Visual Sharing Protection Method for Medical Images

The telecare medical information system (TMIS) aims to establish telecare services and enable the public to access medical services or medical information at remote sites. Authentication and key agreement is essential to ensure data integrity, confidentiality, and availability for TMIS. Most recently, Chen et al. proposed an efficient and secure dynamic ID-based authentication scheme for TMIS, and claimed that their scheme achieves user anonymity. However, we observe that Chen et al.’s scheme achieves neither anonymity nor untraceability, and is subject to the identity guessing attack and tracking attack. In order to protect user privacy, we propose an enhanced authentication scheme which achieves user anonymity and untraceablity. It is a secure and efficient authentication scheme with user privacy preservation which is practical for TMIS.     

A bilinear pairing based anonymous authentication scheme in wireless body area networks for mHealth

Wireless body area networks (WBANs) have become one of the key components of mobile health (mHealth) which provides 24/7 health monitoring service and greatly improves the quality and efficiency of healthcare. However, users’ concern about the security and privacy of their health information has become one of the major obstacles that impede the wide adoption of WBANs. Anonymous and unlinkable authentication is critical to protect the security and privacy of sensitive physiological information in transit from the client to the application provider. We first show that the anonymous authentication scheme of Wang and Zhang based on bilinear pairing is prone to client impersonation attack. Then, we propose an enhanced anonymous authentication scheme to remedy the flaw in Wang and Zhang’s scheme. We give the security analysis to demonstrate that the enhanced scheme achieves the desired security features and withstands various known attacks.     

Towards Secure and Privacy-Preserving Data Sharing in e-Health Systems via Consortium Blockchain

Electronic health record sharing can help to improve the accuracy of diagnosis, where security and privacy preservation are critical issues in the systems. In recent years, blockchain has been proposed to be a promising solution to achieve personal health information (PHI) sharing with security and privacy preservation due to its advantages of immutability. This work proposes a blockchain-based secure and privacy-preserving PHI sharing (BSPP) scheme for diagnosis improvements in e-Health systems. Firstly, two kinds of blockchains, private blockchain and consortium blockchain, are constructed by devising their data structures, and consensus mechanisms. The private blockchain is responsible for storing the PHI while the consortium blockchain keeps records of the secure indexes of the PHI. In order to achieve data security, access control, privacy preservation and secure search, all the data including the PHI, keywords and the patients’ identity are public key encrypted with keyword search. Furthermore, the block generators are required to provide proof of conformance for adding new blocks to the blockchains, which guarantees the system availability. Security analysis demonstrates that the proposed protocol can meet with the security goals. Furthermor, we implement the proposed scheme on JUICE to evaluate the performance.     

An Improved Authentication Scheme for Telecare Medicine Information Systems

The telecare medicine information system enables or supports health-care delivery services. In order to safeguard patients' privacy, such as telephone number, medical record number, health information, etc., a secure authentication scheme will thus be in demand. Recently, Wu et?al. proposed a smart card based password authentication scheme for the telecare medicine information system. Later, He et?al. pointed out that Wu et?al.'s scheme could not resist impersonation attacks and insider attacks, and then presented a new scheme. In this paper, we show that both of them fail to achieve two-factor authentication as smart card based password authentication schemes should achieve. We also propose an improved authentication scheme for the telecare medicine information system, and demonstrate that the improved one satisfies the security requirements of two-factor authentication and is also efficient.     

DigiSwitch: A Device to Allow Older Adults to Monitor and Direct the Collection and Transmission of Health Information Collected at Home

Home monitoring represents an appealing alternative for older adults considering out-of-home long term care and an avenue for informal caregivers and health care providers to gain decision-critical information about an older adults’ health and well-being. However, privacy concerns about having 24/7 monitoring, especially video monitoring, in the home environment have been cited as a major barrier in the design of home monitoring systems. In this paper we describe the design and evaluation of “DigiSwitch”, a medical system designed to allow older adults to view information as it is collected about them and temporarily cease transmission of data for privacy reasons. Results from a series of iterative user studies suggest that control over the transmission of monitoring data from the home is helpful for maintaining user privacy. The studies demonstrate that older adults are able to use the DigiSwitch system to monitor and direct the collection and transmission of health information in their homes, providing these participants with a way to simultaneously maintain privacy and benefit from home monitoring technology.     

