Secure publish-subscribe protocols for heterogeneous medical wireless body area networks

Security and privacy issues in medical wireless body area networks (WBANs) constitute a major unsolved concern because of the challenges posed by the scarcity of resources in WBAN devices and the usability restrictions imposed by the healthcare domain. In this paper, we describe a WBAN architecture based on the well-known publish-subscribe paradigm. We present two protocols for publishing data and sending commands to a sensor that guarantee confidentiality and fine-grained access control. Both protocols are based on a recently proposed ciphertext policy attribute-based encryption (CP-ABE) scheme that is lightweight enough to be embedded into wearable sensors. We show how sensors can implement lattice-based access control (LBAC) policies using this scheme, which are highly appropriate for the eHealth domain. We report experimental results with a prototype implementation demonstrating the suitability of our proposed solution.This work was supported by the MINECO grant TIN2013-46469-R (SPINY: Security and Privacy in the Internet of You)

Secure Management of Personal Health Records by Applying Attribute-Based Encryption

The confidentiality of personal health records is a major problem when patients use commercial Web-based systems to store their health data. Traditional access control mechanisms, such as Role-Based Access Control, have several limitations with respect to enforcing access control policies and ensuring data confidentiality. In particular, the data has to be stored on a central server locked by the access control mechanism, and the data owner loses control on the data from the moment when the data is sent to the requester. Therefore, these mechanisms do not fulfil the requirements of data outsourcing scenarios where the third party storing the data should not have access to the plain data, and it is not trusted to enforce access control policies. In this paper, we describe a new approach which enables secure storage and controlled sharing of patient’s health records in the aforementioned scenarios. A new variant of a ciphertext-policy attribute-based encryption scheme is proposed to enforce patient/organizational access control policies such that everyone can download the encrypted data but only authorized users from the social domain (e.g. family, friends, or fellow patients) or authorized users from the professional\ud domain (e.g. doctors or nurses) are allowed to decrypt it

Data privacy by design: digital infrastructures for clinical collaborations

The clinical sciences have arguably the most stringent security demands on the adoption and roll-out of collaborative e-Infrastructure solutions such as those based upon Grid-based middleware. Experiences from the Medical Research Council (MRC) funded Virtual Organisations for Trials and Epidemiological Studies (VOTES) project and numerous other real world security driven projects at the UK e-Science National e-Science Centre (NeSC – www.nesc.ac.uk) have shown that whilst advanced Grid security and middleware solutions now offer capabilities to address many of the distributed data and security challenges in the clinical domain, the real clinical world as typified by organizations such as the National Health Service (NHS) in the UK are extremely wary of adoption of such technologies: firewalls; ethics; information governance, software validation, and the actual realities of existing infrastructures need to be considered from the outset. Based on these experiences we present a novel data linkage and anonymisation infrastructure that has been developed with close co-operation of the various stakeholders in the clinical domain (including the NHS) that addresses their concerns and satisfies the needs of the academic clinical research community. We demonstrate the implementation of this infrastructure through a representative clinical study on chronic diseases in Scotland

A systematic literature review of cloud computing in eHealth

Cloud computing in eHealth is an emerging area for only few years. There needs to identify the state of the art and pinpoint challenges and possible directions for researchers and applications developers. Based on this need, we have conducted a systematic review of cloud computing in eHealth. We searched ACM Digital Library, IEEE Xplore, Inspec, ISI Web of Science and Springer as well as relevant open-access journals for relevant articles. A total of 237 studies were first searched, of which 44 papers met the Include Criteria. The studies identified three types of studied areas about cloud computing in eHealth, namely (1) cloud-based eHealth framework design (n=13); (2) applications of cloud computing (n=17); and (3) security or privacy control mechanisms of healthcare data in the cloud (n=14). Most of the studies in the review were about designs and concept-proof. Only very few studies have evaluated their research in the real world, which may indicate that the application of cloud computing in eHealth is still very immature. However, our presented review could pinpoint that a hybrid cloud platform with mixed access control and security protection mechanisms will be a main research area for developing citizen centred home-based healthcare applications

