Integrated, reliable and cloud-based personal health record: a scoping review.

Personal Health Records (PHR) emerge as an alternative to integrate patient’s health information to give a global view of patients' status. However, integration is not a trivial feature when dealing with a variety electronic health systems from healthcare centers. Access to PHR sensitive information must comply with privacy policies defined by the patient. Architecture PHR design should be in accordance to these, and take advantage of nowadays technology. Cloud computing is a current technology that provides scalability, ubiquity, and elasticity features. This paper presents a scoping review related to PHR systems that achieve three characteristics: integrated, reliable and cloud-based. We found 101 articles that addressed thosecharacteristics. We identified four main research topics: proposal/developed systems, PHR recommendations for development, system integration and standards, and security and privacy. Integration is tackled with HL7 CDA standard. Information reliability is based in ABE security-privacy mechanism. Cloud-based technology access is achieved via SOA.CONACYT - Consejo Nacional de Ciencia y TecnologíaPROCIENCI

Double Secret Protection: Bridging Federal and State Law To Protect Privacy Rights for Telemental and Mobile Health Users

Mental health care in the United States is plagued by stigma, cost, and access issues that prevent many people from seeking and continuing treatment for mental health conditions. Emergent technology, however, may offer a solution. Through telemental health, patients can connect with providers remotely—avoiding stigmatizing situations that can arise from traditional healthcare delivery, receiving more affordable care, and reaching providers across geographic boundaries. And with mobile health technology, people can use smart phone applications both to self-monitor their mental health and to communicate with their doctors. But people do not want to take advantage of telemental and mobile health unless their privacy is protected. After evaluating the applicability of current health information privacy law to these new forms of treatment, this Note proposes changes to the federal regime to protect privacy rights for telemental and mobile health users

Double Secret Protection: Bridging Federal and State Law To Protect Privacy Rights for Telemental and Mobile Health Users

Mental health care in the United States is plagued by stigma, cost, and access issues that prevent many people from seeking and continuing treatment for mental health conditions. Emergent technology, however, may offer a solution. Through telemental health, patients can connect with providers remotely—avoiding stigmatizing situations that can arise from traditional healthcare delivery, receiving more affordable care, and reaching providers across geographic boundaries. And with mobile health technology, people can use smart phone applications both to self-monitor their mental health and to communicate with their doctors. But people do not want to take advantage of telemental and mobile health unless their privacy is protected. After evaluating the applicability of current health information privacy law to these new forms of treatment, this Note proposes changes to the federal regime to protect privacy rights for telemental and mobile health users

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

Health Access Broker: Secure, Patient-Controlled Management of Personal Health Records in the Cloud

Secure and privacy-preserving management of Personal Health Records (PHRs) has proved to be a major challenge in modern healthcare. Current solutions generally do not offer patients a choice in where the data is actually stored and also rely on at least one fully trusted element that patients must also trust with their data. In this work, we present the Health Access Broker (HAB), a patient-controlled service for secure PHR sharing that (a) does not impose a specific storage location (uniquely for a PHR system), and (b) does not assume any of its components to be fully secure against adversarial threats. Instead, HAB introduces a novel auditing and intrusion-detection mechanism where its workflow is securely logged and continuously inspected to provide auditability of data access and quickly detect any intrusions.Comment: Copy of the paper accepted at 13th International Conference on Computational Intelligence in Security for Information Systems (CISIS

A HYBRIDIZED ENCRYPTION SCHEME BASED ON ELLIPTIC CURVE CRYPTOGRAPHY FOR SECURING DATA IN SMART HEALTHCARE

Recent developments in smart healthcare have brought us a great deal of convenience. Connecting common objects to the Internet is made possible by the Internet of Things (IoT). These connected gadgets have sensors and actuators for data collection and transfer. However, if users' private health information is compromised or exposed, it will seriously harm their privacy and may endanger their lives. In order to encrypt data and establish perfectly alright access control for such sensitive information, attribute-based encryption (ABE) has typically been used. Traditional ABE, however, has a high processing overhead. As a result, an effective security system algorithm based on ABE and Fully Homomorphic Encryption (FHE) is developed to protect health-related data. ABE is a workable option for one-to-many communication and perfectly alright access management of encrypting data in a cloud environment. Without needing to decode the encrypted data, cloud servers can use the FHE algorithm to take valid actions on it. Because of its potential to provide excellent security with a tiny key size, elliptic curve cryptography (ECC) algorithm is also used. As a result, when compared to related existing methods in the literature, the suggested hybridized algorithm (ABE-FHE-ECC) has reduced computation and storage overheads. A comprehensive safety evidence clearly shows that the suggested method is protected by the Decisional Bilinear Diffie-Hellman postulate. The experimental results demonstrate that this system is more effective for devices with limited resources than the conventional ABE when the system’s performance is assessed by utilizing standard model

ShareABEL: Secure Sharing of mHealth Data through Cryptographically-Enforced Access Control

Owners of mobile-health apps and devices often want to share their mHealth data with others, such as physicians, therapists, coaches, and caregivers. For privacy reasons, however, they typically want to share a limited subset of their information with each recipient according to their preferences. In this paper, we introduce ShareABEL, a scalable, usable, and practical system that allows mHealth-data owners to specify access-control policies and to cryptographically enforce those policies so that only parties with the proper corresponding permissions are able to decrypt data. The design (and prototype implementation) of this system makes three contributions: (1) it applies cryptographically-enforced access-control measures to wearable healthcare data, which pose different challenges than Electronic Medical Records (EMRs), (2) it recognizes the temporal nature of mHealth data streams and supports revocation of access to part or all of a data stream, and (3) it departs from the vendor- and device-specific silos of mHealth data by implementing a secure end-to-end system that can be applied to data collected from a variety of mHealth apps and devices

Ensuring patients privacy in a cryptographic-based-electronic health records using bio-cryptography

Several recent works have proposed and implemented cryptography as a means to preserve privacy and security of patients health data. Nevertheless, the weakest point of electronic health record (EHR) systems that relied on these cryptographic schemes is key management. Thus, this paper presents the development of privacy and security system for cryptography-based-EHR by taking advantage of the uniqueness of fingerprint and iris characteristic features to secure cryptographic keys in a bio-cryptography framework. The results of the system evaluation showed significant improvements in terms of time efficiency of this approach to cryptographic-based-EHR. Both the fuzzy vault and fuzzy commitment demonstrated false acceptance rate (FAR) of 0%, which reduces the likelihood of imposters gaining successful access to the keys protecting patients protected health information. This result also justifies the feasibility of implementing fuzzy key binding scheme in real applications, especially fuzzy vault which demonstrated a better performance during key reconstruction