An Efficient Authentication Scheme for Telecare Medicine Information Systems

To ensure patients' privacy, such as telephone number, medical record number, health information, etc., authentication schemes for telecare medicine information systems (TMIS) have been studied widely. Recently, Wei et al. proposed an efficient authentication scheme for TMIS. They claimed their scheme could resist various attacks. However, in this paper, we will show their scheme is vulnerable to an off-line password guessing attack when user's smart card is lost. To improve the security, we propose a new authentication scheme for TMIS. The analysis shows our scheme could overcome the weaknesses in Wei et al.'s scheme and has better performance than their scheme.     

A Reliable RFID Mutual Authentication Scheme for Healthcare Environments

Connected health care provides new opportunities for improving financial and clinical performance. Many connected health care applications such as telecare medicine information system, personally controlled health records system, and patient monitoring have been proposed. Correct and quality care is the goal of connected heath care, and user authentication can ensure the legality of patients. After reviewing authentication schemes for connected health care applications, we find that many of them cannot protect patient privacy such that others can trace users/patients by the transmitted data. And the verification tokens used by these authentication schemes to authenticate users or servers are only password, smart card and RFID tag. Actually, these verification tokens are not unique and easy to copy. On the other hand, biometric characteristics, such as iris, face, voiceprint, fingerprint and so on, are unique, easy to be verified, and hard to be copied. In this paper, a biometrics-based user authentication scheme will be proposed to ensure uniqueness and anonymity at the same time. With the proposed scheme, only the legal user/patient himself/herself can access the remote server, and no one can trace him/her according to transmitted data.     

Differential Privacy Preserving in Big Data Analytics for Connected Health

In Body Area Networks (BANs), big data collected by wearable sensors usually contain sensitive information, which is compulsory to be appropriately protected. Previous methods neglected privacy protection issue, leading to privacy exposure. In this paper, a differential privacy protection scheme for big data in body sensor network is developed. Compared with previous methods, this scheme will provide privacy protection with higher availability and reliability. We introduce the concept of dynamic noise thresholds, which makes our scheme more suitable to process big data. Experimental results demonstrate that, even when the attacker has full background knowledge, the proposed scheme can still provide enough interference to big sensitive data so as to preserve the privacy.     

Secure Dynamic Access Control Scheme of PHR in Cloud Computing

With the development of information technology and medical technology, medical information has been developed from traditional paper records into electronic medical records, which have now been widely applied. The new-style medical information exchange system "personal health records (PHR)" is gradually developed. PHR is a kind of health records maintained and recorded by individuals. An ideal personal health record could integrate personal medical information from different sources and provide complete and correct personal health and medical summary through the Internet or portable media under the requirements of security and privacy. A lot of personal health records are being utilized. The patient-centered PHR information exchange system allows the public autonomously maintain and manage personal health records. Such management is convenient for storing, accessing, and sharing personal medical records. With the emergence of Cloud computing, PHR service has been transferred to storing data into Cloud servers that the resources could be flexibly utilized and the operation cost can be reduced. Nevertheless, patients would face privacy problem when storing PHR data into Cloud. Besides, it requires a secure protection scheme to encrypt the medical records of each patient for storing PHR into Cloud server. In the encryption process, it would be a challenge to achieve accurately accessing to medical records and corresponding to flexibility and efficiency. A new PHR access control scheme under Cloud computing environments is proposed in this study. With Lagrange interpolation polynomial to establish a secure and effective PHR information access scheme, it allows to accurately access to PHR with security and is suitable for enormous multi-users. Moreover, this scheme also dynamically supports multi-users in Cloud computing environments with personal privacy and offers legal authorities to access to PHR. From security and effectiveness analyses, the proposed PHR access scheme in Cloud computing environments is proven flexible and secure and could effectively correspond to real-time appending and deleting user access authorization and appending and revising PHR records.     

Evaluating the Privacy Policies of Mobile Personal Health Records for Pregnancy Monitoring

A mobile personal health record (mPHR) for pregnancy monitoring allows the pregnant woman to track and manage her personal health data. However, owing to the privacy and security issues that may threaten the exchange of this sensitive data, a privacy policy should be established. The aim of this study is to evaluate the privacy policies of 19 mPHRs for pregnancy monitoring (12 for iOS and 7 for Android) using a template covering the characteristics of privacy, security, and standards and regulations. The findings of this study show that none of the privacy policies evaluated entirely comply with the characteristics studied. The developers of mPHRs for pregnancy monitoring are, therefore, requested to improve and pay more attention to the structure and the content of the privacy policies of their apps.     

