Pseudonymization and its Application to Cloud-based eHealth Systems

Responding to the security and privacy issues of information systems, we propose a novel pseudonym solution. This pseudonym solution has provable security to protect the identities of users by employing user-generated pseudonyms. It also provides an encryption scheme to protect the security of the users’ data stored in the public network. Moreover, the pseudonym solution also provides the authentication of pseudonyms without disclosing the users’ identity information. Thus the dependences on powerful trusted third parties and on the trustworthiness of system administrators may be appreciably alleviated. Electronic healthcare systems (eHealth systems), as one kind of everyday information system, with the ability to store and share patients’ health data efficiently, have to manage in-formation of an extremely personal nature. As a consequence of known cases of abuse and attacks, the security of the health data and the privacy of patients are a great concern for many people and thus becoming obstacles to the acceptance and spread of eHealth systems. In this thesis, we survey current eHealth systems in both research and practice, analyzing potential threats to the security and privacy. Cloud-based eHealth systems, in particular, enable applications with many new features in data storing and sharing. We analyze the new issues on security and privacy when cloud technology is introduced into eHealth systems. We demonstrate that our proposed pseudonym solution can be successfully applied to cloud-based eHealth systems. Firstly, we utilize the pseudonym scheme and encryption scheme for storing and retrieving the electronic health records (EHR) in the cloud. The identities of patients and the confidentiality of EHR contents are provably guaranteed by advanced cryptographic algorithms. Secondly, we utilize the pseudonym solution to protect the privacy of patients from the health insurance companies. Only necessary information about patients is disclosed to the health insurance companies, without interrupting the cur-rent normal business processes of health insurance. At last, based on the pseudonym solution, we propose a new procedure for the secondary use of the health data. The new procedure protects the privacy of patients properly and enables patients’ full control and clear consent over their health data to be secondarily used. A prototypical application of a cloud-based eHealth system implementing our proposed solution is presented in order to exhibit the practicability of the solution and to provide intuitive experiences. Some performance estimations of the proposed solution based on the implementation are also provided.Um gewisse Sicherheits- und Datenschutzdefizite heutiger Informationssysteme zu beheben, stellen wir eine neuartige Pseudonymisierungslösung vor, die benutzergenerierte Pseudonyme verwendet und die Identitäten der Pseudonyminhaber nachweisbar wirksam schützt. Sie beinhaltet neben der Pseudonymisierung auch ein Verschlüsselungsverfahren für den Schutz der Vertraulichkeit der Benutzerdaten, wenn diese öffentlich gespeichert werden. Weiterhin bietet sie ein Verfahren zur Authentisierung von Pseudonymen, das ohne die Offenbarung von Benutzeridentitäten auskommt. Dadurch können Abhängigkeiten von vertrauenswürdigen dritten Stellen (trusted third parties) oder von vertrauenswürdigen Systemadministratoren deutlich verringert werden. Elektronische Gesundheitssysteme (eHealth-Systeme) sind darauf ausgelegt, Patientendaten effizient zu speichern und bereitzustellen. Solche Daten haben ein extrem hohes Schutzbedürfnis, und bekannte Fälle von Angriffen auf die Vertraulichkeit der Daten durch Privilegienmissbrauch und externe Attacken haben dazu geführt, dass die Sorge um den Schutz von Gesundheitsdaten und Patientenidentitäten zu einem großen Hindernis für die Verbreitung und Akzeptanz von eHealth-Systemen geworden ist. In dieser Dissertation betrachten wir gegenwärtige eHealth-Systeme in Forschung und Praxis hinsichtlich möglicher Bedrohungen für Sicherheit und Vertraulichkeit der gespeicherten Daten. Besondere Beachtung finden cloudbasierte eHealth-Systeme, die Anwendungen mit neuartigen Konzepten zur Datenspeicherung und -bereitstellung ermöglichen. Wir analysieren Sicherheits- und Vertraulichkeitsproblematiken, die sich beim Einsatz von Cloud-Technologie in eHealth-Systemen ergeben. Wir zeigen, dass unsere Pseudonymisierungslösung erfolgreich auf cloudbasierte eHealth-Systeme angewendet werden kann. Dabei werden zunächst das Pseudonymisierungs- und das Verschlüsselungsverfahren bei der Speicherung und beim Abruf von elektronischen Gesundheitsdatensätzen (electronic health records, EHR) in der Cloud eingesetzt. Die Vertraulichkeit von Patientenidentitäten und EHR-Inhalten werden dabei durch den Einsatz moderner kryptografischer Algorithmen nachweisbar garantiert. Weiterhin setzen wir die Pseudonymisierungslösung zum Schutz der Privatsphäre der Patienten gegenüber Krankenversicherungsunternehmen ein. Letzteren werden lediglich genau diejenigen Patienteninformationen offenbart, die für den störungsfreien Ablauf ihrer Geschäftsprozesse nötig sind. Schließen schlagen wir eine neuartige Vorgehensweise für die Zweitverwertung der im eHealth-System gespeicherten Daten vor, die die Pseudonymisierungslösung verwendet. Diese Vorgehensweise bietet den Patienten angemessenen Schutz für ihre Privatsphäre und volle Kontrolle darüber, welche Daten für eine Zweitverwertung (z.B. für Forschungszwecke) freigegeben werden. Es wird ein prototypisches, cloudbasiertes eHealth-System vorgestellt, das die Pseudonymisierungslösung implementiert, um deren Praktikabilität zu demonstrieren und intuitive Erfahrungen zu vermitteln. Weiterhin werden, basierend auf der Implementierung, einige Abschätzungen der Performanz der Pseudonymisierungslösung angegeben

