The State of Practice About Security in Telemedicine Systems in Chile: Exploratory Study

Abstract

Background: Information security within telemedicine systems is essential to advancing the digital transformation of health care. Telemedicine encompasses diverse modalities, including teleconsultation, telehealth, and remote patient monitoring, all of which depend on digital platforms, secured communication networks, and internet-connected devices. Although these systems have progressed in aligning with information security standards and regulations, there remains a shortage of comprehensive, practice-oriented studies evaluating which aspects of security are effectively addressed and which remain insufficiently managed, particularly within the Chilean context. Objective: This study aims to examine how effectively telemedicine systems in Chile address the core security attributes of confidentiality, availability, and integrity. Methods: Data were analyzed from an evaluation tool designed to assess the quality of telemedicine systems in Chile. Over a 6-year period, 25 telemedicine systems from different providers were assessed, and an in-depth examination of how companies manage key information security subcharacteristics within their systems was undertaken. Results: The findings indicate that 52% (n=13) of telemedicine systems optimally implement cryptographic techniques to protect confidentiality. In contrast, 44% (n=11) lack robust strategies for adapting to, recovering from, and mitigating security-related incidents. Fault tolerance mechanisms are frequently integrated to minimize service disruption caused by system failures. However, the prioritization of data integrity varies: while some companies treat it as a critical requirement, others assign it limited importance. Conclusions: This study offers an understanding of the security priorities and practices adopted by telemedicine providers. It highlights a prevailing tendency to prioritize security measures over usability, underscoring the need for a balanced approach that safeguards patient information while supporting efficient clinical workflows.