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

The JPEG2000 still image coding system: An overview

With the increasing use of multimedia technologies, image compression requires higher performance as well as new features. To address this need in the specific area of still image encoding, a new standard is currently being developed, the JPEG2000. It is not only intended to provide rate-distortion and subjective image quality performance superior to existing standards, but also to provide features and functionalities that current standards can either not address efficiently or in many cases cannot address at all. Lossless and lossy compression, embedded lossy to lossless coding, progressive transmission by pixel accuracy and by resolution, robustness to the presence of bit-errors and region-of-interest coding, are some representative features. It is interesting to note that JPEG2000 is being designed to address the requirements of a diversity of applications, e.g. Internet, color facsimile, printing, scanning, digital photography, remote sensing, mobile applications, medical imagery, digital library and E-commerce

Selected topics on distributed video coding

Distributed Video Coding (DVC) is a new paradigm for video compression based on the information theoretical results of Slepian and Wolf (SW), and Wyner and Ziv (WZ). While conventional coding has a rigid complexity allocation as most of the complex tasks are performed at the encoder side, DVC enables a flexible complexity allocation between the encoder and the decoder. The most novel and interesting case is low complexity encoding and complex decoding, which is the opposite of conventional coding. While the latter is suitable for applications where the cost of the decoder is more critical than the encoder's one, DVC opens the door for a new range of applications where low complexity encoding is required and the decoder's complexity is not critical. This is interesting with the deployment of small and battery-powered multimedia mobile devices all around in our daily life. Further, since DVC operates as a reversed-complexity scheme when compared to conventional coding, DVC also enables the interesting scenario of low complexity encoding and decoding between two ends by transcoding between DVC and conventional coding. More specifically, low complexity encoding is possible by DVC at one end. Then, the resulting stream is decoded and conventionally re-encoded to enable low complexity decoding at the other end. Multiview video is attractive for a wide range of applications such as free viewpoint television, which is a system that allows viewing the scene from a viewpoint chosen by the viewer. Moreover, multiview can be beneficial for monitoring purposes in video surveillance. The increased use of multiview video systems is mainly due to the improvements in video technology and the reduced cost of cameras. While a multiview conventional codec will try to exploit the correlation among the different cameras at the encoder side, DVC allows for separate encoding of correlated video sources. Therefore, DVC requires no communication between the cameras in a multiview scenario. This is an advantage since communication is time consuming (i.e. more delay) and requires complex networking. Another appealing feature of DVC is the fact that it is based on a statistical framework. Moreover, DVC behaves as a natural joint source-channel coding solution. This results in an improved error resilience performance when compared to conventional coding. Further, DVC-based scalable codecs do not require a deterministic knowledge of the lower layers. In other words, the enhancement layers are completely independent from the base layer codec. This is called the codec-independent scalability feature, which offers a high flexibility in the way the various layers are distributed in a network. This thesis addresses the following topics: First, the theoretical foundations of DVC as well as the practical DVC scheme used in this research are presented. The potential applications for DVC are also outlined. DVC-based schemes use conventional coding to compress parts of the data, while the rest is compressed in a distributed fashion. Thus, different conventional codecs are studied in this research as they are compared in terms of compression efficiency for a rich set of sequences. This includes fine tuning the compression parameters such that the best performance is achieved for each codec. Further, DVC tools for improved Side Information (SI) and Error Concealment (EC) are introduced for monoview DVC using a partially decoded frame. The improved SI results in a significant gain in reconstruction quality for video with high activity and motion. This is done by re-estimating the erroneous motion vectors using the partially decoded frame to improve the SI quality. The latter is then used to enhance the reconstruction of the finally decoded frame. Further, the introduced spatio-temporal EC improves the quality of decoded video in the case of erroneously received packets, outperforming both spatial and temporal EC. Moreover, it also outperforms error-concealed conventional coding in different modes. Then, multiview DVC is studied in terms of SI generation, which differentiates it from the monoview case. More specifically, different multiview prediction techniques for SI generation are described and compared in terms of prediction quality, complexity and compression efficiency. Further, a technique for iterative multiview SI is introduced, where the final SI is used in an enhanced reconstruction process. The iterative SI outperforms the other SI generation techniques, especially for high motion video content. Finally, fusion techniques of temporal and inter-view side informations are introduced as well, which improves the performance of multiview DVC over monoview coding. DVC is also used to enable scalability for image and video coding. Since DVC is based on a statistical framework, the base and enhancement layers are completely independent, which is an interesting property called codec-independent scalability. Moreover, the introduced DVC scalable schemes show a good robustness to errors as the quality of decoded video steadily decreases with error rate increase. On the other hand, conventional coding exhibits a cliff effect as the performance drops dramatically after a certain error rate value. Further, the issue of privacy protection is addressed for DVC by transform domain scrambling, which is used to alter regions of interest in video such that the scene is still understood and privacy is preserved as well. The proposed scrambling techniques are shown to provide a good level of security without impairing the performance of the DVC scheme when compared to the one without scrambling. This is particularly attractive for video surveillance scenarios, which is one of the most promising applications for DVC. Finally, a practical DVC demonstrator built during this research is described, where the main requirements as well as the observed limitations are presented. Furthermore, it is defined in a setup being as close as possible to a complete real application scenario. This shows that it is actually possible to implement a complete end-to-end practical DVC system relying only on realistic assumptions. Even though DVC is inferior in terms of compression efficiency to the state of the art conventional coding for the moment, strengths of DVC reside in its good error resilience properties and the codec-independent scalability feature. Therefore, DVC offers promising possibilities for video compression with transmission over error-prone environments requirement as it significantly outperforms conventional coding in this case

Data integrity for active web intermediaries

Master'sMASTER OF SCIENC

The JPEG 2000 still image compression standard

With the increasing use of multimedia technologies, image compression requires higher performance as well as new features. To address this need in the specific area of still image encoding, a new standard is currently being developed, the JPEC2000. It is not only intended to provide rate-distortion and subjective image quality performance superior to existing standards, but also to provide features and functionalities that current standards can either not address efficiently or in many cases cannot address at all. Lossless and lossy compression, embedded lossy to lossless coding, progressive transmission by pixel accuracy and by resolution, robustness to the presence of bit-errors and region-of-interest coding, are some representative features. It is interesting to note that JPEG2000 is being designed to address the requirements of a diversity of applications, e.g. Internet, color facsimile, printing, scanning, digital photography, remote sensing, mobile applications, medical imagery, digital library and E-commerce

Multimedia

The nowadays ubiquitous and effortless digital data capture and processing capabilities offered by the majority of devices, lead to an unprecedented penetration of multimedia content in our everyday life. To make the most of this phenomenon, the rapidly increasing volume and usage of digitised content requires constant re-evaluation and adaptation of multimedia methodologies, in order to meet the relentless change of requirements from both the user and system perspectives. Advances in Multimedia provides readers with an overview of the ever-growing field of multimedia by bringing together various research studies and surveys from different subfields that point out such important aspects. Some of the main topics that this book deals with include: multimedia management in peer-to-peer structures & wireless networks, security characteristics in multimedia, semantic gap bridging for multimedia content and novel multimedia applications

Platforms for handling and development of audiovisual data

Estágio realizado na MOG Solutions e orientado por Vítor TeixeiraTese de mestrado integrado. Engenharia Informátca e Computação. Faculdade de Engenharia. Universidade do Porto. 200