Due to its near-universal adoption, speed, and cost-effectiveness, email remains one of the most common communication channels in healthcare. Consequently, it’s one of the most frequent targets for cyber attacks, as malicious actors are acutely aware of the vast amounts of sensitive data contained in messages – and standard email communication’s inherent vulnerabilities.

In light of this, healthcare organizations must remain aware of the evolving email threat landscape, and implement effective strategies to protect the electronic protected health information (ePHI) included in email messages. Failing to properly secure email communications jeopardizes patient data privacy, which can disrupt operations, result in costly HIPAA compliance violations, and, most importantly, compromise the quality of their patients’ healthcare provision.

With all this in mind, this post details the biggest email threats faced by healthcare organizations today, with the greatest potential to cause your business or practice harm by compromising patient and company data. You can also get our 2025 report on the latest email threats, which includes strategies on how to overcome them.

Ransomware Attacks

Ransomware is a type of malware that encrypts, corrupts, or deletes a healthcare organization’s data or critical systems, and enables the cybercriminals that deployed it to demand a payment (i.e., a ransom) for their restoration. Healthcare personnel can unwittingly download ransomware onto their devices by opening a malicious email attachment or clicking on a link contained in an email.

In recent years, ransomware has emerged as the email security threat with the most significant financial impact. In 2024, for instance, there were over 180 confirmed ransomware attacks with an average paid ransom of nearly $1 million. 

Email Client Misconfiguration

While a healthcare organization may implement email security controls, many fail to know the security gaps of their current email service provider (ESP) or understand the value of a HIPAA compliant email platform, leaving data vulnerable to email threats, such as unauthorized access and ePHI exposure, and also, subsequently, a greater risk of compliance violations and reputation damage.

Common types of email misconfiguration include:

• Lack of enforced TLS encryption: resulting in emails being transmitted in plaintext, rendering the patient data they contain readable by cybercriminals in the event of interception during transit.
• Improper SPF/DKIM/DMARC setup: failure to configure or align these email authentication protocols correctly gives malicious actors greater latitude to successfully spoof trusted domains.
• Disabled or lax user authentication: a lack of authentication measures, such as multi-factor authentication (MFA), increases the risk of unauthorized access and ePHI exposure.
• Misconfigured secure email gateways: incorrect rules or filtering policies can allow phishing emails through or block legitimate messages.
• Outdated or unsupported email client software: simply neglecting to download and apply the latest updates or patches from the email client’s vendor can leave vulnerabilities, which are well-known to cybercriminals, exposed to attack.

Social Engineering Attacks

A social engineering attack involves a malicious actor deceiving or convincing healthcare employees into granting unauthorized access or exposing patient data. Relying on psychological manipulation, social engineering attacks exploit a person’s trust, urgency, fear, or curiosity, and encompass an assortment of threats, including phishing and business email compromise (BEC) attacks, which are covered in greater depth below.

Phishing

As mentioned above, phishing is a type of social engineering attack, but they are so widespread that it warrants its own mention. Phishing sees malicious actors impersonating legitimate companies, or their employees, to trick victims into revealing sensitive patient data. 

Subsequently, healthcare organizations can be subjected to several different types of phishing attacks, which include:

• General phishing: otherwise known as bulk phishing or simply ‘phishing’, these are broad, generic attacks where emails are sent to large numbers of recipients, impersonating trusted entities to steal credentials or deliver malware. 
• Spear phishing: more targeted attacks that involve personalized phishing emails crafted for a specific healthcare organization or individual. These require more research on the part of malicious actors and typically use relevant insider details gleaned from their reconnaissance for additional credibility.
• Whaling: a form of spear phishing that specifically targets healthcare executives or other high-level employees. 
• Clone phishing:  when a cybercriminal duplicates a legitimate email that was previously received by the target, replacing links or attachments with malicious ones.
• Credential phishing: also known as ‘pharming’, this involves emails that link to fake login pages designed to capture healthcare employees’ usernames and passwords under the guise of frequently used legitimate services.

Domain Impersonation and Spoofing

This category of threat revolves around making malicious messages appear legitimate, which can allow them to bypass basic email security checks. As alluded to above, these attacks exploit weaknesses in email client misconfigurations to trick the recipient, typically to expose and exfiltrate patient data, steal employee credentials, or distribute malware.