Identity Management and Authorization Infrastructure in Secure Mobile Access to Electronic Health Records

We live in an age of the mobile paradigm of anytime/anywhere access, as the mobile device is the most ubiquitous device that people now hold. Due to their portability, availability, easy of use, communication, access and sharing of information within various domains and areas of our daily lives, the acceptance and adoption of these devices is still growing. However, due to their potential and raising numbers, mobile devices are a growing target for attackers and, like other technologies, mobile applications are still vulnerable. Health information systems are composed with tools and software to collect, manage, analyze and process medical information (such as electronic health records and personal health records). Therefore, such systems can empower the performance and maintenance of health services, promoting availability, readability, accessibility and data sharing of vital information about a patients overall medical history, between geographic fragmented health services. Quick access to information presents a great importance in the health sector, as it accelerates work processes, resulting in better time utilization. Additionally, it may increase the quality of care. However health information systems store and manage highly sensitive data, which raises serious concerns regarding patients privacy and safety, and may explain the still increasing number of malicious incidents reports within the health domain. Data related to health information systems are highly sensitive and subject to severe legal and regulatory restrictions, that aim to protect the individual rights and privacy of patients. Along side with these legislations, security requirements must be analyzed and measures implemented. Within the necessary security requirements to access health data, secure authentication, identity management and access control are essential to provide adequate means to protect data from unauthorized accesses. However, besides the use of simple authentication models, traditional access control models are commonly based on predefined access policies and roles, and are inflexible. This results in uniform access control decisions through people, different type of devices, environments and situational conditions, and across enterprises, location and time. Although already existent models allow to ensure the needs of the health care systems, they still lack components for dynamicity and privacy protection, which leads to not have desire levels of security and to the patient not to have a full and easy control of his privacy. Within this master thesis, after a deep research and review of the stat of art, was published a novel dynamic access control model, Socio-Technical Risk-Adaptable Access Control modEl (SoTRAACE), which can model the inherent differences and security requirements that are present in this thesis. To do this, SoTRAACE aggregates attributes from various domains to help performing a risk assessment at the moment of the request. The assessment of the risk factors identified in this work is based in a Delphi Study. A set of security experts from various domains were selected, to classify the impact in the risk assessment of each attribute that SoTRAACE aggregates. SoTRAACE was integrated in an architecture with requirements well-founded, and based in the best recommendations and standards (OWASP, NIST 800-53, NIST 800-57), as well based in deep review of the state-of-art. The architecture is further targeted with the essential security analysis and the threat model. As proof of concept, the proposed access control model was implemented within the user-centric architecture, with two mobile prototypes for several types of accesses by patients and healthcare professionals, as well the web servers that handles the access requests, authentication and identity management. The proof of concept shows that the model works as expected, with transparency, assuring privacy and data control to the user without impact for user experience and interaction. It is clear that the model can be extended to other industry domains, and new levels of risks or attributes can be added because it is modular. The architecture also works as expected, assuring secure authentication with multifactor, and secure data share/access based in SoTRAACE decisions. The communication channel that SoTRAACE uses was also protected with a digital certificate. At last, the architecture was tested within different Android versions, tested with static and dynamic analysis and with tests with security tools. Future work includes the integration of health data standards and evaluating the proposed system by collecting users’ opinion after releasing the system to real world.Hoje em dia vivemos em um paradigma móvel de acesso em qualquer lugar/hora, sendo que os dispositivos móveis são a tecnologia mais presente no dia a dia da sociedade. Devido à sua portabilidade, disponibilidade, fácil