Biblio

One of the most challenging issues facing Internet of Medical Things (IoMT) cyber defense is the complexity of their ecosystem coupled with the development of cyber-attacks. Medical equipments lack built-in security and are increasingly becoming connected. Moving beyond traditional security solutions becomes a necessity to protect patients and organizations. In order to effectively deal with the security risks of networked medical devices in such a complex and heterogeneous system, we need to measure security risks and prioritize mitigation actions. In this context, we propose a Fuzzy AHP-based method to assess security attributes of connected medical devices and compare different device models against a selected profile with regards to the user requirements. The proposal aims to empower user security awareness to make well-educated decisions.

With the ubiquitous advancement in smart medical devices and systems, the potential of Remote Patient Monitoring (RPM) network is evolving in modern healthcare systems. The medical professionals (doctors, nurses, or medical experts) can access vitals and sensitive physiological information about the patients and provide proper treatment to improve the quality of life through the RPM network. However, the wireless nature of communication in the RPM network makes it challenging to design an efficient mechanism for secure communication. Many authentication schemes have been proposed in recent years to ensure the security of the RPM network. Pseudonym, digital signature, and Authenticated Key Exchange (AKE) protocols are used for the Internet of Medical Things (IoMT) to develop secure authorization and privacy-preserving communication. However, traditional authentication protocols face overhead challenges due to maintaining a large set of key-pairs or pseudonyms results on the hospital cloud server. In this research work, we identify this research gap and propose a novel secure and efficient privacy-preserving authentication scheme using cuckoo filters for the RPM network. The use of cuckoo filters in our proposed scheme provides an efficient way for mutual anonymous authentication and a secret shared key establishment process between medical professionals and patients. Moreover, we identify the misbehaving sensor nodes using a correlation-based anomaly detection model to establish secure communication. The security analysis and formal security validation using SPAN and AVISPA tools show the robustness of our proposed scheme against message modification attacks, replay attacks, and man-in-the-middle attacks.

This document paper presents a critical and condensed analyze on series of devices that are intended for the military field, making an overview analysis of the technical solutions presented and that identifying those aspects that are really important for the military field or that offering a new approach. We currently have a wide range of medical devices that can be adapted for use in the military, but this adaptation must follow some well-defined aspects. A device that does not offer 100% reliability will be difficult to adopt in a military system, where mistakes are not allowed.

The recent events regarding worldwide human health sped up research efforts and resulted in the tremendous development of new technologies and applications. The last decade proved that new technologies find a proper place in worldwide human health and wellbeing, therefore the security of data during wireless transmission in medical facilities and for medical devices has become a research area of considerable importance. To provide enhanced security using conventional visible light wireless communication, we propose in this paper a novel communication protocol based on asymmetric encryption with a private key. We base the wireless communication protocol described in this work on a data encryption method using block chipers, and we propose it for medical facilities and devices with visible light transmission technology embedded. The asymmetric encryption with a private key algorithm, as part of a transmission protocol, aim to assure the security of sensitive medical data during wireless communication.

With the new coronavirus crisis, medical devices' workload has increased dramatically, leaving them growingly vulnerable to security threats and in need of a comprehensive solution. In this work, we take advantage of the flexible and highly manageable nature of Software Defined Networks (SDN) to design a thoroughgoing security framework that covers a health organization's various security requirements. Our solution comes to be an advanced SDN firewall that solves the issues facing traditional firewalls. It enables the partitioning of the organization's network and the enforcement of different filtering and monitoring behaviors on each partition depending on security conditions. We pursued the network's efficient and dynamic security management with the least human intervention in designing our model which makes it generally qualified to use in networks with different security requirements.

Digital connectivity is fundamental to the health care system to deliver safe and effective care. However, insecure connectivity could be a major threat to patient safety and privacy (e.g., in August 2017, FDA recalled 465,000 pacemakers because of discovering security flaws). Although connecting a patient's pacemaker to the Internet has many advantages for monitoring the patient, this connectivity opens a new door for cyber-attackers to steal the patient data or even control the pacemaker or damage it. Therefore, patients are forced to choose between connectivity and security. This paper presents a framework for secure and private communications between wearable medical devices and patient monitoring systems. The primary objective of this research is twofold, first to identify and analyze the communication vulnerabilities, second, to develop a framework for combating unauthorized access to data through the compromising of computer security. Specifically, hiding targets from cyber-attackers could prevent our system from future cyber-attacks. This is the most effective way to stop cyber-attacks in their first step.

