What You Should Know:
– A new 2025 report from Paubox reveals a critical disconnect between the perceived security readiness and actual email vulnerability within healthcare organizations. While 92% of healthcare IT leaders express confidence in their ability to prevent email-based data breaches, 8 out of 10 admit to worrying about their HIPAA compliance status, highlighting a dangerous overconfidence that leaves patient data exposed.
– The report, “2025 Healthcare Email Security Report” leverages survey data from 150 U.S. healthcare IT leaders, breach analysis, and configuration audits, argues that email remains healthcare’s largest cybersecurity vulnerability. Critical gaps persist due to outdated systems and tools that create significant user frustration, leading staff to bypass security protocols.
The Confidence Gap: Why Perceived Security Isn’t Reality
The confidence expressed by IT leaders is undermined by common on-the-ground realities. The Paubox report points to widespread security weaknesses that are often overlooked, including:
- User-dependent encryption that relies on staff to take extra steps.
- Partially configured email authentication tools like DMARC and SPF.
- A lack of formal incident response workflows for email-related risks, which is a HIPAA violation.
- Failure to review email logs and analytics.
“Too often, organizations rely on infosec policies, user training, or manually enforced controls—rather than implementing automated, policy-driven email encryption solutions,” said Andrew Hicks, a partner at Frazier & Dieter Advisory, LLC. “This overreliance on human-dependent safeguards introduces unnecessary risk.”
This gap is further widened by significant barriers to adopting modern, HIPAA-compliant email solutions. Over half of IT leaders (54%) cited implementation complexity as a top concern, followed by a lack of vendor support (53%), IT staffing shortages (45%), and resistance from leadership (44%).
AI-Powered Threat Detection is Missing in Action
Phishing attacks are becoming more sophisticated, increasingly personalized and generated by AI to evade traditional, rules-based filters. The report highlights that while 89% of healthcare IT leaders believe AI and machine learning are critical for detecting email threats, only 44% are currently using AI-powered threat detection.
This leaves the majority of organizations vulnerable to modern attacks that can easily bypass outdated security measures. “If your email security plan doesn’t already include AI, you’re giving attackers a head start,” the report warns.
Budgets are Out of Touch with Risk
Despite email being the single largest attack vector in healthcare, the report finds a severe underinvestment in securing it. A majority (56%) of healthcare organizations allocate less than 10% of their IT budgets to cybersecurity, with most dedicating less than 6%.
This is starkly lower than in other sectors, such as financial services (10-12%) and general industry (21%). This underfunding persists even as the average cost of a healthcare data breach has climbed to $9.8 million in fines, lawsuits, and operational fallout.
When Security Plans Create Friction
A critical theme of the report is that usability is a core component of security. When security tools are cumbersome, they get bypassed. An overwhelming 86% of IT leaders admit that their current email security tools cause workflow friction for users.
Top frustrations include:
- Complex password resets (54%)
- High rates of false positives in filters (48%)
- Clunky user interfaces (46%)
- Delays from encryption processes (45%)
Perception ≠ Protection: 5 Moves to Make Now
The report concludes that confidence without clarity is dangerous. To move from a state of perceived security to one of genuine protection, healthcare organizations must challenge their assumptions and take decisive action. Paubox recommends five key moves:
- Audit your secure email configurations. Don’t assume they are set up correctly.
- Stop making users choose encryption. Make it automatic and seamless.
- Upgrade detection systems to keep up with AI-powered threats.
- Fund email security in proportion to its risk.
- Choose tools that disappear into the workflow, not ones that disrupt it.
