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Prescribing Strong API Security: A Lifeline for Healthcare Data

Eric Schwake
Oct 25, 2024

In 2024, healthcare organizations face heightened security challenges, mainly as they increasingly rely on Application Programming Interfaces (APIs) to support critical functions. APIs have become indispensable in driving digital transformation and improving operational efficiencies across healthcare systems. However, the rising complexity and volume of APIs, alongside insufficient security practices, have created a vulnerable environment ripe for exploitation. According to industry-specific data lifted from the 2024 State of API Security Report from Salt Security, healthcare organizations are grappling with numerous API security challenges impacting their operations and their ability to protect sensitive patient data.

API Growth and its Impact on Healthcare

The report highlights that 50% of respondents develop, deliver, and integrate one hundred APIs or more. In the healthcare sector, APIs enable seamless platform or system integrations, improve development efficiencies, and support digital transformation initiatives. These APIs connect disparate systems, exchange sensitive patient information, and streamline workflows between electronic health records (EHR), mobile health apps, telemedicine platforms, and insurance systems. While this connectivity is essential for modern healthcare delivery, it also opens new attack surfaces for potential breaches.

However, the rapid adoption of APIs has exposed healthcare organizations to many security risks. More than half of the respondents reported that they had to slow down the rollout of new applications due to concerns over API security. Slowing the pace of application innovation is a particularly concerning trend in healthcare, where timely access to innovative tools and platforms can directly impact patient care. The pressure to innovate while ensuring airtight security is proving to be a significant challenge.

Authentication Challenges and Lack of API Discovery Processes

One of the most troubling statistics from the Salt Security report is that 55% of organizations have experienced authentication problems with their APIs. In healthcare, poor API authentication controls can lead to unauthorized access to patient data, resulting in data breaches, identity theft, and violations of regulations such as the Health Insurance Portability and Accountability Act (HIPAA). Healthcare organizations are vulnerable to attacks that can exploit weak or misconfigured API endpoints without robust authentication mechanisms.

Compounding the issue is the fact that half of the respondents admitted to having no formal process in place for API discovery, while 9% were still determining whether such a process even existed in their organization. Without a clear understanding of the APIs they are exposing, healthcare organizations are flying blind. Untracked or undocumented APIs, also known as "shadow APIs," pose a critical risk, as they can be exploited without the organization’s knowledge, leaving sensitive data exposed to malicious actors.

Infrequent API Updates and Runtime Security Gaps

Another key finding from the report is that 90% of organizations update their primary APIs weekly or less often, creating potential security gaps. In healthcare, where data sensitivity is paramount, even minor delays in patching vulnerabilities can lead to significant security risks. APIs that are not updated frequently enough may harbor unpatched vulnerabilities that hackers can exploit, leading to data breaches or service disruptions. Moreover, 95% of respondents in the healthcare sector expressed concerns that their API inventories lacked sufficient detail to identify exposed sensitive data or personally identifiable information (PII). This lack of visibility increases the likelihood of sensitive patient data being inadvertently exposed or misused.

Perhaps most concerning is the fact that healthcare organizations, more than any other industry, struggle with addressing runtime production security in their API security programs. While healthcare organizations invest in development and testing security measures, these protections often fail to extend to the runtime environment, where APIs are most vulnerable to attacks. This creates a significant security gap that malicious actors can exploit, especially given that 23% of respondents reported experiencing an API security incident in the past year.

Basic API Security Strategies and C-Level Awareness

Despite the clear risks, 55% of healthcare organizations described their API security strategies as "basic." This indicates a lack of maturity in their approach to securing APIs, exposing them to increasingly sophisticated attacks. Many organizations cited limited resources, constrained budgets, and competing priorities as the biggest obstacles to implementing a more comprehensive API security strategy. With these constraints, it's no surprise that 45% of healthcare organizations have elevated API security to a C-level discussion, reflecting growing awareness at the highest levels of leadership.

Additionally, 91% of healthcare organizations acknowledged that generative AI (GenAI) presents at least some concern as a security risk. While GenAI is still an emerging threat, the healthcare sector was the least confident in dealing with these risks, highlighting the need for enhanced capabilities to mitigate potential threats posed by AI-driven attacks.

Building a Robust API Security Framework

The 2024 State of API Security Report paints a clear picture: healthcare organizations are underprepared for the growing complexity of API security. As APIs become more integral to healthcare operations, organizations must prioritize API security as a critical component of their cybersecurity strategy. These measures include implementing more robust authentication measures, improving API discovery processes, incorporating posture governance to address compliance concerns, addressing runtime production security gaps, and updating APIs more frequently to mitigate vulnerabilities.

Moreover, with C-level executives increasingly involved in API security discussions, there is an opportunity to allocate more resources and budget toward developing a comprehensive and proactive API security framework. Healthcare organizations cannot afford to overlook the security of their APIs, especially as the consequences of a breach — whether through data exposure, compliance violations, or service disruptions — can have severe repercussions on both patient safety and organizational trust. By adopting a more mature API security strategy, healthcare organizations can better safeguard sensitive patient data and ensure the integrity of their digital ecosystems.

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If you want to learn more about Salt and how we can help you on your API Security journey through discovery, posture governance, and run-time threat protection, please contact us, schedule a demo, or check out our website.

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