Healthcare IT systems carry a unique risk profile: they store highly sensitive personal data, support mission-critical clinical operations (laboratory workflows, patient records, medication administration), and connect to external service providers. In many hospitals and clinics worldwide, IBM i / AS400 platforms remain the backbone of operations. This makes it essential to bring these legacy systems into the scope of modern security assessments.
Why targeted testing matters in healthcare
The AS400’s architecture is stable and built on an object-oriented security model, but today’s threat environment has shifted dramatically. These systems now interact with APIs, middleware, cloud services, and remote administrators. In a healthcare context, a compromised AS400 could mean more than financial damage: it could expose patient records, corrupt diagnostic results, or disrupt clinical processes. These risks extend far beyond IT—they directly impact patient safety.
What should healthcare-focused AS400 testing cover?
A penetration test tailored to healthcare organizations should address areas where clinical operations are most vulnerable:
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Access and privilege management: Reviewing user profiles, service accounts (e.g., QSECOFR), ALLOBJ rights, and authority collections. Shared admin accounts or default passwords remain common pitfalls.
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Communication interfaces: Telnet, FTP, 5250, DRDA, ODBC services and their logging. Test environments and outdated connections are often left exposed.
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Integration points: Security of APIs and external systems such as EHR/EMR platforms, PACS, LIS, and cloud-based services.
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Logging and detection: Evaluating QAUDJRN and QAUDLVL settings, and how audit logs integrate into the SOC. Can malicious behavior be detected quickly enough?
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Data protection and encryption: Assessing the handling of protected health information (PHI), secure storage, encrypted channels, and backup access controls.
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Operational resilience: Simulating the business impact of a successful attack, while ensuring the test itself does not disrupt critical processes.
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Medical IoT/OT connections: Ensuring proper network segmentation between AS400 platforms and IP-enabled medical devices.
Methodology: safe and clinically aware testing
Pentesting in healthcare environments must be tightly controlled and non-disruptive. A best-practice approach includes:
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Stakeholder alignment: Engaging compliance officers, clinical leadership, IT operations, and legal teams to define the Rules of Engagement (RoE).
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Risk and impact analysis: Identifying which systems are mission-critical, which operations cannot be interrupted, and what redundancies exist.
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Phased execution: Starting with low-risk assessments, moving to deeper exploitation, and post-exploitation only within the agreed RoE. Where possible, tests should be run in isolated environments or sandboxed.
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Detection and response validation: Using the test to measure SOC/IR capabilities—how quickly is activity detected, how effectively do teams respond?
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Documented communication: Establishing clear reporting and escalation paths for any issues identified during testing.
Compliance and regulatory context
Healthcare is one of the most heavily regulated industries. Pentest reports are crucial evidence of due diligence and support compliance with frameworks such as:
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HIPAA Security Rule in the United States
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GDPR in the European Union
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NIS2 Directive for critical infrastructure
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ISO/IEC 27001 for information security management
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Local health data regulations in each jurisdiction
Beyond legal requirements, pentesting demonstrates to patients, regulators, and partners that the organization is proactive in protecting sensitive data.
The role of the right partner
Not every security provider understands AS400. Its architecture, commands, and authority model require specialized expertise. A qualified partner—such as www.superiorpentest.com—brings:
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Expertise in IBM i / AS400 internals
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Non-disruptive but thorough exploitation techniques
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Business-aware reporting with prioritized remediation guidance
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Retesting and SOC/IR training opportunities
This ensures the results are not just technical, but strategically valuable for healthcare leaders.
Security equals patient safety
In healthcare, security gaps are not just IT issues—they are patient safety issues. Downtime in hospital systems can delay treatments. Data leakage can undermine patient trust. Manipulated results can put lives at risk.
By conducting targeted as400 penetration testing, healthcare organizations close blind spots, reduce regulatory exposure, and most importantly, safeguard their patients. Legacy systems and modern platforms alike must be tested regularly—not only to react to threats, but to anticipate them.