Cybersecurity concerns

Cybersecurity is concerned with keeping computer networks and the information they hold safe. [1] It is becoming an increasing concern for aged care providers, care workers, care recipients and their families. As the use of electronic technology in aged care increases, so does the need for measures that keep personal information secure. Technologies that are connected to the internet and store medical records and personal details are vulnerable to cyberattacks. Healthcare systems have become an attractive target for cybercriminals as their defences are relatively weak, and the theft of personal information for ransom attacks has become more frequent. [1] These threats are a particular concern for technology that aids with the management of medicines [2, 3] or controls medical devices such as pacemakers. [4] Here, cyber-attacks may pose an immediate risk to life. 

This evidence theme summarises one of the key issues we identified as part of a scoping review of research on human factors and technology in aged care. We found six studies on this topic. [2, 3, 5-8]  If you require more information on this topic, try using our one-click PubMed searches below. 

Aged care services use technology such as robots, 24-hour monitors, camera surveillance, and falls sensors to provide care. Many of these technologies connect to the internet and increase the risk of cyberattacks.

The six studies we identified discussed risks to cybersecurity and the influence this may have on uptake and engagement with technology in aged care. They reported:

• Aged care users may express reduced trust in technologies connected to the internet [6] and consider the use of robotics and autonomous systems such as artificial intelligence (AI) as risky [8]
• Older adults may be fearful of having robots in their home and connected to the internet for fear of hacking, having personal information stolen, and having their interactions with robots influenced [6]
• Many older adults are concerned that someone they do not know could watch them [7]
• Aged care residents were apprehensive about ‘hackers and scammers’ and believed that the use of computers and technology could result in ‘people stealing your name and information.’ [5] 

One article recommends that cybersecurity should be considered in the code of conduct for technology developers and that direct care workers need regular training to ensure the safety of older people and the security of the organisation’s systems. Specific considerations for cybersecurity of the older LGBTIQ+ community is recommended. [6] People in this community may have chosen not to disclose their sexuality, HIV status, or gender identity to digital platforms such as My Health Record or My Aged Care for fear of adverse consequences. [9] 

The scoping review found a limited number of studies examining concerns for cybersecurity in aged care settings and the impact perceptions of risk may have on the uptake of technologies in home and residential aged care. Those studies found also varied in quality. Further studies are clearly needed to understand the relationship between cybersecurity worries and the acceptance and use of technology by older people and the aged care workforce. We report ethical considerations and concerns for privacy, safety, and dignity as separate evidence themes.

1. Coventry L, Branley D. Cybersecurity in healthcare: A narrative review of trends, threats and ways forward. Maturitas. 2018;113:48-52. 
2. Turjamaa R, Vaismoradi M, Kangasniemi M. Older home care clients' experiences of digitalisation: A qualitative study of experiences of the use of robot for medicines management. Scand J Caring Sci. 2022;00:1–10. 
3. Turjamaa R, Vaismoradi M, Kajander-Unkuri S, Kangasniemi M. Home care professionals' experiences of successful implementation, use and competence needs of robot for medication management in Finland. Nurs Open. 2022;00:1–10. 
4. Saxon LA, Varma N, Epstein LM, Ganz LI, Epstein AE. Factors influencing the decision to proceed to firmware upgrades to implanted pacemakers for cybersecurity risk mitigation. Circulation. 2018;138(12):1274-1276. 
5. Moyle W, Jones C, Murfield J, Liu F. ‘For me at 90, it’s going to be difficult’: Feasibility of using ipad video-conferencing with older adults in long-term aged care. Aging Ment Health. 2020;24(2):349-352. 
6. Poulsen A, Fosch-Villaronga E, Burmeister OK. Cybersecurity, value sensing robots for LGBTIQ+ elderly, and the need for revised codes of conduct. Aust J Inf Sys. 2020;24(0). 
7. Sundgren S, Stolt M, Suhonen R. Ethical issues related to the use of gerontechnology in older people care: A scoping review. Nurs Ethics. 2020;27(1):88-103. 
8. Tan SY, Taeihagh A, Tripathi A. Tensions and antagonistic interactions of risks and ethics of using robotics and autonomous systems in long-term care. Technol Forecast Soc Change. 2021;167.
9. Savage, T. Can digital health improve the lives of LGBTIQ+ people? [Internet]. Australia: LGBTIQ+ Health Australia; 2021 [cited 2023 Feb 22]. Available from: https://www.lgbtiqhealth.org.au/can_digital_health_improve_the_lives_of_lgbtiq_people.