Telemedicine: Privacy

Privacy is one of the largest threats to telehealth as telemedicine services increase every day. The American Telemedicine Association encourages telehealth and online care to be formed based on the protection of patient privacy, the security of patient data, and the decrease of cybersecurity threats. However, the increased use of technology still raises the chance of cyberattacks and the exposure of a patient’s personal information. Examples of privacy risks include the “lack of control over the collection, use, and sharing of data.” In fact, there is no specific set control over how data is collected through a telehealth device, as these devices may transfer information about a patient’s household and those who live in it. Information that should remain private if wished — such as whether a patient is alone or their location — may be exposed through device sensors that can transmit unwanted information.

Privacy risks and cybersecurity go hand-in-hand, so it is no surprise that there are multiple prominent kinds of cyberattacks, including cryptographic attacks, malware, spyware, and man-in-the-middle (MITM) attacks. In 2020, an HIMSS Cybersecurity Survey found that 70% of polled healthcare security professionals experienced security incidents in their organizations. Of these, 57% were phishing attacks, 11% were breaches or data leakage, and 20% were ransomware or other forms of malware. Due to the fact that hospitals often contain outdated networks, clinics and hospitals serve as attractive ransomware targets. Medical centers, such as the Hollywood Presbyterian Medical Center, which paid $17,000, are sometimes subject to payment to regain files or data after being struck with ransomware.

Furthermore, transferring information, whether intentionally or accidentally, opens up the chance for a security breach, which can result in hackers and malware. Between 2014 and 2022, there were 4,959 data breaches in the U.S., which was more than a quarter of the total breaches (14,655). The total number of healthcare records that were either exposed, stolen, or leaked in 2019 was 41.2 million in 505 data breaches, according to the 2019 Healthcare Data Breach report.

These privacy issues have been brought to attention due to research on patients' environments and their trust in telehealth technology. Since many activities involving telehealth include online consultations, patients are concerned about other individuals being overheard in their homes, the uncovering of their living conditions through video conferencing, or having their confidential conversations heard by family members or relatives. According to the National Library of Medicine, studies proved that “providers cited the lack of private workspace for personnel and difficulty in maintaining awareness of the surroundings to protect patient privacy.” Patients who are not experts at handling telehealth technology are also concerned about their privacy and security, as their lack of trust comes from knowing little about the devices they use.

References:

Houser SH, Flite CA, Foster SL. Privacy and Security Risk Factors Related to Telehealth Services – A Systematic Review. Perspectives in Health Information Management [Internet]. 2023 Jan 10;20(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9860467/ 

Hale TM, Kvedar JC. Privacy and Security Concerns in Telehealth. AMA Journal of Ethics [Internet]. 2014 Dec;16(12):981–5. Available from: https://journalofethics.ama-assn.org/article/privacy-and-security-concerns-telehealth/2014-12 

McCue M. Growing Cybersecurity Concerns for Telehealth Services [Internet]. New Jersey State Policy Lab. Available from: https://policylab.rutgers.edu/growing-cybersecurity-concerns-for-telehealth-services/ 

Hourihan D. Cybersecurity in Healthcare 2022: Privacy Risks of Telehealth [Internet]. ThriveDX. 2022. Available from: https://thrivedx.com/resources/article/cybersecurity-in-healthcare-2022-privacy-risks-of-telehealth 

Telemedicine Security and HIPAA [Internet]. Aaaai.org. 2018. Available from: https://www.aaaai.org/Allergist-Resources/Telemedicine/HIPAA