Gregory Webb, CEO at HITRUST

The new reality of information risk

In 2026, the digital enterprise is a global organism. Every business process — whether in financial services, healthcare, energy, or government — is dependent on an ecosystem of hundreds or thousands of interconnected vendors via a host of cloud services, APIs, and data flows. Each connection creates value, but also represents new exposure.

Security and risk executives now recognize that third-party risk is not a compliance box; it’s a business continuity risk. Data breaches, ransomware, and regulatory non-compliance can halt operations, disrupt supply chains, and erode customer trust overnight. In a world where cyber threats evolve faster than policies, resilience has become the true measure of organizational strength.

Assurance that adapts as fast as the threat

Many information security programs still rely on outdated frameworks and static certifications. They check the right boxes, but often fail to keep pace with adversaries that update tactics daily. HITRUST takes a fundamentally different approach. Our Cyber Threat Adaptive (CTA) Program continuously integrates real-world threat intelligence into our i1, e1, and r2 validated assessments, ensuring that controls evolve with the threat landscape.

In 2025 alone, HITRUST reviewed 627 real-world breaches, analyzed 8,500+ threat intelligence articles, evaluated 446,000 threat indicators, and mapped 85,000+ indicators to MITRE ATT&CK techniques and mitigations. This intelligence directly informs updates to the HITRUST CSF, making it a living framework aligned with today’s top threats, not yesterday’s playbooks. That’s why HITRUST-certified environments achieved 99.41% resilience (0.59% breach rate) in 2024 — a measurable, data-backed advantage.

Top threats to watch — and how to respond

Our data confirms that the leading attack vectors remained constant across 2025. But the tactics and technologies behind them are evolving fast. For CISOs and GRC executives, understanding these trends is key to prioritizing investment.

Phishing and social engineering

AI-driven phishing and business email compromise campaigns have become highly personalized and context-aware.

Best practice: Strengthen your defenses with advanced email security, continuous anti-phishing awareness training, and a robust auditing program to stay one step ahead of AI-powered attackers.

Exploiting public-facing applications

Attackers target unpatched web apps and exposed APIs to gain footholds.

Best practice: Stay secure through proactive vulnerability management and strict network segmentation.

Exploiting remote services

The hybrid workforce has expanded the attack surface across VPNs, RDP, and collaboration tools.

Best practice: Shrink your attack surface by eliminating unnecessary applications and elevate your preparedness with proactive threat intelligence.

Drive-by compromise

Compromised legitimate sites deliver malicious payloads to unsuspecting users.

Best practice: Reduce web-based risk with ongoing user education, up-to-date systems, and tightly managed script permissions.

Event-triggered execution

Attackers hide persistence in legitimate system tasks.

Best practice: Enhance resilience by ensuring timely patching and governed privileged access, essential to maintaining trust, compliance, and operational integrity.

The growing business risk of information exposure

Even legally available information, from social media to employee directories, can now fuel precision-targeted attacks. Information gathering has become the silent enabler of cybercrime. Global enterprises must adopt data minimization and contextual access controls across both structured and unstructured data. Reducing the “attackable surface area” of information is now a board-level KPI.

From compliance to confidence: The path forward

In the coming year, leading organizations will move from compliance-driven security to confidence-based assurance, where continuous validation, transparency, and measurable resilience define success. CISOs and GRC executives should

• Make threat intelligence actionable: Integrate adversary data into control design, not just reporting.
• Quantify cyber resilience: Establish metrics for breach likelihood, response maturity, and supply chain exposure.
• Modernize assurance: Adopt continuously updated frameworks like HITRUST CSF that are informed by live threat data and mapped to leading standards (NIST, ISO, PCI DSS, HIPAA).
• Build boardroom visibility: Translate technical risk into business impact using consistent, auditable evidence of control performance.

The bottom line

Your security program must evolve at the speed of threats. Static controls can’t outpace dynamic adversaries, but data-driven assurance can.

Our HITRUST Trust Report demonstrates how organizations leveraging HITRUST achieve higher protection and measurable performance across industries. It’s not theory. It’s proof that resilience is quantifiable and trust is auditable.

Whether your organization is seeking its first HITRUST assessment or aiming to enhance a mature TPRM program, HITRUST helps you stay ready, not just compliant. Download the most recent analysis to learn how to make threat intelligence your competitive advantage.

What is the AI trilemma, and why does it matter for healthcare vendors?

In a recent Foreign Affairs article, “The AI Trilemma,” the author argues that governments are struggling to balance three competing priorities at once: accelerate AI innovation, manage its risks, and build effective assessment programs. While geopolitical in framing, the same dynamic is unfolding inside healthcare vendor ecosystems. Optimizing all three requires moving beyond traditional questionnaires toward independently validated, decision-grade assurance that keeps innovation aligned with regulatory and security expectations.

