Security Issues in Healthcare Applications Using Wireless Medical Sensor Networks: A Survey

Healthcare applications are considered as promising fields for wireless sensor networks, where patients can be monitored using wireless medical sensor networks (WMSNs). Current WMSN healthcare research trends focus on patient reliable communication, patient mobility, and energy-efficient routing, as a few examples. However, deploying new technologies in healthcare applications without considering security makes patient privacy vulnerable. Moreover, the physiological data of an individual are highly sensitive. Therefore, security is a paramount requirement of healthcare applications, especially in the case of patient privacy, if the patient has an embarrassing disease. This paper discusses the security and privacy issues in healthcare application using WMSNs. We highlight some popular healthcare projects using wireless medical sensor networks, and discuss their security. Our aim is to instigate discussion on these critical issues since the success of healthcare application depends directly on patient security and privacy, for ethic as well as legal reasons. In addition, we discuss the issues with existing security mechanisms, and sketch out the important security requirements for such applications. In addition, the paper reviews existing schemes that have been recently proposed to provide security solutions in wireless healthcare scenarios. Finally, the paper ends up with a summary of open security research issues that need to be explored for future healthcare applications using WMSNs

KALwEN: a new practical and interoperable key management scheme for body sensor networks

Key management is the pillar of a security architecture. Body sensor networks (BSNs) pose several challenges–some inherited from wireless sensor networks (WSNs), some unique to themselves–that require a new key management scheme to be tailor-made. The challenge is taken on, and the result is KALwEN, a new parameterized key management scheme that combines the best-suited cryptographic techniques in a seamless framework. KALwEN is user-friendly in the sense that it requires no expert knowledge of a user, and instead only requires a user to follow a simple set of instructions when bootstrapping or extending a network. One of KALwEN's key features is that it allows sensor devices from different manufacturers, which expectedly do not have any pre-shared secret, to establish secure communications with each other. KALwEN is decentralized, such that it does not rely on the availability of a local processing unit (LPU). KALwEN supports secure global broadcast, local broadcast, and local (neighbor-to-neighbor) unicast, while preserving past key secrecy and future key secrecy (FKS). The fact that the cryptographic protocols of KALwEN have been formally verified also makes a convincing case. With both formal verification and experimental evaluation, our results should appeal to theorists and practitioners alike

Wireless Medical Sensor Networks: Design Requirements and Enabling Technologies

This article analyzes wireless communication protocols that could be used in healthcare environments (e.g., hospitals and small clinics) to transfer real-time medical information obtained from noninvasive sensors. For this purpose the features of the three currently most widely used protocols—namely, Bluetooth® (IEEE 802.15.1), ZigBee (IEEE 802.15.4), and Wi-Fi (IEEE 802.11)—are evaluated and compared. The important features under consideration include data bandwidth, frequency band, maximum transmission distance, encryption and authentication methods, power consumption, and current applications. In addition, an overview of network requirements with respect to medical sensor features, patient safety and patient data privacy, quality of service, and interoperability between other sensors is briefly presented. Sensor power consumption is also discussed because it is considered one of the main obstacles for wider adoption of wireless networks in medical applications. The outcome of this assessment will be a useful tool in the hands of biomedical engineering researchers. It will provide parameters to select the most effective combination of protocols to implement a specific wireless network of noninvasive medical sensors to monitor patients remotely in the hospital or at home

