Security and privacy in e-health technologies: a scoping review of challenges and strategies in primary care.

IF 1.9 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Family practice Pub Date : 2026-02-07 DOI:10.1093/fampra/cmag006

Gökçe İşcan, Oğulcan Çöme

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引用次数: 0

Abstract

Background: The rapid integration of e-health technologies-such as telehealth, mobile health (mHealth), and electronic health records-has transformed primary care delivery, especially during the COVID-19 pandemic. However, this transformation has revealed significant vulnerabilities in data privacy and security, particularly in decentralized and resource-limited primary care settings. This scoping review aims to map current evidence on privacy and security concerns related to e-health technologies in primary care and to identify mitigation strategies and research gaps.

Methods: A systematic search was conducted in PubMed, ACM, Scopus, and Web of Science for studies published between 2019 and 2024. Eligible studies addressed both privacy/security issues and e-health technology use in primary care. A two-stage screening process and full-text review were applied. Data were extracted and thematically synthesized.

Results: Fifty-two studies were included. E-health technologies examined included teleconsultations, patient portals, digital decision support tools, and artificial intelligence (AI)-based systems. Among included studies, telehealth accounted for 28%, mHealth and wearables 20%, electronic health records 16%, and AI applications 6%. Common concerns involved data breaches, insufficient encryption, lack of interoperability, consent ambiguity, and challenges in securing virtual consultations. Vulnerable groups-such as older adults and low-literacy populations-faced higher risks. Recommended strategies included privacy-by-design principles, secure infrastructure, user-centered design, clearer governance policies, provider training, and hybrid care models.

Conclusion: Addressing privacy and security in e-health requires more than technical solutions. Equitable, safe, and trustworthy systems must incorporate legal, ethical, and human-centered approaches. In primary care, privacy must be positioned as a core element of digital health equity, not an optional enhancement.

查看原文本刊更多论文

电子保健技术中的安全和隐私：初级保健挑战和战略的范围审查。

背景：远程医疗、移动医疗（mHealth）和电子健康记录等电子卫生技术的快速整合已经改变了初级保健服务，特别是在2019冠状病毒病大流行期间。然而，这种转变暴露了数据隐私和安全方面的重大漏洞，特别是在分散和资源有限的初级保健环境中。本次范围审查的目的是绘制与初级保健中的电子保健技术有关的隐私和安全问题的现有证据，并确定缓解战略和研究差距。方法：系统检索PubMed、ACM、Scopus和Web of Science中2019 - 2024年间发表的研究。符合条件的研究涉及隐私/安全问题和初级保健中的电子保健技术使用。采用两阶段筛选和全文审查。提取数据并进行主题合成。结果：纳入52项研究。研究的电子卫生技术包括远程咨询、患者门户、数字决策支持工具和基于人工智能（AI）的系统。在纳入的研究中，远程医疗占28%，移动医疗和可穿戴设备占20%，电子健康记录占16%，人工智能应用占6%。常见的问题包括数据泄露、加密不足、缺乏互操作性、同意模糊以及确保虚拟咨询的挑战。弱势群体——如老年人和低识字率人群——面临着更高的风险。建议的策略包括设计隐私原则、安全基础设施、以用户为中心的设计、更清晰的治理策略、提供者培训和混合护理模式。结论：解决电子医疗中的隐私和安全问题需要的不仅仅是技术解决方案。公平、安全和值得信赖的系统必须包含法律、道德和以人为本的方法。在初级保健中，隐私必须被定位为数字健康公平的核心要素，而不是可有可无的增强。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Family practice 医学-医学：内科

CiteScore

4.30

自引率

9.10%

发文量

144

审稿时长

4-8 weeks

期刊介绍： Family Practice is an international journal aimed at practitioners, teachers, and researchers in the fields of family medicine, general practice, and primary care in both developed and developing countries. Family Practice offers its readership an international view of the problems and preoccupations in the field, while providing a medium of instruction and exploration. The journal''s range and content covers such areas as health care delivery, epidemiology, public health, and clinical case studies. The journal aims to be interdisciplinary and contributions from other disciplines of medicine and social science are always welcomed.