a blockchain based proposal for protecting healthcare systems through formal methods

Abstract Blockchain technology is one of the most important and disruptive technologies in the world. Multiple industries are adopting the blockchain technology to innovate the way they work. One of the industries that are looking to adopt the blockchain is the healthcare industry. In fact, the protection of the private information stored in hospital database is a critical issue. In this paper we propose a method aimed to protect information exchanged in hospital networks, with particular regard to magnetic resonance images. As required from blockchain technology, each host network must validate the transiting data network: we exploit formal equivalence checking to perform this validation, by modeling magnetic resonance images in terms of automata by exploiting radiomic features

Integration of digital watermarking technique into medical imaging systems

This paper presents the process of integrating digital watermarking technique into medical imaging workflow to evaluate, validate and verify its applicability and appropriateness to medical domains. This is significant to ensure the ability of the proposed approach to tackle security threats that may face medical images during routine medical practices. This work considers two key objectives within the aim of defining a secure and practical digital medical imaging system: current digital medical workflows are deeply analyzed to define security limitations in Picture Archiving and Communication Systems (PACS) of medical imaging; the proposed watermarking approach is then theoretically tested and validated in its ability to operate in a real-world scenario (e.g. PACS). These have been undertaken through identified case studies related to manipulations of medical images within PACS workflow during acquisition, viewing, exchanging and archiving. This work assures the achievement of the identified particular requirements of digital watermarking when applied to digital medical images and also provides robust controls within medical imaging pipelines to detect modifications that may be applied to medical images during viewing, storing and transmitting

Design of a secure architecture for the exchange of biomedical information in m-Health scenarios

