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

End-to-end security in active networks

Active network solutions have been proposed to many of the problems caused by the increasing heterogeneity of the Internet. These ystems allow nodes within the network to process data passing through in several ways. Allowing code from various sources to run on routers introduces numerous security concerns that have been addressed by research into safe languages, restricted execution environments, and other related areas. But little attention has been paid to an even more critical question: the effect on end-to-end security of active flow manipulation. This thesis first examines the threat model implicit in active networks. It develops a framework of security protocols in use at various layers of the networking stack, and their utility to multimedia transport and flow processing, and asks if it is reasonable to give active routers access to the plaintext of these flows. After considering the various security problem introduced, such as vulnerability to attacks on intermediaries or coercion, it concludes not. We then ask if active network systems can be built that maintain end-to-end security without seriously degrading the functionality they provide. We describe the design and analysis of three such protocols: a distributed packet filtering system that can be used to adjust multimedia bandwidth requirements and defend against denial-of-service attacks; an efficient composition of link and transport-layer reliability mechanisms that increases the performance of TCP over lossy wireless links; and a distributed watermarking servicethat can efficiently deliver media flows marked with the identity of their recipients. In all three cases, similar functionality is provided to designs that do not maintain end-to-end security. Finally, we reconsider traditional end-to-end arguments in both networking and security, and show that they have continuing importance for Internet design. Our watermarking work adds the concept of splitting trust throughout a network to that model; we suggest further applications of this idea

Information Systems: Secure Access and Storage in the Age of Cloud Computing

Given that cloud computing is a remotely accessed service, the connection between provider and customer needs to be adequately protected against all known security risks. In order to ensure this, an open and clear specification of all standards, algorithms and security protocols adopted by the cloud provider is required. In this paper, we review current issues concerned with security threats to cloud computing and present a solution based on our unique patented compression-encryption method. The method provides highly efficient data compression where a unique symmetric key is generated as part of the compression process and is dependent on the characteristics of the data. Without the key, the data cannot be decompressed. We focus on threat prevention by cryptography that, if properly implemented, is virtually impossible to break directly. Our security by design is based on two principles: first, defence in depth, where our proposed design is such that more than one subsystem needs to be violated to get both the data and their key. Second, the principle of least privilege, where the attacker may gain access to only part of a system. The paper highlights the benefits of the solution that include high compression ratios, less bandwidth requirements, faster data transmission and response times, less storage space, and less energy consumption among others

Recent Advances in Signal Processing

The signal processing task is a very critical issue in the majority of new technological inventions and challenges in a variety of applications in both science and engineering fields. Classical signal processing techniques have largely worked with mathematical models that are linear, local, stationary, and Gaussian. They have always favored closed-form tractability over real-world accuracy. These constraints were imposed by the lack of powerful computing tools. During the last few decades, signal processing theories, developments, and applications have matured rapidly and now include tools from many areas of mathematics, computer science, physics, and engineering. This book is targeted primarily toward both students and researchers who want to be exposed to a wide variety of signal processing techniques and algorithms. It includes 27 chapters that can be categorized into five different areas depending on the application at hand. These five categories are ordered to address image processing, speech processing, communication systems, time-series analysis, and educational packages respectively. The book has the advantage of providing a collection of applications that are completely independent and self-contained; thus, the interested reader can choose any chapter and skip to another without losing continuity

Robust multi-view video streaming through adaptive intra refresh video transcoding

A multi-view video (MVV) transcoder has been designed. The objective is to deliver maximum quality 3D video data from the source to the 2D video destination, through a wireless communication channel using all of its available bandwidth. This design makes use of the spatial and view downscaling algorithm. The method involves the reuse of motion information obtained from both the reference frames and views. Consequently, highly compressed MVV is converted into low bit rate single view video that is compliant with H.264/AVC format. Adaptive intra refresh (AIR) error resilience tool is configured to mitigate the error propagation resulting from channel conditions. Experimental results indicate that error resilience plus transcoding performed better than the cascaded technique. Simulation results demonstrated an efficient 3D video streaming service applied to low power mobile devices

