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In the last year, cyberattacks on hospitals have surged, putting a spotlight on the need to protect patients’ health data. But hackers don’t need to attack providers directly to get that valuable info. A new cybersecurity report shows it is remarkably easy for bad actors to steal it through third-party apps and data aggregators that tap into providers’ electronic health record systems.

Hacker and cybersecurity analyst Alissa Knight got access to more than 4 million patient and clinician records by exploiting vulnerabilities in data aggregators’ application programming interfaces, along with associated apps that track medications and share patient records — records that include demographics, lab results, medications, procedures, allergies, and more. Collectively, the tested tools can read and write data to the major EHR systems.

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Knight initially set out looking for vulnerabilities in APIs built by the EHR companies themselves. Built on the open Fast Healthcare Interoperability Resources (FHIR) standard for health care data, those APIs are a powerful tool to unify data collected by different systems and support interoperability. “The EHR companies themselves have been partnering with me, allowing me access to their APIs” to conduct security testing, said Knight. But when she couldn’t find any soft spots in their systems, she began testing the FHIR APIs built by third-party data aggregators that interface with electronic health records, along with the gallery of apps that developers have built on those APIs.

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