manuseamento, poder de comunicação, acesso e partilha de informação referentes a várias áreas e domínios das nossas vidas, a aceitação e integração destes dispositivos é cada vez maior. No entanto, devido ao seu potencial e aumento do número de utilizadores, os dispositivos móveis são cada vez mais alvos de ataques, e tal como outras tecnologias, aplicações móveis continuam a ser vulneráveis. Sistemas de informação de saúde são compostos por ferramentas e softwares que permitem recolher, administrar, analisar e processar informação médica (tais como documentos de saúde eletrónicos). Portanto, tais sistemas podem potencializar a performance e a manutenção dos serviços de saúde, promovendo assim a disponibilidade, acessibilidade e a partilha de dados vitais referentes ao registro médico geral dos pacientes, entre serviços e instituições que estão geograficamente fragmentadas. O rápido acesso a informações médicas apresenta uma grande importância para o setor da saúde, dado que acelera os processos de trabalho, resultando assim numa melhor eficiência na utilização do tempo e recursos. Consequentemente haverá uma melhor qualidade de tratamento. Porém os sistemas de informação de saúde armazenam e manuseiam dados bastantes sensíveis, o que levanta sérias preocupações referentes à privacidade e segurança do paciente. Assim se explica o aumento de incidentes maliciosos dentro do domínio da saúde. Os dados de saúde são altamente sensíveis e são sujeitos a severas leis e restrições regulamentares, que pretendem assegurar a proteção dos direitos e privacidade dos pacientes, salvaguardando os seus dados de saúde. Juntamente com estas legislações, requerimentos de segurança devem ser analisados e medidas implementadas. Dentro dos requerimentos necessários para aceder aos dados de saúde, uma autenticação segura, gestão de identidade e controlos de acesso são essenciais para fornecer meios adequados para a proteção de dados contra acessos não autorizados. No entanto, além do uso de modelos simples de autenticação, os modelos tradicionais de controlo de acesso são normalmente baseados em políticas de acesso e cargos pré-definidos, e são inflexíveis. Isto resulta em decisões de controlo de acesso uniformes para diferentes pessoas, tipos de dispositivo, ambientes e condições situacionais, empresas, localizações e diferentes alturas no tempo. Apesar dos modelos existentes permitirem assegurar algumas necessidades dos sistemas de saúde, ainda há escassez de componentes para accesso dinâmico e proteção de privacidade , o que resultam em níveis de segurança não satisfatórios e em o paciente não ter controlo directo e total sobre a sua privacidade e documentos de saúde. Dentro desta tese de mestrado, depois da investigação e revisão intensiva do estado da arte, foi publicado um modelo inovador de controlo de acesso, chamado SoTRAACE, que molda as diferenças de acesso inerentes e requerimentos de segurança presentes nesta tese. Para isto, o SoTRAACE agrega atributos de vários ambientes e domínios que ajudam a executar uma avaliação de riscos, no momento em que os dados são requisitados. A avaliação dos fatores de risco identificados neste trabalho são baseados num estudo de Delphi. Um conjunto de peritos de segurança de vários domínios industriais foram selecionados, para classificar o impacto de cada atributo que o SoTRAACE agrega. O SoTRAACE foi integrado numa arquitectura para acesso a dados médicos, com requerimentos bem fundados, baseados nas melhores normas e recomendações (OWASP, NIST 800-53, NIST 800-57), e em revisões intensivas do estado da arte. Esta arquitectura é posteriormente alvo de uma análise de segurança e modelos de ataque. Como prova deste conceito, o modelo de controlo de acesso proposto é implementado juntamente com uma arquitetura focada no utilizador, com dois protótipos para aplicações móveis, que providênciam vários tipos de acesso de pacientes e profissionais de saúde. A arquitetura é constituída também por servidores web que tratam da gestão de dados, controlo de acesso e autenticação e gestão de identidade. O resultado final mostra que o modelo funciona como esperado, com transparência, assegurando a privacidade e o controlo de dados para o utilizador, sem ter impacto na sua interação e experiência. Consequentemente este modelo pode-se extender para outros setores industriais, e novos níveis de risco ou atributos podem ser adicionados a este mesmo, por ser modular. A arquitetura também funciona como esperado, assegurando uma autenticação segura com multi-fator, acesso e partilha de dados segura baseado em decisões do SoTRAACE. O canal de comunicação que o SoTRAACE usa foi também protegido com um certificado digital. A arquitectura foi testada em diferentes versões de Android, e foi alvo de análise estática, dinâmica e testes com ferramentas de segurança. Para trabalho futuro está planeado a integração de normas de dados de saúde e a avaliação do sistema proposto, através da recolha de opiniões de utilizadores no mundo real

