User-centric and secure electronic authentication for digital health services: a case study for Brazil

Digital transformation of the health domain is in the spotlight of the digitalization of public services across the globe. In line with Brazil's digital agenda (ICP Brazil), digitalization has been accelerated in Brazil in the recent past. eID or digital ID is a recognized and trusted person identification solution when seeking public services using digital means. ICP Brazil has listed several eID solutions in use at different levels of maturity, security and usability. However, it is also essential that the health sector requires an eID service with comparatively higher security and privacy level than an eID used for other public services, due to the sensitivity of health data and processes. This leads to a question of how adequate the current eID solutions are in health service provisions, specifically for patients. Unfortunately, the current knowledge domain lacks the evidence for a concrete answer to this question, and in such circumstances, a thorough and deep analysis of current eID solutions is in demand. This study results in such an attempt and will systematically analyse the technical viability and the issues/opportunities of the available eID services. The outcome leads to proposing a way forward for a suitable eID solution that can be used for the digital health domain in Brazil. It furthermore leads to showing the need for a cloud-based and federated wallet solution instead of eIDs with individual trust certificates. The next step of this work is to define the concrete requirements for a complete solution of the eID system for the health domain.