Abstract
Telemedicine has transformed healthcare delivery by enabling remote consultations, electronic health record management, and real-time patient monitoring. However, the exchange of sensitive medical information across distributed networks raises significant security and privacy concerns, particularly with the emergence of quantum computing. This systematic literature review examines cryptographic approaches for securing telemedicine systems, focusing on classical cryptography, post-quantum cryptography, hybrid cryptographic frameworks, authentication mechanisms, and context-aware security. Following the PRISMA 2020 guidelines, 45 studies were systematically selected and synthesized. The review reveals a shift from conventional cryptographic methods toward hybrid and quantum-resistant solutions, with CRYSTALS-Kyber and ECC–Kyber emerging as the dominant approaches. It further identifies the limited integration of context aware mechanisms into hybrid cryptographic frameworks as a key research gap. The findings highlight adaptive hybrid cryptography as a promising direction for secure, scalable, and quantum-resistant telemedicine systems.