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

Literatur Review Permasalahan Privasi Pada Rekam Medis Elektronik

Rekam Medis Elektronik (RME) merupakan salah satu terobosan dari pemanfaatan teknologi informasi dalam bidang kesehatan bertujuan untuk mempermudah pelayanan kesehatan. Dengan semakin banyaknya penyedia layanan kesehatan yang memanfaatkan RME ini, yang harus diperhatikan bukan hanya masalah migrasi data dari konvensional menjadi digital, namun juga mengenai cara pengamanan data pada RME yang memiliki sifat sensitif dan rahasia yang selama ini permasalahan privasi belum diatur dan ditangani secara memadai pada proses pembuatan RME ini. Untuk menyelesaikan masalah tersebut, peneliti membuat sebuah literatur review mengenai teknik pengamanan data pada 20 artikel prosiding dan jurnal. Teknik pengamanan data yang seringkali digunakan sebagai usaha pengamanan data adalah kriptografi, firewall, dan kontrol akses

A review on visual privacy preservation techniques for active and assisted living

This paper reviews the state of the art in visual privacy protection techniques, with particular attention paid to techniques applicable to the field of Active and Assisted Living (AAL). A novel taxonomy with which state-of-the-art visual privacy protection methods can be classified is introduced. Perceptual obfuscation methods, a category in this taxonomy, is highlighted. These are a category of visual privacy preservation techniques, particularly relevant when considering scenarios that come under video-based AAL monitoring. Obfuscation against machine learning models is also explored. A high-level classification scheme of privacy by design, as defined by experts in privacy and data protection law, is connected to the proposed taxonomy of visual privacy preservation techniques. Finally, we note open questions that exist in the field and introduce the reader to some exciting avenues for future research in the area of visual privacy.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. This work is part of the visuAAL project on Privacy-Aware and Acceptable Video-Based Technologies and Services for Active and Assisted Living (https://www.visuaal-itn.eu/). This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 861091. The authors would also like to acknowledge the contribution of COST Action CA19121 - GoodBrother, Network on Privacy-Aware Audio- and Video-Based Applications for Active and Assisted Living (https://goodbrother.eu/), supported by COST (European Cooperation in Science and Technology) (https://www.cost.eu/)

Preserving medical correctness, readability and consistency in de-identified health records

A health record database contains structured data fields that identify the patient, such as patient ID, patient name, e-mail and phone number. These data are fairly easy to de-identify, that is, replace with other identifiers. However, these data also occur in fields with doctors’ free-text notes written in an abbreviated style that cannot be analyzed grammatically. If we replace a word that looks like a name, but isn’t, we degrade readability and medical correctness. If we fail to replace it when we should, we degrade confidentiality. We de-identified an existing Danish electronic health record database, ending up with 323,122 patient health records. We had to invent many methods for de-identifying potential identifiers in the free-text notes. The de-identified health records should be used with caution for statistical purposes because we removed health records that were so special that they couldn’t be de-identified. Furthermore, we distorted geography by replacing zip codes with random zip codes.</jats:p

Visual Privacy Protection Methods: A Survey

Recent advances in computer vision technologies have made possible the development of intelligent monitoring systems for video surveillance and ambient-assisted living. By using this technology, these systems are able to automatically interpret visual data from the environment and perform tasks that would have been unthinkable years ago. These achievements represent a radical improvement but they also suppose a new threat to individual’s privacy. The new capabilities of such systems give them the ability to collect and index a huge amount of private information about each individual. Next-generation systems have to solve this issue in order to obtain the users’ acceptance. Therefore, there is a need for mechanisms or tools to protect and preserve people’s privacy. This paper seeks to clarify how privacy can be protected in imagery data, so as a main contribution a comprehensive classification of the protection methods for visual privacy as well as an up-to-date review of them are provided. A survey of the existing privacy-aware intelligent monitoring systems and a valuable discussion of important aspects of visual privacy are also provided.This work has been partially supported by the Spanish Ministry of Science and Innovation under project “Sistema de visión para la monitorización de la actividad de la vida diaria en el hogar” (TIN2010-20510-C04-02) and by the European Commission under project “caring4U - A study on people activity in private spaces: towards a multisensor network that meets privacy requirements” (PIEF-GA-2010-274649). José Ramón Padilla López and Alexandros Andre Chaaraoui acknowledge financial support by the Conselleria d'Educació, Formació i Ocupació of the Generalitat Valenciana (fellowship ACIF/2012/064 and ACIF/2011/160 respectively)

Framework for privacy-aware content distribution in peer-to- peer networks with copyright protection