A Mutual Authentication Framework for Wireless Medical Sensor Networks

Wireless medical sensor networks (WMSN) comprise of distributed sensors, which can sense human physiological signs and monitor the health condition of the patient. It is observed that providing privacy to the patient’s data is an important issue and can be challenging. The information passing is done via the public channel in WMSN. Thus, the patient, sensitive information can be obtained by eavesdropping or by unauthorized use of handheld devices which the health professionals use in monitoring the patient. Therefore, there is an essential need of restricting the unauthorized access to the patient’s medical information. Hence, the efficient authentication scheme for the healthcare applications is needed to preserve the privacy of the patients’ vital signs. To ensure secure and authorized communication in WMSN, we design a symmetric key based authentication protocol for WMSN environment. The proposed protocol uses only computationally efficient operations to achieve lightweight attribute. We analyze the security of the proposed protocol. We use a formal security proof algorithm to show the scheme security against known attacks. We also use the Automated Validation of Internet Security Protocols and Applications (AVISPA) simulator to show protocol secure against man-in-the-middle attack and replay attack. Additionally, we adopt an informal analysis to discuss the key attributes of the proposed scheme. From the formal proof of security, we can see that an attacker has a negligible probability of breaking the protocol security. AVISPA simulator also demonstrates the proposed scheme security against active attacks, namely, man-in-the-middle attack and replay attack. Additionally, through the comparison of computational efficiency and security attributes with several recent results, proposed scheme seems to be battered.     

Privacy Protection for Point-of-Care Using Chaotic Maps-Based Authentication and Key Agreement

Recently, remote points-of-care as a novel medical model has emerged and received considerable attention due to its convenient medical services such as efficient real-time monitoring and prompt information feedback. Although the points-of-care has more attractive advantages compared with traditional health care systems, some important issues still require a serious consideration such as privacy protection and the security of the transmitted biomedical signals. In this study, we propose a novel authentication and key agreement mechanism that ensures privacy preservation and provides biomedical signals protection during the communication process by negotiating a shared key to encrypt/decrypt sensitive information. Chaotic maps are employed in our design to achieve mutual authentication and key agreement for resource-constrained points-of-care, which also increases the efficiency in comparison with those schemes designed by Elliptic Curve Cryptography or RSA. Furthermore, dynamic identities are adopted in the proposed scheme to achieve user anonymity and user untraceability for the high-privacy-required points-of-care. The security of the proposed scheme is proven via Real-or-Random model. The performance analysis shows that the proposed scheme reduces computational overhead in comparison with the state-of-the-art schemes.     

A Double Chaotic Layer Encryption Algorithm for Clinical Signals in Telemedicine

Recently, telemedicine offers medical services remotely via telecommunications systems and physiological monitoring devices. This scheme provides healthcare delivery services between physicians and patients conveniently, since some patients can not attend the hospital due to any reason. However, transmission of information over an insecure channel such as internet or private data storing generates a security problem. Therefore, authentication, confidentiality, and privacy are important challenges in telemedicine, where only authorized users should have access to medical or clinical records. On the other hand, chaotic systems have been implemented efficiently in cryptographic systems to provide confidential and privacy. In this work, we propose a novel symmetric encryption algorithm based on logistic map with double chaotic layer encryption (DCLE) in diffusion process and just one round of confusion-diffusion for the confidentiality and privacy of clinical information such as electrocardiograms (ECG), electroencephalograms (EEG), and blood pressure (BP) for applications in telemedicine. The clinical signals are acquired from PhysioBank data base for encryption proposes and analysis. In contrast with recent schemes in literature, we present a secure cryptographic algorithm based on chaos validated with the most complete security analysis until this time. In addition, the cryptograms are validated with the most complete pseudorandomness tests based on National Institute of Standards and Technology (NIST) 800-22 suite. All results are at MATLAB simulations and all them show the effectiveness, security, robustness, and the potential use of the proposed scheme in telemedicine.     

临床教学中面临的患者隐私权保护问题

在医学生临床教学中面临越来越多的患者隐私权保护问题，探讨从增强法律意识、树立道德观念、完善隐私权保护制度、加强医学生人支素质培养等方面着手，建立和谐的医患关系，有利于医患之间的沟通，减少医疗纠纷。     

A Secure Cloud-Assisted Wireless Body Area Network in Mobile Emergency Medical Care System

Recent advances in medical treatment and emergency applications, the need of integrating wireless body area network (WBAN) with cloud computing can be motivated by providing useful and real time information about patients’ health state to the doctors and emergency staffs. WBAN is a set of body sensors carried by the patient to collect and transmit numerous health items to medical clouds via wireless and public communication channels. Therefore, a cloud-assisted WBAN facilitates response in case of emergency which can save patients’ lives. Since the patient’s data is sensitive and private, it is important to provide strong security and protection on the patient’s medical data over public and insecure communication channels. In this paper, we address the challenge of participant authentication in mobile emergency medical care systems for patients supervision and propose a secure cloud-assisted architecture for accessing and monitoring health items collected by WBAN. For ensuring a high level of security and providing a mutual authentication property, chaotic maps based authentication and key agreement mechanisms are designed according to the concept of Diffie-Hellman key exchange, which depends on the CMBDLP and CMBDHP problems. Security and performance analyses show how the proposed system guaranteed the patient privacy and the system confidentiality of sensitive medical data while preserving the low computation property in medical treatment and remote medical monitoring.     