A patient agent controlled customized blockchain based framework for internet of things

Although Blockchain implementations have emerged as revolutionary technologies for various industrial applications including cryptocurrencies, they have not been widely deployed to store data streaming from sensors to remote servers in architectures known as Internet of Things. New Blockchain for the Internet of Things models promise secure solutions for eHealth, smart cities, and other applications. These models pave the way for continuous monitoring of patient’s physiological signs with wearable sensors to augment traditional medical practice without recourse to storing data with a trusted authority. However, existing Blockchain algorithms cannot accommodate the huge volumes, security, and privacy requirements of health data. In this thesis, our first contribution is an End-to-End secure eHealth architecture that introduces an intelligent Patient Centric Agent. The Patient Centric Agent executing on dedicated hardware manages the storage and access of streams of sensors generated health data, into a customized Blockchain and other less secure repositories. As IoT devices cannot host Blockchain technology due to their limited memory, power, and computational resources, the Patient Centric Agent coordinates and communicates with a private customized Blockchain on behalf of the wearable devices. While the adoption of a Patient Centric Agent offers solutions for addressing continuous monitoring of patients’ health, dealing with storage, data privacy and network security issues, the architecture is vulnerable to Denial of Services(DoS) and single point of failure attacks. To address this issue, we advance a second contribution; a decentralised eHealth system in which the Patient Centric Agent is replicated at three levels: Sensing Layer, NEAR Processing Layer and FAR Processing Layer. The functionalities of the Patient Centric Agent are customized to manage the tasks of the three levels. Simulations confirm protection of the architecture against DoS attacks. Few patients require all their health data to be stored in Blockchain repositories but instead need to select an appropriate storage medium for each chunk of data by matching their personal needs and preferences with features of candidate storage mediums. Motivated by this context, we advance third contribution; a recommendation model for health data storage that can accommodate patient preferences and make storage decisions rapidly, in real-time, even with streamed data. The mapping between health data features and characteristics of each repository is learned using machine learning. The Blockchain’s capacity to make transactions and store records without central oversight enables its application for IoT networks outside health such as underwater IoT networks where the unattended nature of the nodes threatens their security and privacy. However, underwater IoT differs from ground IoT as acoustics signals are the communication media leading to high propagation delays, high error rates exacerbated by turbulent water currents. Our fourth contribution is a customized Blockchain leveraged framework with the model of Patient-Centric Agent renamed as Smart Agent for securely monitoring underwater IoT. Finally, the smart Agent has been investigated in developing an IoT smart home or cities monitoring framework. The key algorithms underpinning to each contribution have been implemented and analysed using simulators.Doctor of Philosoph

