Unified API Protection for Healthcare

API adoption is revolutionizing interoperability efforts and health data exchange as providers race to comply with the CMS Interoperability and Patient Access final rule while they work towards implementing the HL7 Fast Healthcare Interoperability Resources (FHIR) standard. A recent survey of developers showed that 71% expect healthcare to rely on APIs more in 2022 than 2021. The wide spread adoption combined with the power and flexibility found in APIs makes them the #1 target for attackers, who use their developer skills for malicious purposes. This data point is validated in the most recent Cequence Security API Usage and Threat Report that found 80% or 1.8 billion of the blocked attacks were API-based.

By the Numbers


Healthcare is one of the biggest adopters of APIs with healthcare API traffic growing by more than 400 percent in 2020.
Marsh McLennan Global Cyber Risk Analytics Center


In a recent study, 100% of 30 of the leading mobile health (mHealth) apps were found to be vulnerable to API attacks which could allow unauthorized individuals to gain access to full patient records.


Personal health information is the most valuable data on the dark web, demanding 10 times more the price of a credit card for a single PHI record.

The API Protection Challenge for Healthcare

Healthcare involves many parties working together such as health insurance, healthcare marketing, pharmacy and prescription management, healthcare tech, and health administration. This makes them a target for attackers and cybercriminals seeking monetary gain by exploiting APIs to steal patient records and healthcare financial data. Attacks on healthcare APIs can introduce a range of risks and they impact the entire business – not just the security team. Business impact examples include:


Whether it’s an automated attack on a perfectly coded API, or a volumetric attack against an API coded without resource or rate limiting (OWASP API#4), the impact on infrastructure teams can cause costs to skyrocket. Worse yet, the web site and mobile app can become non-responsive, resulting in (real) user dissatisfaction.


Security is impacted by efforts to slow or stop API attacks, often struggling to separate real transactions from fake, or worse yet, blindsided by an unprotected shadow API.

Fraud and Compliance Teams

Often engaged directly if the attacks are fake account or ATO related, investigating individual accounts, issuing account reset or delete recommendations. All of which consumes time that could (and should) be spent on broader team goals.

Customer Satisfaction, PR, Brand

A recent IBM study showed that efforts to minimize the loss of customers and manage business disruptions caused by an attack on a healthcare organization accounted for the second-highest cost at $1.42 million (of the total $10.1M per attack). A bad experience due to a slow or unavailable website, or a data breach can drive customers them elsewhere, resulting in a 5x increase in costs of acquiring a new customer.

Limitations of Traditional Defenses

Today’s security teams simply lack the visibility and defense capabilities they need to protect the ever-growing risk from APIs and other application connections. Many believe that compliance with PCI or SOC 2 and a “shift-left, DevOps” approach is sufficient to protect their APIs. The problem with these strategies is that they don’t have a way to “know the unknown”, meaning they aren’t able to look for all APIs and API vulnerabilities without knowing where to look. Even if all APIs are discovered and “known”, attackers can still leverage seemingly legitimate transactions in an attempt to steal data, or commit fraud. Traditional approaches that use WAFs or API gateways depend on easily evadable detection, lack the real-time ability to discern good from bad API activity and are reliant on static, least common denominator protection spread across multiple technology components.

Cequence Secures the Healthcare Industry

Cequence Security believes in taking a holistic approach to defending against API-related data risk with a market-defining Unified API Protection solution that goes beyond API security approaches that may focus solely on one aspect of the API protection journey. Achieving true peace of mind for comprehensive API attack protection means traveling through six distinct steps associated with the Unified API Protection solution:
Healthcare data security
Outside-in discovery: Viewing an organization’s API attack surface from a threat actor perspective to know the unknown.
Inside-out inventory: Performing a comprehensive API inventory, including all existing APIs and connections.
Compliance monitoring: Keeping APIs in compliance with specifications, standards and regulations such as the OpenAPI Specification and ensuring ongoing API governance.
Threat detection: Continuously scanning for threats, including subtle business logic abuses and malicious activity that has not yet been observed.
Threat prevention: Employing countermeasures such as alerts, real-time blocking and even deception, without the need for added third-party data security tools.
Ongoing API testing: Integrating API protection into development, which shifts API security left within the organization, so risky code doesn’t go live.
Unified API Protection is different from fragmented or incomplete API protection offerings because it’s a methodology designed to account for multiple types of risk, across every phase of the API protection lifecycle.

Why Cequence?

With the Cequence Unified API Protection solution, customers can continue to reap the competitive and business advantages of ubiquitous API connectivity. The Cequence solution results in attack futility, failure, and fatigue for even the most relentless of attackers. It significantly improves visibility and protection while reducing cost, minimizing fraud, business abuse, data losses and non-compliance.

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