Access Control Schemes for Implantable Medical Devices: A Survey

Implantable medical devices (IMDs) are electronic devices implanted within human body for diagnostic, monitoring, and therapeutic purposes. It is imperative to guarantee that IMDs are completely secured since the patient’s life is closely bound to the robustness and effectiveness of IMDs. Intuitively, we have to ensure that only the authorized medical personnel and IMD programmer can access the IMD. However, in recent years, several attacks have been reported which can successfully compromise a number of IMD products, e.g., stealing the sensitive health data and issuing fake commands. Up to now, there is no commonly agreed and well-recognized security standards and the protection of IMD is still an open problem. In this paper, we present a comprehensive survey of the existing literature on IMD security, with a focus on the access control schemes to prevent unauthorized access. Specifically, we first reviewed the security incidents, IMD threat model and the development of regulations for IMD security. Next, we classified existing IMD access control schemes based on architecture, type of keys used, access control channel, and logic. We also analyzed how different access control models can be adopted to secure IMD. Besides, we particularly discussed the viability of online authentication and low/zero power authentication in the IMD context.

[1]  Hyogon Kim,et al.  In-vivo NFC: remote monitoring of implanted medical devices with improved privacy , 2012, SenSys '12.

[2]  Catherine Dehollain,et al.  A Closed-Loop Remote Powering Link for Wireless Cortical Implants , 2013, IEEE Sensors Journal.

[3]  Kevin Fu,et al.  Design challenges for secure implantable medical devices , 2012, DAC Design Automation Conference 2012.

[4]  Minkyu Je,et al.  High-Efficiency Wireless Power Transfer for Biomedical Implants by Optimal Resonant Load Transformation , 2013, IEEE Transactions on Circuits and Systems I: Regular Papers.

[5]  Rosalind W. Picard,et al.  Non-contact, automated cardiac pulse measurements using video imaging and blind source separation , 2022 .

[6]  Xiaojiang Du,et al.  Permission-combination-based scheme for Android mobile malware detection , 2014, 2014 IEEE International Conference on Communications (ICC).

[7]  Farinaz Koushanfar,et al.  Heart-to-heart (H2H): authentication for implanted medical devices , 2013, CCS.

[8]  Yuan-Ting Zhang,et al.  Physiological Signal Based Entity Authentication for Body Area Sensor Networks and Mobile Healthcare Systems , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[9]  Niraj K. Jha,et al.  Vibration-based secure side channel for medical devices , 2015, 2015 52nd ACM/EDAC/IEEE Design Automation Conference (DAC).

[10]  Xiaojiang Du,et al.  Adaptive cell relay routing protocol for mobile ad hoc networks , 2006, IEEE Transactions on Vehicular Technology.

[11]  Yuguang Fang,et al.  HCPP: Cryptography Based Secure EHR System for Patient Privacy and Emergency Healthcare , 2011, 2011 31st International Conference on Distributed Computing Systems.

[12]  Xuemin Shen,et al.  PEACE: An efficient and secure patient-centric access control scheme for eHealth care system , 2011, 2011 IEEE Conference on Computer Communications Workshops (INFOCOM WKSHPS).

[13]  Alanson P. Sample,et al.  A Wirelessly-Powered Platform for Sensing and Computation , 2006, UbiComp.

[14]  J. Tsien,et al.  Remote Measurements of Heart and Respiration Rates for Telemedicine , 2013, PloS one.

[15]  Ying Zhang,et al.  An efficient traceable access control scheme with reliable key delegation in mobile cloud computing , 2016, EURASIP J. Wirel. Commun. Netw..

[16]  Srdjan Capkun,et al.  Proximity-based access control for implantable medical devices , 2009, CCS.

[17]  Sandeep K. S. Gupta,et al.  Biosec: a biometric based approach for securing communication in wireless networks of biosensors implanted in the human body , 2003, 2003 International Conference on Parallel Processing Workshops, 2003. Proceedings..

[18]  Nathanael Paul,et al.  Using Bowel Sounds to Create a Forensically-aware Insulin Pump System , 2013, HealthTech.

[19]  Xiaojiang Du,et al.  Implementation and performance analysis of SNMP on a TLS/TCP base , 2001, 2001 IEEE/IFIP International Symposium on Integrated Network Management Proceedings. Integrated Network Management VII. Integrated Management Strategies for the New Millennium (Cat. No.01EX470).

[20]  Yih-Chun Hu,et al.  Body Area Network Security: Robust Key Establishment Using Human Body Channel , 2012, HealthSec.

[21]  Ming Li,et al.  Data security and privacy in wireless body area networks , 2010, IEEE Wireless Communications.

[22]  Juan E. Tapiador,et al.  Security and privacy issues in implantable medical devices: A comprehensive survey , 2015, J. Biomed. Informatics.