Security protocols for mobile ubiquitous e-health systems

Mención Internacional en el título de doctorWearable and implantable medical devices constitute an already established industry nowadays. According to a recent research [113], North America is currently the most important market followed by Europe, Asia-Pacific and the rest of the world. Additionally, the same document remarks the importance of the Asia-Pacific region due to the rising ageing population and the overpopulation in that area. The most common implantable medical devices include pacemakers, defibrillators, cochlear implants, insulin pumps, and neurostimulators among others. In recent years, the proliferation of smartphones and other mobile “smart” devices with substantial computational and communication capabilities have reshaped the way wireless body area network may be implemented. In their current generation (or in a near future), all of them share a common feature: wireless communication capabilities [127]. Moreover, implantable medical devices have the ability to support and store telemetry data facilitating the remote monitoring of the patient. Medical devices can be part of a wireless body area network, operating both as sensors and as actuators and making decisions in real time. On the other hand, a new kind of devices called wearables such as smart bracelets or smart watches have been equipped with several sensors like Photoplethysmogram (PPG) to record the heart beats, accelerometers to count the steps or Global Positioning System (GPS) to geopositioning users and were originally conceived as cheap solutions to help people to improve their workout. However these devices have demonstrated to be quite useful in many healthcare environments due to a huge variety of different and low-cost medical sensors. Thus, patients can be monitored for long periods of time without interfering in their daily life and taking their vital signs constantly under control. Security and privacy issues have been described as two of the most challenging problems of implantable medical devices and, more generally, wireless body area networks [6, 47, 84, 103]. As an example, it has been demonstrated that somebody equipped with a low cost device can eavesdrop on the data exchanged between a reader and a peacemaker and may even induce a cardiac arrest [71]. Health-related data have been the focus of several attacks almost since the adoption of computers in the healthcare domain. As a recent example, in 2010 personal data from more than 26 million of veterans were stolen from the Department of Veterans Affairs’ database in the US by an employee who had access to the database [104]. The Ponemon Institute pointed out that Germany and the US spent in 2013 more than $7.56 and$11 millions, respectively, to protect personal health records from attacks. This PhD dissertation explores the security and privacy of data in healthcare environments where confidential information is measured in real time by some sensors placed in, on, or around the human body. Security and privacy in medical conditions have been widely studied by the research community, nonetheless with the recent boom of wearable devices, new security issues have arisen. The first part of this dissertation is dedicated to the introduction and to expose both the main motivation and objectives of this PhD Thesis. Additionally the contributions and the organization of this document are also presented. In the second part a recent proposal has been analysed from the security and privacy points of view. From this study, vulnerabilities concerning to full disclosure, impersonation, traceability, de-synchronization, and Denial-of-Service (DoS) attacks have been found. These attacks make the protocol infeasible to be introduced with an adequate security and sufficient privacy protection level. Finally, a new protocol named Fingerprint⁺ protocol for Internet of Thing (IoT) is presented, which is based on ISO/IEC 9798-2 and ISO/IEC 18000-6C and whose security is formally verified using BAN logic. In the third part of this dissertation, a new system based on International Standard Organization (ISO) standards and security National Institute of Standards and Technology (NIST) recommendations have been proposed. First, we present a mutual entity authentication protocol inspired on ISO/IEC 9798 Part 2. This system could be deployed in a hospital where Radio Frequency IDentification (RFID) technology may be used to prune blood-handling errors, i.e., the identities of the patients and blood bags are confirmed (authentication protocol) and after that the matching between both entities is checked (verification step). Second, a secure messaging protocol inspired on ISO/IEC 11770 Part 2 and similar to that used in electronic passports is presented. Nowadays the new generation of medical implants possess wireless connectivity. Imagine a doctor equipped with a reader aims to access the records of vital signals stored on the memory of an implant. In this scenario, the doctor (reader) and the patient (implant) are first mutually authenticated and then a secure exchange of data can be performed. The fourth part of this Thesis provides an architecture based on two cryptographic protocols, the first one is for publishing personal data in a body area network composed of different sensors whereas the second one is designed for sending commands to those sensors by guaranteeing the confidentiality and fine-grained access control to the private data. Both protocols are based on a recently proposed public cryptography paradigm named ciphertext policy attribute-based encryption scheme which is lightweight enough to be embedded into wearable devices and sensors. Contrarily to other proposals made on this field, this architecture allows sensors not only to encrypt data but also to decrypt messages generated by other devices. The fifth part presents a new decentralized attribute based encryption scheme named Decentralized Ciphertext-Policy Attribute Based Searchable Encryption that incorporates ciphertext-policy attribute-based encryption with keyword search over encrypted data. This scheme allows users to (a) encrypt their personal data collected by a