Domain spoofing email threats involve altering the “From” address in an email header to make it appear to be from a legitimate domain. If a healthcare organization fails to properly configure authentication protocols like SPF, DKIM, and DMARC, there’s a greater risk of their email servers failing to flag malicious messages and allowing them to land in users’ inboxes.

Domain impersonation, on the other hand, requires cybercriminals to register a domain that closely resembles a legitimate one. This may involve typosquatting, e.g., using “paypa1.com” instead of “paypal.com”. Alternatively, a hacker may utilize a homograph attack, which substitutes visually similar characters, e.g., from different character sets, such as Cyrillic. Malicious actors will then send emails from these fraudulent domains, which often have the ability to bypass basic email filters because they aren’t exact matches for blacklisted domains. Worse still, such emails can appear authentic to users, particularly if the attacker puts in the effort to accurately mimic the branding, formatting, and tone used by the legitimate entity they’re attempting to impersonate. 

Insider Email Threats

In addition to external parties, employees within a healthcare organization can pose email threats to the security of its PHI. On one hand, insider threats can be intentional, involving disgruntled employees or third-party personnel abusing their access privileges to steal or corrupt patient data. Alternatively, they could be the result of mere human error or negligence, stemming from ignorance, or even fatigue.

What’s more, insider threats have been exacerbated by the rise of remote and flexible conditions since the onset of the COVID-19 pandemic, which has created more complex IT infrastructures that are more difficult to manage and control.  

Business Email Compromise (BEC) Attacks

A BEC attack is a highly targeted type of social engineering attack in which cybercriminals gain access to, or copy, a legitimate email account to impersonate a known and trusted individual within an organization. BEC attacks typically require extensive research on the targeted healthcare company and rely less on malicious links or attachments, unlike phishing, which can make them difficult to detect.

Due to the high volume of emails transmitted within the healthcare industry, and the sensitive nature of PHI often included in communications to patients and between organizations, the healthcare industry is a consistent target of BEC attacks.

BEC attacks come in several forms, such as:

• Account compromise: hijacking a real employee’s account and sending fraudulent messages.
• Executive fraud: impersonating high-ranking personnel to request urgent financial transactions or access to sensitive data.
• Invoice fraud: pretending to be a vendor asking for the payment of a fraudulent invoice into an account under their control.

Supply Chain Risk

Healthcare organizations increasingly rely on third-party vendors, including cloud service providers, software vendors, and billing or payment providers to serve their patients and customers. They constantly communicate with their supply chain partners via email, with some messages containing sensitive patient data; moreover, some of these organizations will have various levels of access to the PHI under their care.

Consequently, undetected vulnerabilities or lax security practices within your supply chain network could serve as entry points for email threats and malicious action. For instance, cybercriminals can compromise the email servers of a healthcare company’s third-party vendor or partner, and then send fraudulent emails from their domains to deploy malware or extract patient data.

Another, somewhat harrowing, way to understand supply chain risk is that while your organization may have a robust email security posture, in reality, it’s only as strong as that of your weakest third-party vendor’s security controls.

Download LuxSci’s Email Cyber Threat Readiness Report

To gain further insight into the biggest email threats to healthcare companies in 2025, including increasingly prevalent AI threats, download your copy of LuxSci’s Email Cyber Threat Readiness Report. 

You’ll also learn about the upcoming changes to the HIPAA Security Rule and how it’s set to impact your organization going forward, and the most effective strategies for strengthening your email security posture.

Grab your copy of the report here and begin the journey to strengthening your company’s email threat readiness today.

Successful healthcare marketing campaigns set measurable targets to engage patients and customers, build brand recognition, strengthen market position, and generate business growth, while meeting healthcare regulations and compliance requirements. Marketing teams develop strategies to meet these targets through patient outreach and service promotion, including email marketing and outreach campaigns. These strategies balance business development with patient engagement and compliance requirements, focusing on both short-term acquisition goals and long-term relationship building.