Formalisation and Implementation of the XACML Access Control Mechanism

We propose a formal account of XACML, an OASIS standard adhering to the Policy Based Access Control model for the specifica- tion and enforcement of access control policies. To clarify all ambiguous and intricate aspects of XACML, we provide it with a more manageable alternative syntax and with a solid semantic ground. This lays the basis for developing tools and methodologies which allow software engineers to easily and precisely regulate access to resources using policies. To demonstrate feasibility and effectiveness of our approach, we provide a software tool, supporting the specification and evaluation of policies and access requests, whose implementation fully relies on our formal development

What can management theories offer evidence-based practice? A comparative analysis of measurement tools for organisational context

Background: Given the current emphasis on networks as vehicles for innovation and change in health service delivery, the ability to conceptualise and measure organisational enablers for the social construction of knowledge merits attention. This study aimed to develop a composite tool to measure the organisational context for evidence-based practice (EBP) in healthcare. Methods: A structured search of the major healthcare and management databases for measurement tools from four domains: research utilisation (RU), research activity (RA), knowledge management (KM), and organisational learning (OL). Included studies were reports of the development or use of measurement tools that included organisational factors. Tools were appraised for face and content validity, plus development and testing methods. Measurement tool items were extracted, merged across the four domains, and categorised within a constructed framework describing the absorptive and receptive capacities of organisations. Results: Thirty measurement tools were identified and appraised. Eighteen tools from the four domains were selected for item extraction and analysis. The constructed framework consists of seven categories relating to three core organisational attributes of vision, leadership, and a learning culture, and four stages of knowledge need, acquisition of new knowledge, knowledge sharing, and knowledge use. Measurement tools from RA or RU domains had more items relating to the categories of leadership, and acquisition of new knowledge; while tools from KM or learning organisation domains had more items relating to vision, learning culture, knowledge need, and knowledge sharing. There was equal emphasis on knowledge use in the different domains. Conclusion: If the translation of evidence into knowledge is viewed as socially mediated, tools to measure the organisational context of EBP in healthcare could be enhanced by consideration of related concepts from the organisational and management sciences. Comparison of measurement tools across domains suggests that there is scope within EBP for supplementing the current emphasis on human and technical resources to support information uptake and use by individuals. Consideration of measurement tools from the fields of KM and OL shows more content related to social mechanisms to facilitate knowledge recognition, translation, and transfer between individuals and groups

E-infrastructures fostering multi-centre collaborative research into the intensive care management of patients with brain injury

Clinical research is becoming ever more collaborative with multi-centre trials now a common practice. With this in mind, never has it been more important to have secure access to data and, in so doing, tackle the challenges of inter-organisational data access and usage. This is especially the case for research conducted within the brain injury domain due to the complicated multi-trauma nature of the disease with its associated complex collation of time-series data of varying resolution and quality. It is now widely accepted that advances in treatment within this group of patients will only be delivered if the technical infrastructures underpinning the collection and validation of multi-centre research data for clinical trials is improved. In recognition of this need, IT-based multi-centre e-Infrastructures such as the Brain Monitoring with Information Technology group (BrainIT - www.brainit.org) and Cooperative Study on Brain Injury Depolarisations (COSBID - www.cosbid.de) have been formed. A serious impediment to the effective implementation of these networks is access to the know-how and experience needed to install, deploy and manage security-oriented middleware systems that provide secure access to distributed hospital based datasets and especially the linkage of these data sets across sites. The recently funded EU framework VII ICT project Advanced Arterial Hypotension Adverse Event prediction through a Novel Bayesian Neural Network (AVERT-IT) is focused upon tackling these challenges. This chapter describes the problems inherent to data collection within the brain injury medical domain, the current IT-based solutions designed to address these problems and how they perform in practice. We outline how the authors have collaborated towards developing Grid solutions to address the major technical issues. Towards this end we describe a prototype solution which ultimately formed the basis for the AVERT-IT project. We describe the design of the underlying Grid infrastructure for AVERT-IT and how it will be used to produce novel approaches to data collection, data validation and clinical trial design is also presented