El paradigma de m-Salud (salud móvil) aboga por la integración masiva de las más avanzadas tecnologías de comunicación, red móvil y sensores en aplicaciones y sistemas de salud, para fomentar el despliegue de un nuevo modelo de atención clínica centrada en el usuario/paciente. Este modelo tiene por objetivos el empoderamiento de los usuarios en la gestión de su propia salud (p.ej. aumentando sus conocimientos, promocionando estilos de vida saludable y previniendo enfermedades), la prestación de una mejor tele-asistencia sanitaria en el hogar para ancianos y pacientes crónicos y una notable disminución del gasto de los Sistemas de Salud gracias a la reducción del número y la duración de las hospitalizaciones. No obstante, estas ventajas, atribuidas a las aplicaciones de m-Salud, suelen venir acompañadas del requisito de un alto grado de disponibilidad de la información biomédica de sus usuarios para garantizar una alta calidad de servicio, p.ej. fusionar varias señales de un usuario para obtener un diagnóstico más preciso. La consecuencia negativa de cumplir esta demanda es el aumento directo de las superficies potencialmente vulnerables a ataques, lo que sitúa a la seguridad (y a la privacidad) del modelo de m-Salud como factor crítico para su éxito. Como requisito no funcional de las aplicaciones de m-Salud, la seguridad ha recibido menos atención que otros requisitos técnicos que eran más urgentes en etapas de desarrollo previas, tales como la robustez, la eficiencia, la interoperabilidad o la usabilidad. Otro factor importante que ha contribuido a retrasar la implementación de políticas de seguridad sólidas es que garantizar un determinado nivel de seguridad implica unos costes que pueden ser muy relevantes en varias dimensiones, en especial en la económica (p.ej. sobrecostes por la inclusión de hardware extra para la autenticación de usuarios), en el rendimiento (p.ej. reducción de la eficiencia y de la interoperabilidad debido a la integración de elementos de seguridad) y en la usabilidad (p.ej. configuración más complicada de dispositivos y aplicaciones de salud debido a las nuevas opciones de seguridad). Por tanto, las soluciones de seguridad que persigan satisfacer a todos los actores del contexto de m-Salud (usuarios, pacientes, personal médico, personal técnico, legisladores, fabricantes de dispositivos y equipos, etc.) deben ser robustas y al mismo tiempo minimizar sus costes asociados. Esta Tesis detalla una propuesta de seguridad, compuesta por cuatro grandes bloques interconectados, para dotar de seguridad a las arquitecturas de m-Salud con unos costes reducidos. El primer bloque define un esquema global que proporciona unos niveles de seguridad e interoperabilidad acordes con las características de las distintas aplicaciones de m-Salud. Este esquema está compuesto por tres capas diferenciadas, diseñadas a la medidas de los dominios de m-Salud y de sus restricciones, incluyendo medidas de seguridad adecuadas para la defensa contra las amenazas asociadas a sus aplicaciones de m-Salud. El segundo bloque establece la extensión de seguridad de aquellos protocolos estándar que permiten la adquisición, el intercambio y/o la administración de información biomédica -- por tanto, usados por muchas aplicaciones de m-Salud -- pero no reúnen los niveles de seguridad detallados en el esquema previo. Estas extensiones se concretan para los estándares biomédicos ISO/IEEE 11073 PHD y SCP-ECG. El tercer bloque propone nuevas formas de fortalecer la seguridad de los tests biomédicos, que constituyen el elemento esencial de muchas aplicaciones de m-Salud de carácter clínico, mediante codificaciones novedosas. Finalmente el cuarto bloque, que se sitúa en paralelo a los anteriores, selecciona herramientas genéricas de seguridad (elementos de autenticación y criptográficos) cuya integración en los otros bloques resulta idónea, y desarrolla nuevas herramientas de seguridad, basadas en señal -- embedding y keytagging --, para reforzar la protección de los test biomédicos.The paradigm of m-Health (mobile health) advocates for the massive integration of advanced mobile communications, network and sensor technologies in healthcare applications and systems to foster the deployment of a new, user/patient-centered healthcare model enabling the empowerment of users in the management of their health (e.g. by increasing their health literacy, promoting healthy lifestyles and the prevention of diseases), a better home-based healthcare delivery for elderly and chronic patients and important savings for healthcare systems due to the reduction of hospitalizations in number and duration. It is a fact that many m-Health applications demand high availability of biomedical information from their users (for further accurate analysis, e.g. by fusion of various signals) to guarantee high quality of service, which on the other hand entails increasing the potential surfaces for attacks. Therefore, it is not surprising that security (and privacy) is commonly included among the most important barriers for the success of m-Health. As a non-functional requirement for m-Health applications, security has received less attention than other technical issues that were more pressing at earlier development stages, such as reliability, eficiency, interoperability or usability. Another fact that has contributed to delaying the enforcement of robust security policies is that guaranteeing a certain security level implies costs that can be very relevant and that span along diferent dimensions. These include budgeting (e.g. the demand of extra hardware for user authentication), performance (e.g. lower eficiency and interoperability due to the addition of security elements) and usability (e.g. cumbersome configuration of devices and applications due to security options). Therefore, security solutions that aim to satisfy all the stakeholders in the m-Health context (users/patients, medical staff, technical staff, systems and devices manufacturers, regulators, etc.) shall be robust and, at the same time, minimize their associated costs. This Thesis details a proposal, composed of four interrelated blocks, to integrate appropriate levels of security in m-Health architectures in a cost-efcient manner. The first block designes a global scheme that provides different security and interoperability levels accordingto how critical are the m-Health applications to be implemented. This consists ofthree layers tailored to the m-Health domains and their constraints, whose security countermeasures defend against the threats of their associated m-Health applications. Next, the second block addresses the security extension of those standard protocols that enable the acquisition, exchange and/or management of biomedical information | thus, used by many m-Health applications | but do not meet the security levels described in the former scheme. These extensions are materialized for the biomedical standards ISO/IEEE 11073 PHD and SCP-ECG. Then, the third block proposes new ways of enhancing the security of biomedical standards, which are the centerpiece of many clinical m-Health applications, by means of novel codings. Finally the fourth block, with is parallel to the others, selects generic security methods (for user authentication and cryptographic protection) whose integration in the other blocks results optimal, and also develops novel signal-based methods (embedding and keytagging) for strengthening the security of biomedical tests. The layer-based extensions of the standards ISO/IEEE 11073 PHD and SCP-ECG can be considered as robust, cost-eficient and respectful with their original features and contents. The former adds no attributes to its data information model, four new frames to the service model |and extends four with new sub-frames|, and only one new sub-state to the communication model. Furthermore, a lightweight architecture consisting of a personal health device mounting a 9 MHz processor and an aggregator mounting a 1 GHz processor is enough to transmit a 3-lead electrocardiogram in real-time implementing the top security layer. The extra requirements associated to this extension are an initial configuration of the health device and the aggregator, tokens for identification/authentication of users if these devices are to be shared and the implementation of certain IHE profiles in the aggregator to enable the integration of measurements in healthcare systems. As regards to the extension of SCP-ECG, it only adds a new section with selected security elements and syntax in order to protect the rest of file contents and provide proper role-based access control. The overhead introduced in the protected SCP-ECG is typically 2{13 % of the regular file size, and the extra delays to protect a newly generated SCP-ECG file and to access it for interpretation are respectively a 2{10 % and a 5 % of the regular delays. As regards to the signal-based security techniques developed, the embedding method is the basis for the proposal of a generic coding for tests composed of biomedical signals, periodic measurements and contextual information. This has been adjusted and evaluated with electrocardiogram and electroencephalogram-based tests, proving the objective clinical quality of the coded tests, the capacity of the coding-access system to operate in real-time (overall delays of 2 s for electrocardiograms and 3.3 s for electroencephalograms) and its high usability. Despite of the embedding of security and metadata to enable m-Health services, the compression ratios obtained by this coding range from ' 3 in real-time transmission to ' 5 in offline operation. Complementarily, keytagging permits associating information to images (and other signals) by means of keys in a secure and non-distorting fashion, which has been availed to implement security measures such as image authentication, integrity control and location of tampered areas, private captioning with role-based access control, traceability and copyright protection. The tests conducted indicate a remarkable robustness-capacity tradeoff that permits implementing all this measures simultaneously, and the compatibility of keytagging with JPEG2000 compression, maintaining this tradeoff while setting the overall keytagging delay in only ' 120 ms for any image size | evidencing the scalability of this technique. As a general conclusion, it has been demonstrated and illustrated with examples that there are various, complementary and structured manners to contribute in the implementation of suitable security levels for m-Health architectures with a moderate cost in budget, performance, interoperability and usability. The m-Health landscape is evolving permanently along all their dimensions, and this Thesis aims to do so with its security. Furthermore, the lessons learned herein may offer further guidance for the elaboration of more comprehensive and updated security schemes, for the extension of other biomedical standards featuring low emphasis on security or privacy, and for the improvement of the state of the art regarding signal-based protection methods and applications

