving issues in four to seven days, and 14% resolving issues within eight to fourteen days, although it is common for backlogs to grow in less urgent areas. Healthcare is a heavily regulated industry, with data security requirements under HIPAA. The HIPAA Security Rule requires a risk analysis to be conducted to identify all risks and vulnerabilities to electronic protected health information, which explains, to a certain extent, why there is a low prevalence of serious vulnerabilities. There are also risk management requirements under HIPAA, which are reflected in the data, as 94% of healthcare organizations resolve business-critical issues in less than two weeks.
The slow rates of resolution of vulnerabilities in general and the poor half-life score in healthcare are likely due to a range of factors, such as the continued use of legacy systems, which create technology roadblocks, along with resource constraints. Cobalt also suggests there may be divisions between the departments ordering pentests and the teams implementing fixes, and less mature teams may struggle with the complexity of remediations.
The survey revealed the biggest security concerns in healthcare to be GenAI (71%), third-party software (48%), and exploited vulnerabilities (40%), with the top attack vectors being third-party software (68%), AI-enabled features (45%), and phishing/malware (32%). Given the high level of concern about third-party software, Cobalt recommends that healthcare providers require their vendors to provide comprehensive pentesting reports before procurement. Cobalt also recommends integrating pentesting into the development lifecycle, proactively testing for AI and genAI vulnerabilities, adopting a programmatic approach to offensive security, and conducting regular red team exercises to test real-world detection and response capabilities.
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