[23]  Xiaojiang Du,et al.  Designing efficient routing protocol for heterogeneous sensor networks , 2005, PCCC 2005. 24th IEEE International Performance, Computing, and Communications Conference, 2005..

[24]  Moncef Gabbouj,et al.  ShakeMe: Key Generation from Shared Motion , 2015, 2015 IEEE International Conference on Computer and Information Technology; Ubiquitous Computing and Communications; Dependable, Autonomic and Secure Computing; Pervasive Intelligence and Computing.

[25]  Amr M. Youssef,et al.  Security Tradeoffs in Cyber Physical Systems: A Case Study Survey on Implantable Medical Devices , 2016, IEEE Access.

[26]  Erchin Serpedin,et al.  Physical layer security for wireless implantable medical devices , 2015, 2015 IEEE 20th International Workshop on Computer Aided Modelling and Design of Communication Links and Networks (CAMAD).

[27]  Mohsen Guizani,et al.  Defending DoS Attacks on Broadcast Authentication in Wireless Sensor Networks , 2008, 2008 IEEE International Conference on Communications.

[28]  Niraj K. Jha,et al.  Hijacking an insulin pump: Security attacks and defenses for a diabetes therapy system , 2011, 2011 IEEE 13th International Conference on e-Health Networking, Applications and Services.

[29]  Ming Li,et al.  Secure ad hoc trust initialization and key management in wireless body area networks , 2013, TOSN.

[30]  Meng Zhang,et al.  Trustworthiness of Medical Devices and Body Area Networks , 2014, Proceedings of the IEEE.

[31]  K.K. Venkatasubramanian,et al.  EKG-based key agreement in Body Sensor Networks , 2008, IEEE INFOCOM Workshops 2008.

[32]  Meng Zhang,et al.  MedMon: Securing Medical Devices Through Wireless Monitoring and Anomaly Detection , 2013, IEEE Transactions on Biomedical Circuits and Systems.

[33]  Nitesh Saxena,et al.  On pairing constrained wireless devices based on secrecy of auxiliary channels: the case of acoustic eavesdropping , 2010, CCS '10.

[34]  Ingrid Verbauwhede,et al.  On the Feasibility of Cryptography for a Wireless Insulin Pump System , 2016, CODASPY.

[35]  Kevin Fu,et al.  Pacemakers and Implantable Cardiac Defibrillators: Software Radio Attacks and Zero-Power Defenses , 2008, 2008 IEEE Symposium on Security and Privacy (sp 2008).

[36]  Fan Zhang,et al.  OPFKA: Secure and efficient Ordered-Physiological-Feature-based key agreement for wireless Body Area Networks , 2013, 2013 Proceedings IEEE INFOCOM.

[37]  Srdjan Capkun,et al.  On Limitations of Friendly Jamming for Confidentiality , 2013, 2013 IEEE Symposium on Security and Privacy.

[38]  Brent Waters,et al.  Ciphertext-Policy Attribute-Based Encryption , 2007, 2007 IEEE Symposium on Security and Privacy (SP '07).

[39]  Cong Wang,et al.  Achieving Secure, Scalable, and Fine-grained Data Access Control in Cloud Computing , 2010, 2010 Proceedings IEEE INFOCOM.

[40]  Bart Preneel,et al.  Secure remote reprogramming of implantable medical devices ∗ , 2014 .

[41]  Cong Wang,et al.  SBVLC: Secure barcode-based visible light communication for smartphones , 2014, IEEE INFOCOM 2014 - IEEE Conference on Computer Communications.

[42]  Xiaojiang Du,et al.  Patient Infusion Pattern based Access Control Schemes for Wireless Insulin Pump System , 2015, IEEE Transactions on Parallel and Distributed Systems.

[43]  Grammati E. Pantziou,et al.  Providing advanced remote medical treatment services through pervasive environments , 2010, Personal and Ubiquitous Computing.

[44]  Yuguang Fang,et al.  CAM: Cloud-Assisted Privacy Preserving Mobile Health Monitoring , 2013, IEEE Transactions on Information Forensics and Security.

[45]  Xiaojiang Du,et al.  PIPAC: Patient infusion pattern based access control scheme for wireless insulin pump system , 2013, 2013 Proceedings IEEE INFOCOM.

[46]  Christos Strydis,et al.  Enhancing Heart-Beat-Based Security for mHealth Applications , 2017, IEEE Journal of Biomedical and Health Informatics.

[47]  Soufiene Djahel,et al.  Toward energy-efficient and trustworthy eHealth monitoring system , 2015, China Communications.

[48]  Kevin Fu,et al.  Absence Makes the Heart Grow Fonder: New Directions for Implantable Medical Device Security , 2008, HotSec.

