Security in Telehealth Systems from a Software Engineering Viewpoint: A Systematic Mapping Study

Telehealth systems (TS's) deliver health care outside of traditional healthcare facilities through the use of telecommunications technology. Technologies and software systems help healthcare professionals to offer remote care of elderly and physically less able patients as well as remote surgeries, treatments, and diagnoses.  Aiming at ensuring the functionality of TS's, several systemic properties must be satisfied, including security. Despite there are studies that discuss different security incidents that involve TS's, it is difficult to have a clear standpoint about which are the most reported security issues and which solutions have been proposed.  Furthermore, since TS's are composed of software systems, it is not clear which key areas of Software Engineering are relevant to develop secure TS's. In this article,  we described a systematic mapping study in order to detect, organize, and characterize security issues in TS's for the purpose of discussing how Software Engineering may help to develop secure TS's. We identified 41 primary studies that were classified according to their research theme, target problem, security issue addressed, and the corresponding proposal(s). Results show that (i) four security issues were identified; (ii) three security strategies were distinguished from handling security issues; and (iii) the most relevant research themes addressed by primary studies are related to insecure data transmission and privacy.  The study's remarks point that Software Engineering has an important role in the mission to mitigate security incidents in TS's. Areas such as requirements, software architecture, and security patterns are essentials to manage security issues.