Beyond the click: Pixel tracking technologies and patient data security in hospitals.

Digital tracking technologies have transformed and enhanced online data collection across industries. Their integration into healthcare systems, however, raises urgent concerns about patient privacy and security. This study provides the first large-scale empirical analysis of pixel tracking technologies on US hospital websites and their unintended consequences for data breaches. Using historical website data from the Wayback Machine (2012-2023), we find that 66% of the sample employed pixel tracking, despite stringent privacy regulations. Our results reveal that third-party pixel use significantly increases data breach risk, underscoring a previously undocumented cybersecurity vulnerability. These findings highlight a critical regulatory gap in healthcare privacy, as tracking pixels operate outside the traditional scope of Health Insurance Portability and Accountability Act protections. As hospitals increasingly rely on digital tools, our study calls for reevaluating privacy and data security safeguards and regulatory oversight to address the emerging risks of modern tracking technologies.