Learning from real-world risk assessment examples helps organizations understand what vulnerabilities to look for and how different findings are prioritized. These case studies represent common scenarios found during healthcare risk assessments.
Case Study 1: Small Dental Practice Assessment
Organization Profile
12-person dental practice with 3 dentists, 6 hygienists/assistants, and 3 administrative staff. Using a 5-year-old practice management system for patient records and billing.
Key Findings Identified
CRITICAL
Finding: All staff use shared login credentials to access practice management system
Threat: Cannot determine who accessed which patient records; unauthorized access possible
Vulnerability: System allows multiple users per account; no individual authentication
Current Control: Password changed quarterly
Impact: Violates HIPAA unique user ID requirement
Remediation: Request vendor update for individual accounts (2 weeks); implement temporary access log review (interim)
HIGH
Finding: Workstations in open reception area can display patient data on screens visible to others
Threat: Unauthorized viewing of patient information by staff or visitors
Vulnerability: Monitors positioned facing reception area
Current Control: Staff instructed to minimize displays (no enforcement)
Impact: Multiple patient privacy violations possible
Remediation: Purchase and install privacy screens ($200); position monitors differently
HIGH
Finding: No documented incident response procedures
Threat: System outage or breach response is uncoordinated
Vulnerability: Staff unclear on reporting procedures or notification requirements
Current Control: None documented
Impact: Delayed response to incidents; potential regulatory violations
Remediation: Develop and document incident response plan (4 weeks); train staff
MEDIUM
Finding: Backup tapes stored in same office as server
Threat: Physical damage or theft could destroy both operational and backup data
Vulnerability: No offsite backup storage
Current Control: Backup tapes in locked cabinet
Impact: Data loss if facility damaged; recovery not possible
Remediation: Move backup copies to offsite secure location (2 weeks)
LOW
Finding: Annual security training documentation incomplete
Threat: Staff unaware of security policies and incident reporting
Vulnerability: Training provided but not formally documented
Current Control: Training conducted informally
Impact: Compliance documentation gap
Remediation: Implement training tracking system; document completion (ongoing)
Assessment Outcome
Total assessment cost: approximately $4,500 (80 hours internal staff time). Critical items addressed within 30 days at minimal cost. High-risk items incorporated into next quarterly budget. Practice now has documented baseline for annual updates.
Case Study 2: Multi-Specialty Medical Group Assessment
Organization Profile
55-person medical group with 8 specialty practices across 3 locations. Multiple EHR systems (practices haven't fully integrated), cloud-based patient portal, multiple vendors for labs and imaging.
Key Findings Identified
CRITICAL
Finding: Business associate agreements missing encryption requirements
Threat: Lab and imaging vendors not required to encrypt PHI
Vulnerability: Outdated vendor contracts from 5+ years ago
Current Control: Vendors claim to be HIPAA-compliant but agreement doesn't specify
Impact: Risk exposure through vendors; regulatory violation
Remediation: Renegotiate business associate agreements with updated terms (6 weeks)
CRITICAL
Finding: Patient portal stores passwords in readable (non-hashed) format in database
Threat: Database breach could expose thousands of patient passwords
Vulnerability: Vendor doesn't follow industry standard for password storage
Current Control: Database access restricted; server firewall in place
Impact: Significant breach risk; affects 15,000+ active patient accounts
Remediation: Vendor emergency patch required (2-week vendor timeline)
HIGH
Finding: No multi-factor authentication for remote EHR access
Threat: Compromised provider credentials could provide full EHR access
Vulnerability: Physicians access EHR remotely using only username/password
Current Control: VPN connection required
Impact: Significant breach risk from compromised credentials
Remediation: Implement multi-factor authentication for remote access (8 weeks, requires vendor update)
HIGH
Finding: No centralized patch management for workstations
Threat: Known vulnerabilities in Windows and third-party software unpatched
Vulnerability: IT staff manually patch systems; inconsistent across three locations
Current Control: Windows updates enabled on some systems
Impact: Significant malware and exploit risk
Remediation: Implement centralized patch management solution (4 weeks)
MEDIUM
Finding: Telehealth platform lacking comprehensive audit logging
Threat: Unable to detect or investigate unauthorized access to telehealth sessions
Vulnerability: Vendor doesn't provide detailed access logs
Current Control: Basic connection logging available
Impact: Difficult to audit telehealth use and detect breaches
Remediation: Evaluate alternative vendors with better audit capabilities (12 weeks)
Assessment Outcome
Total assessment cost: approximately $22,000 (200 hours internal + $8,000 external consultant). Comprehensive findings guide IT investment over next 12 months. Remediation prioritization helps focus limited IT resources on highest-risk items first.
