Biblio

Advances in deep neural networks (DNNs) have shown tremendous promise in the medical domain. However, the deep learning tools that are helping the domain, can also be used against it. Given the prevalence of fraud in the healthcare domain, it is important to consider the adversarial use of DNNs in manipulating sensitive data that is crucial to patient healthcare. In this work, we present the design and implementation of a DNN-based image translation attack on biomedical imagery. More specifically, we propose Jekyll, a neural style transfer framework that takes as input a biomedical image of a patient and translates it to a new image that indicates an attacker-chosen disease condition. The potential for fraudulent claims based on such generated `fake' medical images is significant, and we demonstrate successful attacks on both X-rays and retinal fundus image modalities. We show that these attacks manage to mislead both medical professionals and algorithmic detection schemes. Lastly, we also investigate defensive measures based on machine learning to detect images generated by Jekyll.

Health Information Technology Systems (HITS) are increasingly used to improve the quality of patient care while reducing costs. These systems have been developed in response to the changing models of care to an ongoing relationship between patient and care team, supported by the use of technology due to the increased instance of chronic disease. However, the use of HITS may increase the risk to patient safety and security. While standards can be used to address and manage these risks, significant communication problems exist between experts working in different departments. These departments operate in silos often leading to communication breakdowns. For example, risk management stakeholders who are not clinicians may struggle to understand, define and manage risks associated with these systems when talking to medical professionals as they do not understand medical terminology or the associated care processes. In order to overcome this communication problem, we propose the use of the “Three Amigos” approach together with the use of the SIMPLE tool that has been developed to assist patients in understanding medical terms. This paper examines how the “Three Amigos” approach and the SIMPLE tool can be used to improve estimation of severity of risk by non-clinical risk management stakeholders and provides a practical example of their use in a ten step risk management process.