1. What is security debt, and how is it different from technical debt?
Security debt is the accumulation of vulnerabilities and outright gaps that occurs as technology products and portfolios mature, and network architectures and security baselines evolve. If IT stands still while the world around it changes, dangers accrue on their own. Unlike technical debt, security debt includes unknown risks and unpredictable mitigations: You don’t know what you don’t know. In healthcare, this hidden security debt presents risks to patient safety and privacy, invites cyberattacks and can lead to compliance and audit failures.
2. What are common causes of security debt?
Healthcare accumulates more security debt than many other industries because of the sector’s necessary investment in specialized medical equipment and niche software systems. Healthcare IT often must rely on patchwork solutions to integrate legacy and newer applications and networks, and each obsolete or obscure device in the network adds to the risk profile.
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3. What happens when security debt accumulates?
In healthcare, the risks of security debt can be severe: A breach could halt procedures, delay critical lab and pathology results, and block access to patient chart information. When unaddressed vulnerabilities accumulate, hospitals can suffer not just financial losses and reputational harm, but also real-time problems that put patients’ lives at risk.
4. What strategies can reduce the risk of security debt?
Operationally, strategies such as continuous monitoring constantly assess the security status of networks, systems, devices and applications. With real-time visibility into security posture, IT teams can prioritize remediation of risks before they turn into breaches. More important, though, is long-term management of security debt. High-quality vulnerability assessment tools, outside risk assessments and budget support to replace the most vulnerable legacy systems all help mitigate security debt. IT teams should also conduct impact assessments to prioritize patching and protect devices and applications closely associated with patient care delivery.
5. How can healthcare IT balance clinical needs with remediation?
IT teams need to fight to put security debt reduction as a line item — and deliverable — in capital plans and clinical priority lists. Healthcare administrators will always want to prioritize resources for patient care, so IT teams must clearly present data to management on the hidden risk security debt poses to clinical goals. Debt accumulates when things are out of balance. This means that it’s the job of the IT department to get a seat at the table to be aware of patient care initiatives with IT components and to ensure that underinvestment in security doesn’t lead to catastrophic system failure in the future.