The use of peer-to-peer (P2P) networks for multimedia distribution has spread out globally in recent years. This mass popularity is primarily driven by the efficient distribution of content, also giving rise to piracy and copyright infringement as well as privacy concerns. An end user (buyer) of a P2P content distribution system does not want to reveal his/her identity during a transaction with a content owner (merchant), whereas the merchant does not want the buyer to further redistribute the content illegally. Therefore, there is a strong need for content distribution mechanisms over P2P networks that do not pose security and privacy threats to copyright holders and end users, respectively. However, the current systems being developed to provide copyright and privacy protection to merchants and end users employ cryptographic mechanisms, which incur high computational and communication costs, making these systems impractical for the distribution of big files, such as music albums or movies.El uso de soluciones de igual a igual (peer-to-peer, P2P) para la distribución multimedia se ha extendido mundialmente en los últimos años. La amplia popularidad de este paradigma se debe, principalmente, a la distribución eficiente de los contenidos, pero también da lugar a la piratería, a la violación del copyright y a problemas de privacidad. Un usuario final (comprador) de un sistema de distribución de contenidos P2P no quiere revelar su identidad durante una transacción con un propietario de contenidos (comerciante), mientras que el comerciante no quiere que el comprador pueda redistribuir ilegalmente el contenido más adelante. Por lo tanto, existe una fuerte necesidad de mecanismos de distribución de contenidos por medio de redes P2P que no supongan un riesgo de seguridad y privacidad a los titulares de derechos y los usuarios finales, respectivamente. Sin embargo, los sistemas actuales que se desarrollan con el propósito de proteger el copyright y la privacidad de los comerciantes y los usuarios finales emplean mecanismos de cifrado que implican unas cargas computacionales y de comunicaciones muy elevadas que convierten a estos sistemas en poco prácticos para distribuir archivos de gran tamaño, tales como álbumes de música o películas.L'ús de solucions d'igual a igual (peer-to-peer, P2P) per a la distribució multimèdia s'ha estès mundialment els darrers anys. L'àmplia popularitat d'aquest paradigma es deu, principalment, a la distribució eficient dels continguts, però també dóna lloc a la pirateria, a la violació del copyright i a problemes de privadesa. Un usuari final (comprador) d'un sistema de distribució de continguts P2P no vol revelar la seva identitat durant una transacció amb un propietari de continguts (comerciant), mentre que el comerciant no vol que el comprador pugui redistribuir il·legalment el contingut més endavant. Per tant, hi ha una gran necessitat de mecanismes de distribució de continguts per mitjà de xarxes P2P que no comportin un risc de seguretat i privadesa als titulars de drets i els usuaris finals, respectivament. Tanmateix, els sistemes actuals que es desenvolupen amb el propòsit de protegir el copyright i la privadesa dels comerciants i els usuaris finals fan servir mecanismes d'encriptació que impliquen unes càrregues computacionals i de comunicacions molt elevades que fan aquests sistemes poc pràctics per a distribuir arxius de grans dimensions, com ara àlbums de música o pel·lícules

Introductory Computer Forensics

INTERPOL (International Police) built cybercrime programs to keep up with emerging cyber threats, and aims to coordinate and assist international operations for ?ghting crimes involving computers. Although signi?cant international efforts are being made in dealing with cybercrime and cyber-terrorism, ?nding effective, cooperative, and collaborative ways to deal with complicated cases that span multiple jurisdictions has proven dif?cult in practic

Visual Perception in School-Aged Children: A Psychometric Study of the Correlation between Computer-based and Paper-based Scores on the Motor-Free Visual Perception Test, 3rd Edition

Visual perceptual skills are often assessed using paper-and-pencil tests such as the Motor-Free Visual Perception Test, 3rd Edition (MVPT-3). A computer-based version of this assessment was independently developed. This study aimed to establish its reliability by comparing scores of 3rd grade children at a local private school on each of the two testing mediums using a test-retest method. A strong correlation of age adjusted raw scores on the two testing mediums were anticipated, which would indicate that the computer-based version of the MVPT-3 is as reliable as the paper-based version. The current study found inconclusive results after correlational analysis, but results showed that 72.5% of participants received clinically comparable results. Clinically comparable results indicate that within the practical settings which this assessment may be utilized, the practitioner administering the assessment would offer similar recommendations. Regarding participants who did not receive clinically comparable results, assessment medium order is associated with incomparable scores. These results support the C-MVPT-III as a reliable and valid tool.  M.S

Principles of Security and Trust

This open access book constitutes the proceedings of the 8th International Conference on Principles of Security and Trust, POST 2019, which took place in Prague, Czech Republic, in April 2019, held as part of the European Joint Conference on Theory and Practice of Software, ETAPS 2019. The 10 papers presented in this volume were carefully reviewed and selected from 27 submissions. They deal with theoretical and foundational aspects of security and trust, including on new theoretical results, practical applications of existing foundational ideas, and innovative approaches stimulated by pressing practical problems

Crowdfunding Non-fungible Tokens on the Blockchain

Non-fungible tokens (NFTs) have been used as a way of rewarding content creators. Artists publish their works on the blockchain as NFTs, which they can then sell. The buyer of an NFT then holds ownership of a unique digital asset, which can be resold in much the same way that real-world art collectors might trade paintings. However, while a deal of effort has been spent on selling works of art on the blockchain, very little attention has been paid to using the blockchain as a means of fundraising to help finance the artist’s work in the first place. Additionally, while blockchains like Ethereum are ideal for smaller works of art, additional support is needed when the artwork is larger than is feasible to store on the blockchain. In this paper, we propose a fundraising mechanism that will help artists to gain financial support for their initiatives, and where the backers can receive a share of the profits in exchange for their support. We discuss our prototype implementation using the SpartanGold framework. We then discuss how this system could be expanded to support large NFTs with the 0Chain blockchain, and describe how we could provide support for ongoing storage of these NFTs