Healthcare leaders are under pressure to adopt AI-enabled capabilities quickly. Clinical documentation support, revenue cycle automation, patient engagement tools, cybersecurity monitoring — AI functionality is increasingly embedded across the vendor stack. Yet every new AI-enabled product introduces additional data flows, algorithmic decision influence, and third-party dependencies.

The result is a localized version of the AI trilemma

• Move quickly to capture innovation.
• Reduce risk to protect patients and data.
• Evaluate vendors and technologies effectively.

Trying to optimize all three at once exposes the limits of traditional third-party risk management (TPRM).

Why do traditional TPRM approaches break down with AI-enabled vendors?

Historically, many organizations relied on vendor questionnaires, point-in-time assessments, or self-attestation to evaluate risk. That approach was already strained before AI. With AI, it breaks down more quickly.

AI-enabled vendors may rely on

• Cloud infrastructure providers
• Foundation model developers
• Data labeling subcontractors
• External APIs and integrations
• Continuous model updates

This creates not just third-party risk, but fourth- and fifth-party risk — often invisible to the relying organization. Traditional TPRM models were not designed to account for continuously evolving AI systems or layered model dependencies.

As AI systems update dynamically and rely on interconnected services, risk posture can change between assessment cycles. Static documentation cannot keep pace with dynamic model behavior.

How are regulatory expectations increasing around AI and vendor risk?

At the same time, regulatory expectations in healthcare are tightening. HHS has emphasized the importance of “recognized security practices” and proposed updates to strengthen cybersecurity safeguards under the HIPAA Security Rule. Organizations are expected not merely to claim controls exist, but to demonstrate that they operate effectively.

Meanwhile, NIST’s AI Risk Management Framework (AI RMF) provides structured guidance for identifying and managing AI-specific risks, including governance, data management, monitoring, and accountability.

Together, these developments signal a shift from policy-based compliance to demonstrable, operational effectiveness. The tension is clear: AI innovation accelerates, but the evidence required to support trust must accelerate with it.

What does decision-grade assurance look like in AI-driven TPRM?

The answer to the AI trilemma inside TPRM is not slowing innovation. It is elevating assurance.

Healthcare organizations need

• Clearly defined AI security expectations for vendors
• Risk-based scoping of AI-enabled services
• Independently validated evidence that security and privacy controls are implemented and operating effectively
• Repeatable, comparable assurance artifacts that reduce duplicative reviews

In other words, they need decision-grade assurance — not marketing claims.

When assurance is standardized and independently validated, organizations can move more confidently. They reduce duplicative assessments, shorten procurement cycles, and maintain alignment with rising regulatory expectations.

For organizations seeking a structured way to demonstrate AI security and risk management effectiveness, the HITRUST AI assessment provides a certifiable, independently validated approach aligned to recognized security practices and emerging AI risks. It enables organizations to evaluate vendors’ AI-specific controls within the broader assurance framework already trusted across healthcare, helping bridge innovation and risk management without creating parallel compliance tracks.

How can healthcare organizations innovate without losing assurance?

The geopolitical AI trilemma is about balancing speed, safety, and oversight. Inside healthcare vendor ecosystems, the same challenge exists — but the operational solution is clearer:

Innovation without validated assurance is risk acceleration.
Innovation with validated assurance is resilience.

Organizations that embed validated, standardized assurance into their TPRM and AI strategies do not have to choose between innovation and risk management. They create a structured path to adopt AI technologies responsibly, protect sensitive data, and sustain regulatory alignment — all while maintaining operational velocity.

Preparing for a ransomware attack is now a mission-critical priority for healthcare organizations. Ransomware incidents can disrupt clinical operations, delay patient care, expose sensitive health data, and create significant regulatory and financial consequences. As healthcare ecosystems become more digitally connected, building ransomware resilience requires more than reactive controls. It demands structured preparation, tested response plans, and validated assurance.

Learn about a practical, healthcare-specific roadmap to help organizations prepare for a ransomware attack, mitigate its impact, and recover effectively when prevention alone is not enough.

Understanding the ransomware threat landscape

What is ransomware and how does it work?

Ransomware is a type of malicious software that encrypts systems or data, making them inaccessible until a ransom is paid, often accompanied by threats to publicly release stolen data. In healthcare, ransomware attacks frequently target electronic health records (EHRs), imaging systems, scheduling platforms, billing applications, and connected medical devices.

Modern ransomware attacks often use double or triple extortion tactics, combining system encryption with data exfiltration and denial-of-service threats. This significantly raises the stakes for healthcare providers, where downtime and data exposure can directly impact patient safety.

Why ransomware attacks are on the rise

In 2025, 8.9 million health care records were compromised due to ransomware. Healthcare remains one of the most targeted sectors for ransomware due to the high value of protected health information (PHI), the complexity of clinical environments, and the limited tolerance for operational disruption. Many organizations rely on legacy systems, third-party vendors, and cloud platforms that expand the attack surface faster than security programs can mature.