Towards end-to-end security in internet of things based healthcare

Healthcare IoT systems are distinguished in that they are designed to serve human beings, which primarily raises the requirements of security, privacy, and reliability. Such systems have to provide real-time notifications and responses concerning the status of patients. Physicians, patients, and other caregivers demand a reliable system in which the results are accurate and timely, and the service is reliable and secure. To guarantee these requirements, the smart components in the system require a secure and efficient end-to-end communication method between the end-points (e.g., patients, caregivers, and medical sensors) of a healthcare IoT system. The main challenge faced by the existing security solutions is a lack of secure end-to-end communication. This thesis addresses this challenge by presenting a novel end-to-end security solution enabling end-points to securely and efficiently communicate with each other. The proposed solution meets the security requirements of a wide range of healthcare IoT systems while minimizing the overall hardware overhead of end-to-end communication. End-to-end communication is enabled by the holistic integration of the following contributions. The first contribution is the implementation of two architectures for remote monitoring of bio-signals. The first architecture is based on a low power IEEE 802.15.4 protocol known as ZigBee. It consists of a set of sensor nodes to read data from various medical sensors, process the data, and send them wirelessly over ZigBee to a server node. The second architecture implements on an IP-based wireless sensor network, using IEEE 802.11 Wireless Local Area Network (WLAN). The system consists of a IEEE 802.11 based sensor module to access bio-signals from patients and send them over to a remote server. In both architectures, the server node collects the health data from several client nodes and updates a remote database. The remote webserver accesses the database and updates the webpage in real-time, which can be accessed remotely. The second contribution is a novel secure mutual authentication scheme for Radio Frequency Identification (RFID) implant systems. The proposed scheme relies on the elliptic curve cryptography and the D-Quark lightweight hash design. The scheme consists of three main phases: (1) reader authentication and verification, (2) tag identification, and (3) tag verification. We show that among the existing public-key crypto-systems, elliptic curve is the optimal choice due to its small key size as well as its efficiency in computations. The D-Quark lightweight hash design has been tailored for resource-constrained devices. The third contribution is proposing a low-latency and secure cryptographic keys generation approach based on Electrocardiogram (ECG) features. This is performed by taking advantage of the uniqueness and randomness properties of ECG's main features comprising of PR, RR, PP, QT, and ST intervals. This approach achieves low latency due to its reliance on reference-free ECG's main features that can be acquired in a short time. The approach is called Several ECG Features (SEF)-based cryptographic key generation. The fourth contribution is devising a novel secure and efficient end-to-end security scheme for mobility enabled healthcare IoT. The proposed scheme consists of: (1) a secure and efficient end-user authentication and authorization architecture based on the certificate based Datagram Transport Layer Security (DTLS) handshake protocol, (2) a secure end-to-end communication method based on DTLS session resumption, and (3) support for robust mobility based on interconnected smart gateways in the fog layer. Finally, the fifth and the last contribution is the analysis of the performance of the state-of-the-art end-to-end security solutions in healthcare IoT systems including our end-to-end security solution. In this regard, we first identify and present the essential requirements of robust security solutions for healthcare IoT systems. We then analyze the performance of the state-of-the-art end-to-end security solutions (including our scheme) by developing a prototype healthcare IoT system

REISCH: incorporating lightweight and reliable algorithms into healthcare applications of WSNs

Healthcare institutions require advanced technology to collect patients' data accurately and continuously. The tradition technologies still suffer from two problems: performance and security efficiency. The existing research has serious drawbacks when using public-key mechanisms such as digital signature algorithms. In this paper, we propose Reliable and Efficient Integrity Scheme for Data Collection in HWSN (REISCH) to alleviate these problems by using secure and lightweight signature algorithms. The results of the performance analysis indicate that our scheme provides high efficiency in data integration between sensors and server (saves more than 24% of alive sensors compared to traditional algorithms). Additionally, we use Automated Validation of Internet Security Protocols and Applications (AVISPA) to validate the security procedures in our scheme. Security analysis results confirm that REISCH is safe against some well-known attacks

