Medical Internet of Things: A Survey of the Current Threat and Vulnerability Landscape

The Internet of things (IoT) is a system that utilizes the Internet to facilitate communication between sensors and devices. Given the ubiquitous nature of IoT devices, it is seemingly inevitable that IoT would be used as a conduit to transform healthcare. One such medical IoT (mIoT) device that is revolutionizing healthcare is the medical implant device. These mIoT implant devices which control insulin pumps, cardioverter defibrillators and bone growth stimulators have redefined the way patient data is accessed, and healthcare is delivered. These implant devices are a double-edged sword. While they allow for the effective and efficient noninvasive treatment of patients, this external communication makes the medical implants vulnerable to cyberattacks synonymous with IoT devices. As a result, privacy and security vulnerabilities have surfaced as pronounced challenges for mIoT devices. This work summarizes and synthesizes the inherent vulnerabilities associated with mIoT devices and the implications regarding patient safety

IoT Health Devices: Exploring Security Risks in the Connected Landscape

The concept of the Internet of Things (IoT) spans decades, and the same can be said for its inclusion in healthcare. The IoT is an attractive target in medicine; it offers considerable potential in expanding care. However, the application of the IoT in healthcare is fraught with an array of challenges, and also, through it, numerous vulnerabilities that translate to wider attack surfaces and deeper degrees of damage possible to both consumers and their confidence within health systems, as a result of patient-specific data being available to access. Further, when IoT health devices (IoTHDs) are developed, a diverse range of attacks are possible. To understand the risks in this new landscape, it is important to understand the architecture of IoTHDs, operations, and the social dynamics that may govern their interactions. This paper aims to document and create a map regarding IoTHDs, lay the groundwork for better understanding security risks in emerging IoTHD modalities through a multi-layer approach, and suggest means for improved governance and interaction. We also discuss technological innovations expected to set the stage for novel exploits leading into the middle and latter parts of the 21st century

Securing the Internet of Healthcare

Cybersecurity, including the security of information technology (IT), is a critical requirement in ensuring society trusts, and therefore can benefit from, modern technology. Problematically, though, rarely a day goes by without a news story related to how critical data has been exposed, exfiltrated, or otherwise inappropriately used or accessed as a result of supply chain vulnerabilities. From the Russian government\u27s campaign to influence the 2016 U.S. presidential election to the September 2017 Equifax breach of more than 140-million Americans\u27 credit reports, mitigating cyber risk has become a topic of conversation in boardrooms and the White House, on Wall Street and Main Street. But oftentimes these discussions miss the problems replete in the often-expansive supply chains on which many of these products and services we depend on are built; this is particularly true in the medical device context. The problem recently made national news with the FDA-mandated recall of more than 400,000 pacemakers that were found to be vulnerable to hackers necessitating a firmware update. This Article explores the myriad vulnerabilities in the supply chain for medical devices, investigates existing FDA cybersecurity and privacy regulations to identify any potential governance gaps, and suggests a path forward to boost cybersecurity due diligence for manufacturers by making use of new approaches and technologies, including blockchain

Securing the Internet of Healthcare

Cybersecurity, which includes the security of information technology (IT), is critical to ensuring that society trusts, and therefore can benefit from, modern technology. Problematically, though, rarely a day goes by without a news story related to how critical data has been exposed, exfiltrated, or otherwise inappropriately used or accessed as a result of supply chain vulnerabilities. From the Russian government’s campaign to influence the 2016 U.S. presidential election to the September 2017 Equifax breach of more than 140 million Americans’ credit reports, cyber risk has become a topic of conversation in boardrooms and the White House, on Wall Street and main street. But these discussions often miss the problems replete in the expansive supply chains on which many of these products and services we depend on are built; this is particularly true in the medical device context. The problem recently made national news with the voluntary recall of more than 400,000 pacemakers that were found to be vulnerable to hackers, necessitating a firmware update. This Article explores the myriad vulnerabilities in the supply chain for medical devices, investigates existing FDA cybersecurity and privacy regulations to identify any potential governance gaps, and suggests a path forward to boost cybersecurity due diligence for manufacturers by making use of new approaches and technologies, including blockchain

Cybersecurity Vulnerabilities in Medical Devices: A Complex Environment and Multifaceted Problem

The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat

A review on recent advances in implanted medical devices security

The Implanted Medical Devices (IMD) industry has grown over the past few decades and is expected to grow in the coming ones. Being an asset for the health and quality of life of a patient, the availability of IMD-related products, their increasing complexity and advances in communication capabilities do not seem to have been seamlessly accompanied by cybersecurity concerns. Recent IMD can be integrated in the concept of IoT (Internet of Things) and thus, they are also exposed to attacks impacting on privacy and, above all, on the health and even the life of the device users. While in an early stage of the IMD development, the security procedures were based on the existing classic protocols and models and their functional capabilities were the focus of development, recent efforts have been made to address security from the start. In this paper we review the most recent contributions on the cybersecurity of IMD products and we highlight innovative ideas that represent new design and development paradigms of these devices next generations. In this review it is reinforced that the technological evolution and the progressive access of attackers to resources capable of exploiting multiple vulnerabilities can have a crucial impact in the IMD already implanted in the patient's body, designed to remain in operation for many years. Also, it brings the need to develop novel and robust protocols to guarantee security compatible with constrained computing resources and extremely low energy requirements to be feasible. Finally, the security and privacy concerns regarding this kind of devices should be addressed in the design phase and policies must move from damage mitigation to threat prevention.5311-8814-F0ED | Sara Maria da Cruz Maia de Oliveira PaivaN/

Security risks of medical devices in wireless environments

The advancement of wireless medical devices technology, that has developed in hospitals and migrated into the home environment, has created unsustainability in in terms of the management of security for such devices. Through this paper, we shall attempt to explain how medical devices have completely changed the way security needs to be approached in the medical field. We shall also explore the history of medical devices and the organizational problems faced for the development of these devices, the different stakeholders strengths and weaknesses, especially if the device is implanted inside the body of a patient. Once the risk is understood we can then endeavour to mitigate it. We shall also explore how we can put in place a system of prioritization of medical devices that will enable us to reduce the risk threshold for our medical devices

Have You Updated Your Toaster? Transatlantic Approaches to Governing the Internet of Everything

As Internet-connected devices become ubiquitous, it remains an open question whether security— or privacy—can or will scale, or whether a combination of perverse incentives, new problems, and new impacts of old problems like “technical debt” amassing from products being rushed to market before being fully vetted, will derail progress and exacerbate cyber insecurity. This Article investigates contemporary approaches to Internet of Things (IoT) governance through an in- depth comparative case study focusing on the European Union (EU) and the United States. Particular attention is paid to the impact on IoT security of the General Data Protection Regulation (GDPR) and the Network Information Security (NIS) Directive in the EU, and the influence of the U.S. National Institute for Standards and Technology Cybersecurity Framework (NIST CSF), with a focus on mitigating the risk of politically motivated attacks on civilians. We analyze reform proposals and apply lessons from major prior Internet governance debates to argue for a polycentric approach to improving IoT security and privacy in the transatlantic context