Internet of Things (IoT) is spreading increasingly in different areas of application. Accordingly, IoT also gets deployed in health care including ambient assisted living, telemedicine or medical smart homes. However, IoT also involves risks. Next to increased security issues also safety concerns are occurring. Deploying health care sensors and utilizing medical data causes a high need for IoT architectures free of vulnerabilities in order to identify weak points as early as possible. To address this, we are developing a safety and security analysis approach including a standardized meta model and an IoT safety and security framework comprising a customizable analysis language.

The economic progress of the Internet of Things (IoT) is phenomenal. Applications range from checking the alignment of some components during a manufacturing process, monitoring of transportation and pedestrian levels to enhance driving and walking path, remotely observing terminally ill patients by means of medical devices such as implanted devices and infusion pumps, and so on. To provide security, encrypting the data becomes an indispensable requirement, and symmetric encryptions algorithms are becoming a crucial implementation in the resource constrained environments. Typical symmetric encryption algorithms like Advanced Encryption Standard (AES) showcases an assumption that end points of communications are secured and that the encryption key being securely stored. However, devices might be physically unprotected, and attackers may have access to the memory while the data is still encrypted. It is essential to reserve the key in such a way that an attacker finds it hard to extract it. At present, techniques like White-Box cryptography has been utilized in these circumstances. But it has been reported that applying White-Box cryptography in IoT devices have resulted in other security issues like the adversary having access to the intermediate values, and the practical implementations leading to Code lifting attacks and differential attacks. In this paper, a solution is presented to overcome these problems by demonstrating the need of White-Box Cryptography to enhance the security by utilizing the cipher block chaining (CBC) mode.

Integrated Clinical Environment (ICE) is a standardized framework for achieving device interoperability in medical cyber-physical systems. The ICE utilizes high-level supervisory apps and a low-level communication middleware to coordinate medical devices. The need to design complex ICE systems that are both safe and effective has presented numerous challenges, including interoperability, context-aware intelligence, security and privacy. In this paper, we present a data flow analysis framework for the ICE systems. The framework performs the combination of static and dynamic analysis for the sensitive data and operations in the ICE systems. Our experiments demonstrate that the data flow analysis framework can record how the medical devices transmit sensitive data and perform misuse detection by tracing the runtime context of the sensitive operations.

In this paper, we address the fundamental problem of securely bootstrapping a group of wireless devices to a hub, when none of the devices share prior associations (secrets) with the hub or between them. This scenario aligns with the secure deployment of body area networks, IoT, medical devices, industrial automation sensors, autonomous vehicles, and others. We develop VERSE, a physical-layer group message integrity verification primitive that effectively detects advanced wireless signal manipulations that can be used to launch man-in-the-middle (MitM) attacks over wireless. Without using shared secrets to establish authenticated channels, such attacks are notoriously difficult to thwart and can undermine the authentication and key establishment processes. VERSE exploits the existence of multiple devices to verify the integrity of the messages exchanged within the group. We then use VERSE to build a bootstrapping protocol, which securely introduces new devices to the network. Compared to the state-of-the-art, VERSE achieves in-band message integrity verification during secure pairing using only the RF modality without relying on out-of-band channels or extensive human involvement. It guarantees security even when the adversary is capable of fully controlling the wireless channel by annihilating and injecting wireless signals. We study the limits of such advanced wireless attacks and prove that the introduction of multiple legitimate devices can be leveraged to increase the security of the pairing process. We validate our claims via theoretical analysis and extensive experimentations on the USRP platform. We further discuss various implementation aspects such as the effect of time synchronization between devices and the effects of multipath and interference. Note that the elimination of shared secrets, default passwords, and public key infrastructures effectively addresses the related key management challenges when these are considered at scale.

Healthcare Internet of Things (HIoT) is transforming healthcare industry by providing large scale connectivity for medical devices, patients, physicians, clinical and nursing staff who use them and facilitate real-time monitoring based on the information gathered from the connected things. Heterogeneity and vastness of this network provide both opportunity and challenges for information collection and sharing. Patient-centric information such as health status and medical devices used by them must be protected to respect their safety and privacy, while healthcare knowledge should be shared in confidence by experts for healthcare innovation and timely treatment of patients. In this paper an overview of HIoT is given, emphasizing its characteristics to those of Big Data, and a security and privacy architecture is proposed for it. Context-sensitive role-based access control scheme is discussed to ensure that HIoT is reliable, provides data privacy, and achieves regulatory compliance.