Security for networked smart healthcare systems: A systematic review

Background and Objectives Smart healthcare systems use technologies such as wearable devices, Internet of Medical Things and mobile internet technologies to dynamically access health information, connect patients to health professionals and health institutions, and to actively manage and respond intelligently to the medical ecosystem's needs. However, smart healthcare systems are affected by many challenges in their implementation and maintenance. Key among these are ensuring the security and privacy of patient health information. To address this challenge, several mitigation measures have been proposed and some have been implemented. Techniques that have been used include data encryption and biometric access. In addition, blockchain is an emerging security technology that is expected to address the security issues due to its distributed and decentralized architecture which is similar to that of smart healthcare systems. This study reviewed articles that identified security requirements and risks, proposed potential solutions, and explained the effectiveness of these solutions in addressing security problems in smart healthcare systems. Methods This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines and was framed using the Problem, Intervention, Comparator, and Outcome (PICO) approach to investigate and analyse the concepts of interest. However, the comparator is not applicable because this review focuses on the security measures available and in this case no comparable solutions were considered since the concept of smart healthcare systems is an emerging one and there are therefore, no existing security solutions that have been used before. The search strategy involved the identification of studies from several databases including the Cumulative Index of Nursing and Allied Health Literature (CINAL), Scopus, PubMed, Web of Science, Medline, Excerpta Medical database (EMBASE), Ebscohost and the Cochrane Library for articles that focused on the security for smart healthcare systems. The selection process involved removing duplicate studies, and excluding studies after reading the titles, abstracts, and full texts. Studies whose records could not be retrieved using a predefined selection criterion for inclusion and exclusion were excluded. The remaining articles were then screened for eligibility. A data extraction form was used to capture details of the screened studies after reading the full text. Of the searched databases, only three yielded results when the search strategy was applied, i.e., Scopus, Web of science and Medline, giving a total of 1742 articles. 436 duplicate studies were removed. Of the remaining articles, 801 were excluded after reading the title, after which 342 after were excluded after reading the abstract, leaving 163, of which 4 studies could not be retrieved. 159 articles were therefore screened for eligibility after reading the full text. Of these, 14 studies were included for detailed review using the formulated research questions and the PICO framework. Each of the 14 included articles presented a description of a smart healthcare system and identified the security requirements, risks and solutions to mitigate the risks. Each article also summarized the effectiveness of the proposed security solution. Results The key security requirements reported were data confidentiality, integrity and availability of data within the system, with authorisation and authentication used to support these key security requirements. The identified security risks include loss of data confidentiality due to eavesdropping in wireless communication mediums, authentication vulnerabilities in user devices and storage servers, data fabrication and message modification attacks during transmission as well as while the data is at rest in databases and other storage devices. The proposed mitigation measures included the use of biometric accessing devices; data encryption for protecting the confidentiality and integrity of data; blockchain technology to address confidentiality, integrity, and availability of data; network slicing techniques to provide isolation of patient health data in 5G mobile systems; and multi-factor authentication when accessing IoT devices, servers, and other components of the smart healthcare systems. The effectiveness of the proposed solutions was demonstrated through their ability to provide a high level of data security in smart healthcare systems. For example, proposed encryption algorithms demonstrated better energy efficiency, and improved operational speed; reduced computational overhead, better scalability, efficiency in data processing, and better ease of deployment. Conclusion This systematic review has shown that the use of blockchain technology, biometrics (fingerprints), data encryption techniques, multifactor authentication and network slicing in the case of 5G smart healthcare systems has the potential to alleviate possible security risks in smart healthcare systems. The benefits of these solutions include a high level of security and privacy for Electronic Health Records (EHRs) systems; improved speed of data transaction without the need for a decentralized third party, enabled by the use of blockchain. However, the proposed solutions do not address data protection in cases where an intruder has already accessed the system. This may be potential avenues for further research and inquiry

The Applications of the Internet of things in the Medical Field

The Internet of Things (IoT) paradigm promises to make “things” include a more generic set of entities such as smart devices, sensors, human beings, and any other IoT objects to be accessible at anytime and anywhere. IoT varies widely in its applications, and one of its most beneficial uses is in the medical field. However, the large attack surface and vulnerabilities of IoT systems needs to be secured and protected. Security is a requirement for IoT systems in the medical field where the Health Insurance Portability and Accountability Act (HIPAA) applies. This work investigates various applications of IoT in healthcare and focuses on the security aspects of the two internet of medical things (IoMT) devices: the LifeWatch Mobile Cardiac Telemetry 3 Lead (MCT3L), and the remote patient monitoring system of the telehealth provider Vivify Health, as well as their implementations