Fuzzy Cognitive Scenario Mapping for Causes of Cybersecurity in Telehealth Services.

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.

A Risk Assessment Framework Proposal Based on Bow-Tie Analysis for Medical Image Diagnosis Sharing within Telemedicine.

The purpose of this paper is to propose a framework for cybersecurity risk management in telemedicine. The framework, which uses a bow-tie approach for medical image diagnosis sharing, allows the identification, analysis, and assessment of risks, considering the ISO/TS 13131:2014 recommendations. The bow-tie method combines fault tree analysis (FTA) and event tree analysis (ETA). The literature review supported the identification of the main causes and forms of control associated with cybersecurity risks in telemedicine. The main finding of this paper is that it is possible, through a structured model, to manage risks and avoid losses for everyone involved in the process of exchanging medical image information through telemedicine services. Through the framework, those responsible for the telemedicine services can identify potential risks in cybersecurity and act preventively, recognizing the causes even as, in a mitigating way, identifying viable controls and prioritizing investments. Despite the existence of many studies on cybersecurity, the paper provides theoretical contributions to studies on cybersecurity risks and features a new methodological approach, which incorporates both causes and consequences of the incident scenario.