The panic among medical control, information, and device administrators is due to surmounting number of high-profile attacks on healthcare facilities. This hostile situation is going to lead the health informatics industry to cloud-hoarding of medical data, control flows, and site governance. While different healthcare enterprises opt for cloud-based solutions, it is a matter of time when fog computing environment are formed. Because of major gaps in reported techniques for fog security administration for health data i.e. absence of an overarching certification authority (CA), the security provisioning is one of the the issue that we address in this paper. We propose a security provisioning model (AZSPM) for medical devices in fog environments. We propose that the AZSPM can be build by using atomic security components that are dynamically composed. The verification of authenticity of the atomic components, for trust sake, is performed by calculating the processor clock cycles from service execution at the resident hardware platform. This verification is performed in the fully sand boxed environment. The results of the execution cycles are matched with the service specifications from the manufacturer before forwarding the mobile services to the healthcare cloud-lets. The proposed model is completely novel in the fog computing environments. We aim at building the prototype based on this model in a healthcare information system environment.

Presented at the NSA Science of Security Quarterly Meeting, July 2016.

Today's cyber-physical systems (CPSs) can have very different characteristics in terms of control algorithms, configurations, underlying infrastructure, communication protocols, and real-time requirements. Despite these variations, they all face the threat of malicious attacks that exploit the vulnerabilities in the cyber domain as footholds to introduce safety violations in the physical processes. In this paper, we focus on a class of attacks that impact the physical processes without introducing anomalies in the cyber domain. We present the common challenges in detecting this type of attacks in the contexts of two very different CPSs (i.e., power grids and surgical robots). In addition, we present a general principle for detecting such cyber-physical attacks, which combine the knowledge of both cyber and physical domains to estimate the adverse consequences of malicious activities in a timely manner.

Design and testing of pacemaker is challenging because of the need to capture the interaction between the physical processes (e.g. voltage signal in cardiac tissue) and the embedded software (e.g. a pacemaker). At the same time, there is a growing need for design and certification methodologies that can provide quality assurance for the embedded software. We describe recent progress in simulation-based techniques that are capable of ensuring guaranteed coverage. Our methods employ discrep- ancy functions, which impose bounds on system dynamics, and proceed through iteratively constructing over-approximations of the reachable set of states. We are able to prove time bounded safety or produce counterexamples. We illustrate the techniques by analyzing a family of pacemaker designs against time duration requirements and synthesize safe parameter ranges. We conclude by outlining the potential uses of this technology to improve the safety of medical device designs.

Using heterogeneous clouds has been considered to improve performance of big-data analytics for healthcare platforms. However, the problem of the delay when transferring big-data over the network needs to be addressed. The purpose of this paper is to analyze and compare existing cloud computing environments (PaaS, IaaS) in order to implement middleware services. Understanding the differences and similarities between cloud technologies will help in the interconnection of healthcare platforms. The paper provides a general overview of the techniques and interfaces for cloud computing middleware services, and proposes a cloud architecture for healthcare. Cloud middleware enables heterogeneous devices to act as data sources and to integrate data from other healthcare platforms, but specific APIs need to be developed. Furthermore, security and management problems need to be addressed, given the heterogeneous nature of the communication and computing environment. The present paper fills a gap in the electronic healthcare register literature by providing an overview of cloud computing middleware services and standardized interfaces for the integration with medical devices.

This paper is a proposal for a poster. In it we describe a medical device security approach that researchers at Fraunhofer used to analyze different kinds of medical devices for security vulnerabilities. These medical devices were provided to Fraunhofer by a medical device manufacturer whose name we cannot disclose due to non-disclosure agreements.

According to a 2011 survey in healthcare, the most commonly reported breaches of protected health information involved employees snooping into medical records of friends and relatives. Logging mechanisms can provide a means for forensic analysis of user activity in software systems by proving that a user performed certain actions in the system. However, logging mechanisms often inconsistently capture user interactions with sensitive data, creating gaps in traces of user activity. Explicit design principles and systematic testing of logging mechanisms within the software development lifecycle may help strengthen the overall security of software. The objective of this research is to observe the current state of logging mechanisms by performing an exploratory case study in which we systematically evaluate logging mechanisms by supplementing the expected results of existing functional black-box test cases to include log output. We perform an exploratory case study of four open-source electronic health record (EHR) logging mechanisms: OpenEMR, OSCAR, Tolven eCHR, and WorldVistA. We supplement the expected results of 30 United States government-sanctioned test cases to include log output to track access of sensitive data. We then execute the test cases on each EHR system. Six of the 30 (20%) test cases failed on all four EHR systems because user interactions with sensitive data are not logged. We find that viewing protected data is often not logged by default, allowing unauthorized views of data to go undetected. Based on our results, we propose a set of principles that developers should consider when developing logging mechanisms to ensure the ability to capture adequate traces of user activity.