Healthcare Marketing Strategy Development

Marketing in healthcare requires detailed approaches that respect patient privacy and medical ethics. Marketing teams create plans that address both revenue targets and patient and customers needs, while navigating regulations that govern healthcare communications, privacy and data security. Their work includes market research, campaign development and messaging, and results tracking across multiple channels. These plans typically incorporate email, digital, and community outreach methods to connect with patients and healthcare partners. Teams analyze current patient segments, demographic data, local healthcare needs, and market opportunities to develop targeted campaigns that resonate with specific patient populations and groups. Marketing departments also work closely with medical and business line staff to ensure all messaging and content accurately represent healthcare services and products, while maintaining professional standards and brand consistency.

Audience Segmentation Techniques

Marketing teams can improve conversion rates by targeting their audiences by numerous subgroups. The teams divide potential patients and customers into multiple subgroups based on specific healthcare needs and conditions, service utilization patterns, demographics, and behavioral characteristics. These segments include patients with chronic condition management needs, those seeking preventive care, and individuals requiring specialized treatments. With the right campaign management tools, teams can create custom messaging for each segment addressing their concerns and interests. For example. departments conducting email healthcare marketing campaigns can use patient data to identify recurring treatment needs and develop targeted follow-up programs. They track response rates across different segments to refine their targeting approaches and message development. This segmentation allows for more efficient resource allocation and higher conversion rates across marketing channels.

Patient Outreach and Relationship Building

Marketing teams develop methods, such as email outreach campaigns, to reach new patients and maintain connections with current ones. The teams analyze patient data to understand healthcare usage patterns and create targeted outreach programs that address community needs. These programs include detailed health education materials, preventive care information, new products, and service updates delivered through carefully selected communication channels, typically over secure email and via patient portals. Marketing departments track patient engagement through these touchpoints, from initial contact, to product and service delivery, to ongoing relationships and active engagement. They measure program effectiveness through patient response rates, conversions, such as appointment scheduling patterns or new plan enrollments, and satisfaction surveys. This data helps teams refine their communication approaches and develop more effective patient engagement strategies. Healthcare marketing initiatives also focus on building trust through transparent communication about treatment options, costs, and expected outcomes, all of which needs to be transmitted securely win a way that meets HIPAA compliance requirements.

Building Healthcare Product and Service Awareness

Healthcare organizations should develop marketing campaigns to promote their range of medical services, products and/or specialties. Marketing teams typically research regional healthcare needs and service gaps to identify growth opportunities within specific medical areas. They create targeted promotion strategies for each service or product line, considering factors like local competition, patient demographics, and insurance coverage. These campaigns often include physician referral programs, community health education events, and specialized outreach to patient groups who might benefit from specific services. Again, it’s critical to secure these communications, especially when PHI is being used, to protect patient privacy and meet HIPAA compliance requirements. Teams should continuosly monitor performance through patient volume metrics, engagement rates and conversions, revenue tracking, and market penetration rates. This information guides decisions about resource allocation and helps identify which services need additional marketing support.

Market Position and Competitive Analysis

Healthcare providers should also conduct regular market analyses to understand their competitive position and identify opportunities for growth. Marketing teams study regional healthcare trends, track competitor offerings, and assess patient satisfaction with current services. They use this information to develop campaign strategies that highlight their unique capabilities and treatment options. Market research includes patient preference surveys, analysis of healthcare utilization patterns, and assessment of emerging medical technologies. Teams use these insights to adjust their healthcare marketing messages and service offerings to meet changing patient needs. They should also monitor their market share across different service lines and geographic areas to ensure marketing efforts maintain or improve their competitive position.

Performance Measurement and Optimization

Finally, marketing departments must establish detailed metrics to evaluate their programs and demonstrate return on investment to internal teams and management. This includes tracking patient acquisition costs, engagement, satisfaction scores, and revenue generation across all marketing initiatives. Teams should use analytics tools to measure campaign performance across different channels and adjust strategies based on results. Regular reporting helps organizations understand which marketing efforts deliver the best outcomes and where to focus future investments. This data-driven approach ensures healthcare marketing resources target the most effective channels and messages. Teams should also monitor long-term trends in patient and customer retention, and referral patterns to assess the lasting impact of their healthcare marketing efforts.