Authentication with Distortion Criteria

In a variety of applications, there is a need to authenticate content that has experienced legitimate editing in addition to potential tampering attacks. We develop one formulation of this problem based on a strict notion of security, and characterize and interpret the associated information-theoretic performance limits. The results can be viewed as a natural generalization of classical approaches to traditional authentication. Additional insights into the structure of such systems and their behavior are obtained by further specializing the results to Bernoulli and Gaussian cases. The associated systems are shown to be substantially better in terms of performance and/or security than commonly advocated approaches based on data hiding and digital watermarking. Finally, the formulation is extended to obtain efficient layered authentication system constructions.Comment: 22 pages, 10 figure

Digital watermarking : applicability for developing trust in medical imaging workflows state of the art review

Medical images can be intentionally or unintentionally manipulated both within the secure medical system environment and outside, as images are viewed, extracted and transmitted. Many organisations have invested heavily in Picture Archiving and Communication Systems (PACS), which are intended to facilitate data security. However, it is common for images, and records, to be extracted from these for a wide range of accepted practices, such as external second opinion, transmission to another care provider, patient data request, etc. Therefore, confirming trust within medical imaging workflows has become essential. Digital watermarking has been recognised as a promising approach for ensuring the authenticity and integrity of medical images. Authenticity refers to the ability to identify the information origin and prove that the data relates to the right patient. Integrity means the capacity to ensure that the information has not been altered without authorisation. This paper presents a survey of medical images watermarking and offers an evident scene for concerned researchers by analysing the robustness and limitations of various existing approaches. This includes studying the security levels of medical images within PACS system, clarifying the requirements of medical images watermarking and defining the purposes of watermarking approaches when applied to medical images

Joint Compression and Watermarking Using Variable-Rate Quantization and its Applications to JPEG

In digital watermarking, one embeds a watermark into a covertext, in such a way that the resulting watermarked signal is robust to a certain distortion caused by either standard data processing in a friendly environment or malicious attacks in an unfriendly environment. In addition to the robustness, there are two other conflicting requirements a good watermarking system should meet: one is referred as perceptual quality, that is, the distortion incurred to the original signal should be small; and the other is payload, the amount of information embedded (embedding rate) should be as high as possible. To a large extent, digital watermarking is a science and/or art aiming to design watermarking systems meeting these three conflicting requirements. As watermarked signals are highly desired to be compressed in real world applications, we have looked into the design and analysis of joint watermarking and compression (JWC) systems to achieve efficient tradeoffs among the embedding rate, compression rate, distortion and robustness. Using variable-rate scalar quantization, an optimum encoding and decoding scheme for JWC systems is designed and analyzed to maximize the robustness in the presence of additive Gaussian attacks under constraints on both compression distortion and composite rate. Simulation results show that in comparison with the previous work of designing JWC systems using fixed-rate scalar quantization, optimum JWC systems using variable-rate scalar quantization can achieve better performance in the distortion-to-noise ratio region of practical interest. Inspired by the good performance of JWC systems, we then investigate its applications in image compression. We look into the design of a joint image compression and blind watermarking system to maximize the compression rate-distortion performance while maintaining baseline JPEG decoder compatibility and satisfying the additional constraints imposed by watermarking. Two watermarking embedding schemes, odd-even watermarking (OEW) and zero-nonzero watermarking (ZNW), have been proposed for the robustness to a class of standard JPEG recompression attacks. To maximize the compression performance, two corresponding alternating algorithms have been developed to jointly optimize run-length coding, Huffman coding and quantization table selection subject to the additional constraints imposed by OEW and ZNW respectively. Both of two algorithms have been demonstrated to have better compression performance than the DQW and DEW algorithms developed in the recent literature. Compared with OEW scheme, the ZNW embedding method sacrifices some payload but earns more robustness against other types of attacks. In particular, the zero-nonzero watermarking scheme can survive a class of valumetric distortion attacks including additive noise, amplitude changes and recompression for everyday usage