Wireless Body Area Network (WBAN) according to a policy of attributes; (b) define a set of keywords to enable other users (e.g., hospital stuff) to perform encrypted search over their personal (encrypted) data; (c) securely store the encrypted data on a semi-honest server and let the semi-honest server run the (encrypted) keyword search. Note that any user can perform a keyword query on the encrypted data, however the decryption of the resulting ciphertexts is possible only for users whose attribute satisfy the policy with which the data had been encrypted. We state and prove the security of our scheme against an honest-but-curious server and a passive adversary. Finally, we implement our system on heterogeneous devices and demonstrate its efficiency and scalability. Finally, this document ends with a conclusions achieved during this PhD and a summary of the main published contributions.Los dispositivos médicos implantables como los marcapasos o las bombas de insulina fueron concebidas originalmente para controlar automáticamente ciertos parámetros biológicos y, llegado el caso, poder actuar ante comportamientos anómalos como ataques cardíacos o episodios de hipoglucemia. Recientemente, han surgido uno dispositivos llamados wearables como las pulseras cuantificadoras, los relojes inteligentes o las bandas pectorales. Estos dispositivos han sido equipados con un número de sensores con capacidad de monitorizar señales vitales como el ritmo cardíaco, los movimientos (acelerómetros) o sistemas de posicionamiento (GPS) entre otros muchas opciones, siendo además una solución asequible y accesible para todo el mundo. A pesar de que el propósito original fue la mejora del rendimiento en actividades deportivas, estos dispositivos han resultado ser de gran utilidad en entornos médicos debido a su amplia variedad de sensores. Esta tecnología puede ayudar al personal médico a realizar seguimientos personalizados, constantes y en tiempo real del comportamiento de los pacientes, sin necesidad de interferir en sus vidas cotidianas. Esta Tesis doctoral está centrada en la seguridad y privacidad en entornos médicos, donde la información es recogida en tiempo real a través de una serie de sensores que pueden estar implantados o equipados en el propio paciente. La seguridad y la privacidad en entornos médicos ha sido el foco de muchos investigadores, no obstante con el reciente auge de los wearables se han generado nuevos retos debido a que son dispositivos con fuertes restricciones de cómputo, de memoria, de tamaño o de autonomía. En la primera parte de este documento, se introduce el problema de la seguridad y la privacidad en el paradigma de Internet de las cosas y haciendo especial hincapié en los entornos médicos. La motivación así como los principales objetivos y contribuciones también forman parte de este primer capítulo introductorio. La segunda parte de esta Tesis presenta un nuevo protocolo de autenticación basado en RFID para IoT. Este capítulo analiza previamente, desde el punto de vista de la seguridad y la privacidad un protocolo publicado recientemente y, tras demostrar que carece de las medidas de seguridad suficientes, un nuevo protocolo llamado Fingerprint⁺ compatible con los estándares de seguridad definidos en el estándar ISO/IEC 9798-2 y EPC-C1G2 (equivalente al estándard ISO/IEC 18000-6C) ha sido propuesto. Un nuevo sistema basado en estándares ISO y en recomendaciones realizadas por el NIST ha sido propuesto en la tercera parte de esta Tesis. En este capítulo se presentan dos protocolos bien diferenciados, el primero de ellos consiste en un protocolo de autenticación basado en el estándar ISO/IEC 9798 Part 2. A modo de ejemplo, este protocolo puede evitar problemas de compatibilidad sanguínea, es decir, primero se confirma que el paciente es quien dice ser y que la bolsa de sangre realmente contiene sangre (proceso de autenticación). Posteriormente se comprueba que esa bolsa de sangre va a ser compatible con el paciente (proceso de verificación). El segundo de los protocolos propuestos consiste en un protocolo seguro para el intercambio de información basado en el estándar ISO/IEC 11770 Part 2 (el mismo que los pasaportes electrónicos). Siguiendo con el ejemplo médico, imaginemos que un doctor equipado con un lector de radiofrecuencia desea acceder a los datos que un dispositivo implantado en el paciente está recopilando. En este escenario tanto el lector como el implante, se deben autenticar mutuamente para poder realizar el intercambio de información de manera segura. En el cuarto capítulo, una nueva arquitectura basada en el modelo de Publish/Subscribe ha sido propuesto. Esta solución está compuesta de dos protocolos, uno para el intercambio de información en una red de área personal y otro para poder reconfigurar el comportamiento de los sensores. Ambos protocolos están diseñados para garantizar tanto la seguridad como la privacidad de todos los datos que se envían en la red. Para ello, el sistema está basado en un sistema de criptografía de clave pública llamado Attribute Based Encryption que es suficientemente ligero y versátil como para ser implementado en dispositivos con altas restricciones de cómputo y de memoria. A continuación, en el quinto capítulo se propone una solución completamente orientada a entornos médicos donde la información que los sensores obtienen de los pacientes es cifrada y almacenada en servidores públicos. Una vez en estos servidores, cualquier usuario con privilegios suficientes puede realizar búsquedas sobre datos cifrados, obtener la información y descifrarla. De manera adicional, antes de que los datos cifrados se manden a la nube, el paciente puede definir una serie de palabras claves que se enlazarán a los datos para permitir posteriormente búsquedas y así obtener la información relacionada a un tema en concreto de manera fácil y eficiente. El último capítulo de esta Tesis se muestran las principales conclusiones obtenidas así como un resumen de las contribuciones científicas publicadas durante el período doctoral.Programa Oficial de Doctorado en Ciencia y Tecnología InformáticaPresidente: Arturo Ribagorda Garnacho.- Secretario: Jorge Blasco Alís.- Vocal: Jesús Garicia López de Lacall