[49]  Xiaojiang Du,et al.  Biometric-based two-level secure access control for Implantable Medical Devices during emergencies , 2011, 2011 Proceedings IEEE INFOCOM.

[50]  Kevin Fu,et al.  They can hear your heartbeats: non-invasive security for implantable medical devices , 2011, SIGCOMM.

[51]  Mehmet A. Orgun,et al.  Ideas and Challenges for Securing Wireless Implantable Medical Devices: A Review , 2017, IEEE Sensors Journal.

[52]  Noureddine Boudriga,et al.  Securing implantable cardiac medical devices: use of radio frequency energy harvesting , 2013, TrustED '13.

[53]  Colleen Swanson,et al.  SoK: Security and Privacy in Implantable Medical Devices and Body Area Networks , 2014, 2014 IEEE Symposium on Security and Privacy.

[54]  Yao Zheng,et al.  Scalable and Secure Sharing of Personal Health Records in Cloud Computing Using Attribute-Based Encryption , 2019, IEEE Transactions on Parallel and Distributed Systems.

[55]  Erchin Serpedin,et al.  A comparative review on the wireless implantable medical devices privacy and security , 2014, 2014 4th International Conference on Wireless Mobile Communication and Healthcare - Transforming Healthcare Through Innovations in Mobile and Wireless Technologies (MOBIHEALTH).

[56]  Jie Wu,et al.  Defending Resource Depletion Attacks on Implantable Medical Devices , 2010, 2010 IEEE Global Telecommunications Conference GLOBECOM 2010.

[57]  Xiaojiang Du,et al.  Achieving Secure and Efficient Data Access Control for Cloud-Integrated Body Sensor Networks , 2015, Int. J. Distributed Sens. Networks.

[58]  Miodrag Potkonjak,et al.  Matched Digital PUFs for Low Power Security in Implantable Medical Devices , 2014, 2014 IEEE International Conference on Healthcare Informatics.

[59]  Fan Zhang,et al.  Securing communications between external users and wireless body area networks , 2013, HotWiSec '13.

[60]  Kyung Sup Kwak,et al.  Secure Wake-Up Scheme for WBANs , 2010, IEICE Trans. Commun..

[61]  Gengfa Fang,et al.  Multiple ECG Fiducial Points-Based Random Binary Sequence Generation for Securing Wireless Body Area Networks , 2017, IEEE Journal of Biomedical and Health Informatics.

[62]  Gengfa Fang,et al.  A non-key based security scheme supporting emergency treatment of wireless implants , 2014, 2014 IEEE International Conference on Communications (ICC).

[63]  Yacine Challal,et al.  Secure and Scalable Cloud-Based Architecture for e-Health Wireless Sensor Networks , 2012, 2012 21st International Conference on Computer Communications and Networks (ICCCN).

[64]  R. Kalaiselvi,et al.  SCALABLE AND SECURE SHARING OF PERSONAL HEALTH RECORDS IN CLOUD COMPUTING , 2016 .

[65]  Liehuang Zhu,et al.  Conditional Ciphertext-Policy Attribute-Based Encryption Scheme in Vehicular Cloud Computing , 2016, Mob. Inf. Syst..

[66]  Pedro Peris-López,et al.  Secure Publish-Subscribe Protocols for Heterogeneous Medical Wireless Body Area Networks , 2014, Sensors.

[67]  Xiaojiang Du,et al.  Poster: near field communication based access control for wireless medical devices , 2014, MobiHoc '14.

[68]  Ayan Banerjee,et al.  PSKA: Usable and Secure Key Agreement Scheme for Body Area Networks , 2010, IEEE Transactions on Information Technology in Biomedicine.

[69]  Brent Waters,et al.  Attribute-based encryption for fine-grained access control of encrypted data , 2006, CCS '06.

[70]  Carmen C. Y. Poon,et al.  A novel biometrics method to secure wireless body area sensor networks for telemedicine and m-health , 2006, IEEE Communications Magazine.

[71]  Fengyuan Xu,et al.  IMDGuard: Securing implantable medical devices with the external wearable guardian , 2011, 2011 Proceedings IEEE INFOCOM.

[72]  Neil W. Bergmann,et al.  Walkie-Talkie: Motion-Assisted Automatic Key Generation for Secure On-Body Device Communication , 2016, 2016 15th ACM/IEEE International Conference on Information Processing in Sensor Networks (IPSN).

[73]  Alan Borning,et al.  Patients, pacemakers, and implantable defibrillators: human values and security for wireless implantable medical devices , 2010, CHI.

[74]  Farinaz Koushanfar,et al.  Balancing security and utility in Medical Devices? , 2013, 2013 50th ACM/EDAC/IEEE Design Automation Conference (DAC).

[75]  Chang-Seop Park.  Security Mechanism Based on Hospital Authentication Server for Secure Application of Implantable Medical Devices , 2014, BioMed research international.