Abstract

Hospital organizations have adopted telehealth systems to expand their services to a portion of the Brazilian population with limited access to healthcare, mainly due to the geographical distance between their communities and hospitals. The importance and usage of those services have recently increased due to the COVID-19 state-level mobility interventions. These services work with sensitive and confidential data that contain medical records, medication prescriptions, and results of diagnostic processes. Understanding how cybersecurity impacts the development of telehealth strategies is crucial for creating secure systems for daily operations. In the application reported in this article, the Fuzzy Cognitive Maps (FCMs) translated the complexity of cybersecurity in telehealth services into intelligible and objective results in an expert-based cognitive map. The tool also allowed the construction of scenarios simulating the possible implications caused by common factors that affect telehealth systems. FCMs provide a better understanding of cybersecurity strategies using expert knowledge and scenario analysis, enabling the maturation of cybersecurity in telehealth services.

Highlights

  • The Brazilian Ministry of Health created the national telehealth system in 2007 with the initial objective of promoting family health remotely by using Information and Communication Technologies (ICT)

  • The concept of cybersecurity was explained to the ICT manager—it refers to the art of ensuring the existence and continuity of a nation’s information society, guaranteeing and protecting in cyberspace all of its information assets and critical infrastructure

  • The interaction with the ICT manager was essential for analyzing concepts that influence cyberattacks in telehealth systems, especially in the testimony of their possible consequences associated with the system’s vulnerabilities

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Summary

Introduction

The Brazilian Ministry of Health created the national telehealth system in 2007 with the initial objective of promoting family health remotely by using Information and Communication Technologies (ICT). One factor that justifies implementing this system is delivering healthcare to people living in remote communities where the nearest hospital care is distant. During the first semester of 2020, telehealth, called telemedicine strategies, became essential in Brazil and many other countries due to the COVID-19 pandemic pressure on the limited hospital resources and the related response from public authorities imposing quarantine campaigns and mobility interventions worldwide. According to Nepomuceno et al [2], when many potentially infected patients require regular or intensive care at the same time, hospitals with limited resources end up overloaded, the probability of propagation increases, and, as a result, the health systems collapse due to the lack of technical resources, fatigue, and overloading health teams. COVID-19 lockdown and social distance strategies in many have presented an opportunity for both doctors and patients to use telemedicine as a new manner of engagement and treatment in many regions [3,4]

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