End-Users' Knowledge and Perception about Security of Mobile Health Apps: An Empirical Study

Context: Mobile health applications (mHealth apps for short) are being increasingly adopted in the healthcare sector, enabling stakeholders such as governments, health units, medics, and patients, to utilize health services in a pervasive manner. Despite having several known benefits, mHealth apps entail significant security and privacy challenges that can lead to data breaches with serious social, legal, and financial consequences. Objective: This research presents an empirical investigation about security awareness of end-users of mHealth apps that are available on major mobile platforms, including Android and iOS. Method: We collaborated with two mHealth providers in Saudi Arabia to survey 101 end-users, investigating their security awareness about (i) existing and desired security features, (ii) security related issues, and (iii) methods to improve security knowledge. Results: Findings indicate that majority of the end-users are aware of the existing security features provided by the apps (e.g., restricted app permissions); however, they desire usable security (e.g., biometric authentication) and are concerned about privacy of their health information (e.g., data anonymization). End-users suggested that protocols such as session timeout or Two-factor authentication (2FA) positively impact security but compromise usability of the app. Security-awareness via social media, peer guidance, or training from app providers can increase end-users trust in mHealth apps. Conclusion: This research investigates human-centric knowledge based on empirical evidence and provides a set of guidelines to develop secure and usable mHealth apps.