Improvement of a Privacy Authentication Scheme Based on Cloud for Medical Environment

Medical systems allow patients to receive care at different hospitals. However, this entails considerable inconvenience through the need to transport patients and their medical records between hospitals. The development of Telecare Medicine Information Systems (TMIS) makes it easier for patients to seek medical treatment and to store and access medical records. However, medical data stored in TMIS is not encrypted, leaving patients’ private data vulnerable to external leaks. In 2014, scholars proposed a new cloud-based medical information model and authentication scheme which would not only allow patients to remotely access medical services but also protects patient privacy. However, this scheme still fails to provide patient anonymity and message authentication. Furthermore, this scheme only stores patient medical data, without allowing patients to directly access medical advice. Therefore, we propose a new authentication scheme, which provides anonymity, unlinkability, and message authentication, and allows patients to directly and remotely consult with doctors. In addition, our proposed scheme is more efficient in terms of computation cost. The proposed system was implemented in Android system to demonstrate its workability.     

Challenges Associated with Privacy in Health Care Industry: Implementation of HIPAA and the Security Rules

This paper discusses the challenges associated with privacy in health care in the electronic information age based on the Health Insurance Portability and Accountability Act (HIPAA) and the Security Rules. We examine the storing and transmission of sensitive patient data in the modern health care system and discuss current security practices that health care providers institute to comply with HIPAA Security Rule regulations. Based on our research results, we address current outstanding issues that act as impediments to the successful implementation of security measures and conclude the discussion and offer possible avenues of future research.     

(a,k)-Anonymous Scheme for Privacy-Preserving Data Collection in IoT-based Healthcare Services Systems

The widely use of IoT technologies in healthcare services has pushed forward medical intelligence level of services. However, it also brings potential privacy threat to the data collection. In healthcare services system, health and medical data that contains privacy information are often transmitted among networks, and such privacy information should be protected. Therefore, there is a need for privacy-preserving data collection (PPDC) scheme to protect clients (patients) data. We adopt (a,k)-anonymity model as privacy pretection scheme for data collection, and propose a novel anonymity-based PPDC method for healthcare services in this paper. The threat model is analyzed in the client-server-to-user (CS2U) model. On client-side, we utilize (a,k)-anonymity notion to generate anonymous tuples which can resist possible attack, and adopt a bottom-up clustering method to create clusters that satisfy a base privacy level of (a₁,k₁)-anonymity. On server-side, we reduce the communication cost through generalization technology, and compress (a₁,k₁)-anonymous data through an UPGMA-based cluster combination method to make the data meet the deeper level of privacy (a₂,k₂)-anonymity (a₁?≥?a₂, k₂ ≥?k₁). Theoretical analysis and experimental results prove that our scheme is effective in privacy-preserving and data quality.     

Legal issues concerning electronic health information: privacy, quality, and liability.

Personally identifiable health information about individuals and general medical information is increasingly available in electronic form in health databases and through online networks. The proliferation of electronic data within the modern health information infrastructure presents significant benefits for medical providers and patients, including enhanced patient autonomy, improved clinical treatment, advances in health research and public health surveillance, and modern security techniques. However, it also presents new legal challenges in 3 interconnected areas: privacy of identifiable health information, reliability and quality of health data, and tortbased liability. Protecting health information privacy (by giving individuals control over health data without severely restricting warranted communal uses) directly improves the quality and reliability of health data (by encouraging individual uses of health services and communal uses of data), which diminishes tort-based liabilities (by reducing instances of medical malpractice or privacy invasions through improvements in the delivery of health care services resulting in part from better quality and reliability of clinical and research data). Following an analysis of the interconnectivity of these 3 areas and discussing existing and proposed health information privacy laws, recommendations for legal reform concerning health information privacy are presented. These include (1) recognizing identifiable health information as highly sensitive, (2) providing privacy safeguards based on fair information practices, (3) empowering patients with information and rights to consent to disclosure (4) limiting disclosures of health data absent consent, (5) incorporating industry-wide security protections, (6) establishing a national data protection authority, and (7) providing a national minimal level of privacy protections.