Verification approach for medical data in e-healthcare system based on biometric and watermarking

Medical information is crucial in the healthcare system, and its manipulation can lead to misdiagnosis. Medical images also contain personal information for patients; hence, information security and privacy protection are paramount when transferring medical images over the Internet. Biometric approach and watermarking techniques are used to achieve this purpose. The focus of this paper was on a biometric watermarking system with a frequency domain in which the sender's iris code is employed as a sender authentication key. The privacy of the patient's information is preserved by encrypting it and embedding the key in the cover medical image created by the Discrete Wavelet Transform. The algorithm has shown that the proposed system has met previous requirements

Digital watermarking : applicability for developing trust in medical imaging workflows state of the art review

Medical images can be intentionally or unintentionally manipulated both within the secure medical system environment and outside, as images are viewed, extracted and transmitted. Many organisations have invested heavily in Picture Archiving and Communication Systems (PACS), which are intended to facilitate data security. However, it is common for images, and records, to be extracted from these for a wide range of accepted practices, such as external second opinion, transmission to another care provider, patient data request, etc. Therefore, confirming trust within medical imaging workflows has become essential. Digital watermarking has been recognised as a promising approach for ensuring the authenticity and integrity of medical images. Authenticity refers to the ability to identify the information origin and prove that the data relates to the right patient. Integrity means the capacity to ensure that the information has not been altered without authorisation. This paper presents a survey of medical images watermarking and offers an evident scene for concerned researchers by analysing the robustness and limitations of various existing approaches. This includes studying the security levels of medical images within PACS system, clarifying the requirements of medical images watermarking and defining the purposes of watermarking approaches when applied to medical images

Hybrid multiple watermarking technique for securing medical images of modalities MRI, CT scan, and X-ray

In order to contribute to the security of sharing and transferring medical images, we had presented a multiple watermarking technique for multiple protections; it was based on the combination of three transformations: the discrete wavelet transform (DWT), the fast Walsh-Hadamard transform (FWHT) and, the singular value decomposition (SVD). In this paper, three watermark images of sizes 512x 512 were inserted into a single medical image of various modalities such as magnetic resonance imaging (MRI), computed tomography (CT), and X-Radiation (X-ray). After applying DWT up to the third level on the original image, the high-resolution sub-bands were being selected subsequently to apply FWHT and then SVD. The singular values of the three watermark images were inserted into the singular values of the cover medical image. The experimental results showed the effectiveness of the proposed method in terms of quality and robustness compared to other reported techniques cited in the literature

Digital watermarking in medical images

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University, 05/12/2005.This thesis addresses authenticity and integrity of medical images using watermarking. Hospital Information Systems (HIS), Radiology Information Systems (RIS) and Picture Archiving and Communication Systems (P ACS) now form the information infrastructure for today's healthcare as these provide new ways to store, access and distribute medical data that also involve some security risk. Watermarking can be seen as an additional tool for security measures. As the medical tradition is very strict with the quality of biomedical images, the watermarking method must be reversible or if not, region of Interest (ROI) needs to be defined and left intact. Watermarking should also serve as an integrity control and should be able to authenticate the medical image. Three watermarking techniques were proposed. First, Strict Authentication Watermarking (SAW) embeds the digital signature of the image in the ROI and the image can be reverted back to its original value bit by bit if required. Second, Strict Authentication Watermarking with JPEG Compression (SAW-JPEG) uses the same principal as SAW, but is able to survive some degree of JPEG compression. Third, Authentication Watermarking with Tamper Detection and Recovery (AW-TDR) is able to localise tampering, whilst simultaneously reconstructing the original image

A Study of Data Security on E-Governance using Steganographic Optimization Algorithms

Steganography has been used massively in numerous fields to maintain the privacy and integrity of messages transferred via the internet. The need to secure the information has augmented with the increase in e-governance usage. The wide adoption of e-governance services also opens the doors to cybercriminals for fraudulent activities in cyberspace. To deal with these cybercrimes we need optimized and advanced steganographic techniques. Various advanced optimization techniques can be applied to steganography to obtain better results for the security of information. Various optimization techniques like particle swarm optimization and genetic algorithms with cryptography can be used to protect information for e-governance services. In this study, a comprehensive review of steganographic algorithms using optimization techniques is presented. A new perspective on using this technique to protect the information for e-governance is also presented. Deep Learning might be the area that can be used to automate the steganography process in combination with other method