Case Study 3: Hospital System Assessment
Organization Profile
200+ bed hospital with integrated delivery network spanning 5 hospitals and 15 clinics. Epic EHR, multiple legacy systems being sunset, extensive cloud services (Microsoft Azure, Amazon AWS), complex business associate ecosystem.
Significant Findings Examples
HIGH
Finding: Cloud data residency unknown for certain datasets
Threat: PHI may be stored in unapproved geographic locations
Vulnerability: Cloud service provider default settings not reviewed; data location assumptions made
Current Control: Cloud services procured per security standards but not validated post-deployment
Impact: Potential regulatory violations if PHI stored outside US
Remediation: Comprehensive cloud infrastructure audit and reconfiguration (8-12 weeks)
HIGH
Finding: Legacy laboratory system with unpatched security vulnerabilities continues operating
Threat: Known vulnerabilities in unsupported legacy system
Vulnerability: System running Windows Server 2003; cannot be updated; end-of-life
Current Control: Network segmentation and firewall rules limit exposure
Impact: Targeted attack risk; system breach possible
Remediation: Replace legacy system with modern equivalent (12-18 month project with budget approval)
MEDIUM
Finding: Mobile device management program lacks enforcement for jailbroken/rooted devices
Threat: Staff with modified mobile devices could bypass security controls
Vulnerability: MDM policy exists but doesn't automatically disable access
Current Control: MDM enrollment required; vulnerability detection available
Impact: Some endpoints potentially compromised; policy not enforced
Remediation: Configure MDM to automatically block noncompliant devices (2 weeks)
Assessment Outcome
Full enterprise assessment cost: approximately $85,000 (500+ hours internal staff + $35,000 external consultant firm + software). Comprehensive findings guide 3-year capital and operational budget planning. Establishes governance model for ongoing risk management.
Learn From Your Own Assessment
These case studies show the range of vulnerabilities organizations discover during assessment. Medcurity's risk assessment methodology helps you identify, prioritize, and remediate risks specific to your organization.
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Common Risk Assessment Finding Patterns
Findings Often Discovered
- Access control gaps: Shared credentials, excessive privileges, inadequate termination procedures
- Encryption deficiencies: Missing encryption on portable devices, unencrypted data transmission
- Patch management issues: Unpatched systems, outdated operating systems, missing security updates
- Business associate risks: Inadequate vendor agreements, insufficient vendor security oversight
- Documentation gaps: Policies missing or outdated, incomplete training records, no incident procedures
- Physical security vulnerabilities: Unsecured server rooms, visible monitors, uncontrolled facility access
- Backup and disaster recovery weaknesses: Inadequate backup frequency, backups on-site only, untested recovery
- Audit and logging deficiencies: Missing or inadequate logging, logs not reviewed, retention too short
Frequently Asked Questions
Q: Are these examples realistic for my organization?
These case studies represent actual findings from healthcare organizations of different sizes. Your organization will likely have some similar findings combined with unique risks based on your specific systems, processes, and business model. Use these examples to understand what assessors look for.
Q: Can we learn from others' breaches to improve our assessment?
Absolutely. OCR enforcement actions and public breach notifications reveal common vulnerabilities. Include findings from breach notifications in your threat identification process. Ask: "Could this vulnerability exist in our environment?"
Q: What if our assessment findings don't match these examples?
Different organizations have different risk profiles. Small practices may identify simpler findings; complex systems reveal more sophisticated vulnerabilities. The risk assessment process should fit your organization's unique environment, systems, and risk tolerance.
Q: How should we prioritize remediation when we have many findings?
Use risk scoring from these examples: Critical items require immediate action or interim protection. High-risk findings get 30-60 day remediation targets. Medium-risk items get 90-day timelines. Low-risk items fit in annual planning. Document and prioritize based on actual organizational impact.