Facing the blockchain endpoint vulnerability, an SGX-based solution for secure eHealth auditing

According to McAfee Labs, even in 2019, the eHealth sector is confirmed as one of the most critical in terms of cybersecurity incidents. It is estimated that more than 176 million patient records were target of attacks between 2009 and 2017, and with a single attack, in 2018, more than 1.4 million patient records were affected at UnityPoint Health. To cope with such a dramatic situation, one of the main strategic priority in the eHealth field is represented by the adoption of Blockchain. Specifically, according to a Deloittes survey, 55% of healthcare executives believe that blockchain technology will disrupt the healthcare industry. Unfortunately, while blockchain provides a valuable tool for enhancing the security of health applications and related data, it cannot be assumed as a panacea for data security. As an example, the so-called Endpoint Vulnerability issue is a well-known problem of Blockchain-based solutions: in such a case the attacker successful in gaining control of the end-point can tamper data off-chain during its generation and/or before it is sent to the chain. In this paper, we face such an issue by shielding the endpoint through the Intel Software Guard eXtension (SGX) technology. We demonstrate our solution for an auditing software belonging to the European eHealth management system (namely OpenNCP). We also discuss how our solution can be generalized to any other Blockchain-based solution. Finally, an experimental evaluation has been conducted to prove the actual feasibility of the proposed solution under the requirements of the real eHealth system

Advancing Healthcare Security: A Cutting-Edge Zero-Trust Blockchain Solution for Protecting Electronic Health Records

The effective management of electronic health records (EHRs) is vital in healthcare. However, traditional systems often need help handling data inconsistently, providing limited access, and coordinating poorly across facilities. This study aims to tackle these issues using blockchain technology to improve EHR systems' data security, privacy, and interoperability. By thoroughly analyzing blockchain's applications in healthcare, we propose an innovative solution that leverages blockchain's decentralized and immutable nature, combined with advanced encryption techniques such as the Advanced Encryption Standard and Zero Knowledge Proof Protocol, to fortify EHR systems. Our research demonstrates that blockchain can effectively overcome significant EHR challenges, including fragmented data and interoperability problems, by facilitating secure and transparent data exchange, leading to enhanced coordination, care quality, and cost-efficiency across healthcare facilities. This study offers practical guidelines for implementing blockchain technology in healthcare, emphasizing a balanced approach to interoperability, privacy, and security. It represents a significant advancement over traditional EHR systems, boosting security and affording patients greater control over their health records. Doi: 10.28991/HIJ-2023-04-03-012 Full Text: PD

A user-centric privacy-preserving authentication protocol for IoT-AmI environments

Ambient Intelligence (AmI) in Internet of Things (IoT) has empowered healthcare professionals to monitor, diagnose, and treat patients remotely. Besides, the AmI-IoT has improved patient engagement and gratification as doctors’ interactions have become more comfortable and efficient. However, the benefits of the AmI-IoT-based healthcare applications are not availed entirely due to the adversarial threats. IoT networks are prone to cyber attacks due to vulnerable wireless mediums and the absentia of lightweight and robust security protocols. This paper introduces computationally-inexpensive privacy-assuring authentication protocol for AmI-IoT healthcare applications. The use of blockchain & fog computing in the protocol guarantees unforgeability, non-repudiation, transparency, low latency, and efficient bandwidth utilization. The protocol uses physically unclonable functions (PUF), biometrics, and Ethereum powered smart contracts to prevent replay, impersonation, and cloning attacks. Results prove the resource efficiency of the protocol as the smart contract incurs very minimal gas and transaction fees. The Scyther results validate the robustness of the proposed protocol against cyber-attacks. The protocol applies lightweight cryptography primitives (Hash, PUF) instead of conventional public-key cryptography and scalar multiplications. Consequently, the proposed protocol is better than centralized infrastructure-based authentication approaches