For a deeper look at why this issue continues to escalate, explore the ransomware threat and its growing impact across regulated industries.

Common entry points and attack vectors

Most ransomware incidents begin with well-known weaknesses, including

• Third-party vendor or cloud service provider compromises
• Phishing emails targeting clinicians and administrative staff
• Compromised credentials and weak identity controls
• Unpatched systems and outdated software

Understanding these entry points is a foundational step in any effort to prepare for a ransomware attack.

Core strategies for ransomware preparedness

Conducting risk assessments

A ransomware risk assessment helps healthcare organizations identify critical systems, data flows, and dependencies most likely to be targeted or disrupted. This includes evaluating

• Availability and integrity of EHR systems
• Clinical workflow dependencies and downtime tolerance
• Third-party and cloud service risks
• Backup coverage for mission-critical assets

These assessments should be integrated into broader enterprise risk management programs and aligned with recognized cybersecurity frameworks for ransomware.

Building a robust incident response plan

A documented ransomware response plan is essential for minimizing confusion and downtime during an attack. Healthcare-specific plans should clearly define

• Decision-making authority during an incident
• Communication protocols with clinicians, leadership, regulators, and patients
• Coordination with legal counsel, cyber insurers, and incident response partners
• Criteria for system isolation, clinical workarounds, and recovery prioritization

Regular tabletop exercises ensure teams understand their roles before a real incident occurs.

Backup and recovery best practices

Reliable, tested backups remain one of the most effective ransomware mitigation controls. Healthcare organizations should

• Maintain offline or immutable backups
• Test restoration procedures for clinical and operational systems
• Ensure backups include EHRs, imaging systems, and connected devices

Without validated recovery capabilities, even well-designed response plans may fail under real-world conditions.

Ransomware risks in the healthcare sector

Unique threats facing healthcare organizations

Ransomware in healthcare presents risks that extend beyond financial loss. System outages can delay diagnoses, interrupt treatments, and force providers to divert patients or revert to manual processes. At the same time, PHI is highly valuable on the black market, making healthcare organizations prime targets for data extortion.

Third-party vendors and service providers compound these risks, as attackers increasingly exploit indirect access paths. Industry analysis shows growing concern around how ransomware has affected TPRM and vendor ecosystems.

Regulatory compliance and risk mitigation strategies

Ransomware incidents often trigger regulatory scrutiny under HIPAA, state privacy laws, and contractual obligations. Healthcare organizations must demonstrate not only that safeguards existed, but that risks were proactively assessed, mitigated, and governed.

This makes structured, auditable security programs essential not just for compliance, but for operational resilience.

Leveraging cybersecurity assessments for defense

How HITRUST supports ransomware readiness

The HITRUST framework provides a prescriptive, scalable approach to preparing for ransomware attacks in healthcare. By harmonizing regulatory requirements, security controls, and risk-based assurance, HITRUST enables organizations to assess their vendors and

• Identify and remediate ransomware-related control gaps
• Align security practices with healthcare regulatory expectations
• Strengthen risk management programs

Rather than relying on fragmented controls, HITRUST supports a unified and measurable approach to ransomware resilience.

Integrating assessments into your security strategy

Healthcare organizations that integrate assessments like HITRUST into their security programs benefit from

• Consistent control implementation across systems and vendors
• Benchmarking and maturity measurement
• Clear evidence of due diligence for regulators, partners, and patients

This improves preparedness across the full incident lifecycle, from prevention to response and recovery.

Certification and assurance benefits

For healthcare organizations assessing their vendors, HITRUST certification provides independent validation that security and risk controls are both designed and operating effectively. Rather than relying on self-attestations or fragmented questionnaires, healthcare organizations can use HITRUST certification to gain confidence that vendor environments are prepared to withstand ransomware threats.

HITRUST certification

• Demonstrates that vendors have proactively implemented controls to reduce ransomware risk
• Builds trust and transparency across the healthcare ecosystem, including regulators and business partners
• Reduces assessment fatigue by replacing duplicative vendor reviews with a standardized, validated approach

This assurance helps healthcare organizations ensure that ransomware resilience is embedded into vendor governance and operations.

Conclusion: Building long-term resilience

Continuous monitoring and improvement

Preparing for a ransomware attack is not a one-time initiative. Healthcare organizations must continuously monitor threats, test controls, assess vendors, and incorporate lessons learned from incidents and exercises into program improvements.

Staying ahead of emerging threats

As ransomware actors increasingly target third-party vendors, cloud platforms, and interconnected healthcare systems, organizations need adaptable and validated security strategies. Those that invest in threat-adaptive frameworks, ongoing risk assessments, and independent assurance will be best positioned to protect patient care and sustain trust over time.

Protect your organization from ransomware threats. Explore how HITRUST can help you build a resilient cybersecurity strategy today.