Patients, pacemakers, and implantable defibrillators: human values and security for wireless implantable medical devices

Implantable medical devices (IMDs) improve patients' quality of life and help sustain their lives. In this study, we explore patient views and values regarding their devices to inform the design of computer security for wireless IMDs. We interviewed 13 individuals with implanted cardiac devices. Key questions concerned the evaluation of 8 mockups of IMD security systems. Our results suggest that some systems that are technically viable are nonetheless undesirable to patients. Patients called out a number of values that affected their attitudes towards the systems, including perceived security, safety, freedom from unwanted cultural and historical associations, and self-image. In our analysis, we extend the Value Sensitive Design value dams and flows technique in order to suggest multiple, complementary systems; in our discussion, we highlight some of the usability, regulatory, and economic complexities that arise from offering multiple options. We conclude by offering design guidelines for future security systems for IMDs.

[1]  Eric S. K. Yu,et al.  Designing for Privacy in a Multi-agent World , 2002, Trust, Reputation, and Security.

[2]  Abigail Sellen,et al.  Design for Privacy in Ubiquitous Computing Environments , 1993, ECSCW.

[3]  Jessica K. Miller,et al.  Value tensions in design: the value sensitive design, development, and appropriation of a corporation's groupware system , 2007, GROUP.

[4]  Simson L. Garfinkel,et al.  Security and Usability , 2005 .

[5]  Sandeep K. S. Gupta,et al.  Criticality aware access control model for pervasive applications , 2006, Fourth Annual IEEE International Conference on Pervasive Computing and Communications (PERCOM'06).

[6]  Anne Adams,et al.  Multimedia information changes the whole privacy ballgame , 2000, CFP '00.

[7]  Paul Dourish,et al.  Unpacking "privacy" for a networked world , 2003, CHI '03.

[8]  Lorrie Faith Cranor,et al.  Security and Usability: Designing Secure Systems that People Can Use , 2005 .

[9]  James A. Landay,et al.  Approximate Information Flows: Socially-Based Modeling of Privacy in Ubiquitous Computing , 2002, UbiComp.

[10]  James A. Landay,et al.  Modeling Privacy Control in Context-Aware Systems , 2002, IEEE Pervasive Comput..

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

[12]  Nigel Davies,et al.  Preserving Privacy in Environments with Location-Based Applications , 2003, IEEE Pervasive Comput..

[13]  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).

[14]  Jesús Favela,et al.  Quality of Privacy (QoP) for the Design of Ubiquitous Healthcare Applications , 2006, J. Univers. Comput. Sci..

[15]  Marc Langheinrich,et al.  A Privacy Awareness System for Ubiquitous Computing Environments , 2002, UbiComp.

[16]  Carol A. Curran.  Nurse Tracking Systems: Do the Benefits to Nurse Managers Outweigh Risks to Nurses’ Privacy?: Writing for the CON Position , 2002 .

[17]  James A. Landay,et al.  An architecture for privacy-sensitive ubiquitous computing , 2004, MobiSys '04.

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

[19]  Marcela D. Rodríguez,et al.  Privacy-Aware Autonomous Agents for Pervasive Healthcare , 2006, IEEE Intelligent Systems.

[20]  Kevin Fu,et al.  Security and Privacy for Implantable Medical Devices , 2008, IEEE Pervasive Comput..

[21]  Morten Kyng,et al.  Cardboard Computers: Mocking-it-up or Hands-on the Future , 1992 .

[22]  Frederick J. Manning,et al.  Innovation and Invention In Medical Devices: Workshop Summary , 2001 .

[23]  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..