With the healthcare sector’s rapid digitization, the lines between IT infrastructure and patient care have blurred, creating an expanded attack surface for malicious actors. We sat down with Chloe Maraina, a leading business intelligence expert specializing in data science and cybersecurity, to dissect the findings of a recent threat intelligence report. Our conversation explores the dangerous “cascading effect” of cyberattacks, the sophisticated evolution of phishing tactics, the specialization of ransomware gangs, and the alarming rise of a new extortion strategy targeting healthcare organizations.
With hospital systems so interconnected, a cyberattack on one area can trigger a “cascading effect.” Can you walk us through how a single breach can escalate into a widespread patient safety crisis, perhaps providing a step-by-step example of how this unfolds?
Absolutely. The cascading effect is the defining trend we saw in 2025, and it’s terrifyingly simple in its execution. Imagine a phishing email successfully targets an administrative employee. That single entry point gives an attacker a foothold. From there, they move silently through the network. Because of the rapid digitization and cloud adoption in healthcare, systems that were never engineered for this kind of threat are now connected. The attacker might first hit the electronic health records (EHR) database, locking doctors and nurses out of patient histories, allergies, and medication schedules. Then, they could paralyze the system that manages diagnostic equipment like MRI machines or CT scanners. Suddenly, what began as a single click on a malicious link has spiraled into a situation where critical medical procedures are delayed or canceled. These disruptions are no longer just financial or operational; they are lethal, and research is now showing direct links between these attacks and increased patient mortality rates. It’s a true patient safety crisis, not just an IT disruption.
Phishing remains the primary entry point for attacks, with hackers now using sophisticated themes like “AI Transformation” to target IT staff. Why is this approach so effective, and what specific technical and human-focused training can organizations implement to counter this evolving threat?
This new wave of phishing is so effective because it’s tailored and contextual. It’s a far cry from the poorly worded emails of the past. Hackers understand that IT administrators are focused on modernization and compliance, so they craft lures with themes like “AI Transformation” or “Regulatory Compliance.” These are legitimate, high-priority topics, making the emails look like essential internal communications. We saw this vector used for initial access in a staggering 89% of incidents. To make matters worse, attackers will use malicious domains that incorporate trusted healthcare terms like “HIPAA,” or even build malicious subdomains into legitimate healthcare websites, making them incredibly difficult to spot. Countering this requires a dual approach. On the technical side, advanced email filtering is crucial. But on the human side, generic annual training isn’t enough. Organizations need to implement continuous, simulation-based training that exposes employees, especially IT staff, to these highly sophisticated and believable lures so they can build the muscle memory to question and verify everything.
Threat actor groups are becoming highly specialized, with some like Qilin targeting EHR databases and others like Sinobi focusing on biotech. How should a C-suite leader assess their organization’s unique vulnerabilities and tailor defenses against these distinct attacker profiles and tactics?
A C-suite leader today must move beyond thinking of cyber threats as a generic problem. They are facing a diverse ecosystem of specialized adversaries. For instance, if you lead a large hospital network, a group like Qilin should be your top concern, as they’ve matured into a high-tempo operation using malware specifically designed to cripple the databases storing your electronic health records. If you’re at the helm of a biotech firm, the new group Sinobi is watching you. We also saw INC Ransom surge last year, hitting 34 different healthcare organizations, from regional hospitals to national public health systems. The key for a leader is to conduct a threat-informed risk assessment. This means not just identifying your own vulnerabilities but actively profiling the groups most likely to target your specific sub-sector. You have to ask, “Who would want my data, and how would they try to get it?” Only then can you tailor your defenses, whether that means strengthening database protections against Qilin or securing intellectual property from a group like Devman2, which is notorious for massive data exfiltration.
A recent trend shows a 300% rise in extortion-only attacks where hackers demand small sums, like $50 per patient. Why is this micro-extortion tactic so effective, and what new challenges does it pose for a hospital’s legal, financial, and incident response teams?
This micro-extortion tactic is deviously clever and represents a significant shift in the ransomware ecosystem. We saw attacks involving solely extortion jump 300% from 2023. By demanding a small sum, say $50 to $500 per patient whose data they’ve stolen, the attackers create a very different kind of problem for the hospital. A multi-million dollar ransom demand immediately involves corporate insurance carriers, legal teams, and federal law enforcement. It’s a slow, bureaucratic process. But a series of small demands effectively bypasses those channels. The attackers are betting that the organization will see it as easier and faster to pay these smaller sums to make the problem disappear, especially given the unique sensitivity of private health data. This poses a huge challenge. It forces incident response teams to grapple with a high volume of small-scale negotiations and payments, and it puts legal and financial teams in a gray area where standard protocols for large-scale breaches don’t apply. It’s a faster, more direct path for attackers to get paid.
What is your forecast for healthcare cybersecurity?
My forecast is that the stakes will only get higher. The trends we’re seeing—increasing interconnectedness, the adoption of AI-driven workflows, and the relentless expansion of the healthcare attack surface—are not slowing down. This means that the “cascading effect” will become even more pronounced, and the line between a cyber incident and a mass-casualty event will continue to blur. Threat actors have recognized that healthcare is uniquely vulnerable, not just financially, but ethically, due to the life-or-death nature of the services provided. We will see them continue to refine their tactics, from more sophisticated phishing lures to new extortion models. The industry can no longer view cybersecurity as a compliance checkbox or an IT department issue. It must be treated as a core component of patient safety, with the same level of seriousness and investment as clinical care itself.
