ehealth cloud security challenges: a survey

Due to the increased number of parties, devices, and applications involved, there is an increase in data compromise threats. the challenges and issues of cloud computing. Organizations should also have plans in place to, recover from security breaches when they occur. is centralization of data, attackers with one-stop honey-pot to steal data and intercept data in-motion and (2) moves data ownership to the cloud service. In this paper, we study the use of cloud computing in the healthcare industry and different cloud security and privacy challenges. The task of aggregating health records from different sources in a single repository is a complex task since the aggregator needs to use different standards and protocols to guarantee interoperability between different stakeholders. Finally, the private healthcare data, are accessed and stored securely by implementing a decoy, technique with a fog computing facility. (iii)Security and privacy: open and shared environment is prone to data loss and theft [20]. Confidentiality is the act of ensuring that patients health data are kept completely undisclosed to unauthorized entities. ird, encoding and encrypting data; however, there is a chance to, reveal the encryption key using advanced computer tech-, nology. Proses kriptografi masih sering dikombinasikan dengan steganografi dalam mekanisme pengamanan data dan penyembunyian data. Waters, “Attribute-based encryption for fine-grained access control of encrypted data,” in, S. Sneha and P. Asha, “Privacy preserving on E-Health records based on Anonymization technique,”, B. Dhivya, S. P. S. Ibrahim, and R. Kirubakaran, “Hybrid cryptographic access control for cloud based electronic health records systems,”, K. Shah and V. Prasad, “Security for healthcare data on cloud,”, S. Supriya and S. Padaki, “Data security and privacy challenges in adopting solutions for IOT,” in, R. Zhang and L. Liu, “Security models and requirements for healthcare application clouds,” in, H. Löhr, A.-R. Sadeghi, and M. Winandy, “Securing the e-health cloud,” in, J. L. Griffin, T. Jaeger, R. Perez, R. Sailer, L. Van Doorn, and R. Cáceres, “Trusted virtual domains: toward secure distributed services,” in, K. J. Cios and G. William Moore, “Uniqueness of medical data mining,”, S. White, “A review of big data in health care: challenges and opportunities,”, O. Tene and J. Polonetsky, “Privacy in the age of big data: a time for big decisions,”, M. A. Ottom, “Big data in healthcare: review and open research issues,”. safety of a healthcare system. on the survey of security challenges in cloud storage system from different perspectives. Delegating data control to the cloud, leads to an increase in the risk of data compromises, as the. Identify challenges and requirements, measure the cloud implementations and study the system in general are the objectives of the survey. Customers pay according to consumption. This architecture is based on Trusted Virtual Domains (TVDs) that extend the protection of privacy-sensitive data from centrally managed secure networks to the client platforms of the end-users. In this paper, we study the use of cloud computing in the healthcare industry and different cloud security and privacy challenges. e, cloud applications are often generic, and custom, (vi) Vulnerability to attacks: the cloud is prone to dif-, Nowadays, healthcare is centered on accessing medical re-, cords anytime and anywhere. ere are different approaches to, maintaining audit controls for such information; e.g., In-, tegrating the Healthcare Enterprise (IHE) specifies a profile, records was accessed? RQ3. CSA’s latest survey, Cloud Security Complexity: Challenges in Managing Security in Hybrid and Multi-Cloud Environments, examines information security concerns in a complex cloud environment. e side goal is to reduce computational complexity and, communication overhead. Edge computing aims at processing data at the edge of the network rather than processing data at the data center as in traditional eHealth cloud solutions. Applying multilayer security measures to guarantee that only authorized users can access the system might slow the system down and collides with the doctors need for fast and quick systems. In the future, we will propose a holistic solution that attempts to balance all contradicting requirements. Nearly 9 in 10 organizations are using cloud-native apps; but due to security and networking issues, only 10% run half or more business apps on Kubernetes and only 12% run a … e, article classifies the security threats posed on healthcare. ... survey on the interface between cloud security and cloud In this type of identification, there is a chance to reidentify the patient because patient information has been recorded at some stage (anonymized data). However, security and privacy issues present a Below we review US (e.g., HIPAA and HITECH) and international standards (e.g., ISO/IEC 27000 and General Data Protection Regulation (GDPR)). Nowadays, healthcare is centered on accessing medical records anytime and anywhere. The remainder of the paper is organized as follows: Section 2 presents background information about cloud computing. e new regulation gives consumers the right to be. Patient data are available, anytime and anywhere for doctors to analyze and, hardware and software. e proposed, protocol can generate a session key among the participants, to communicate securely. We are committed to sharing findings related to COVID-19 as quickly as possible. is paper tries to answer, (i) RQ1. Versicherungsmedizin / herausgegeben von Verband der Lebensversicherungs-Unternehmen e.V. On the other hand, the use of different standards makes it, hard to secure the application and makes it prone to security, breaches. Below we, review US (e.g., HIPAA and HITECH) and international, standards (e.g., ISO/IEC 27000 and General Data Protection, healthcare systems. Removing these data to meet De-identi-. It has much flexibility like on demand resources and services availability. Encryption uses a computer algorithm to decode data and generate the key where knowing or guessing the key is highly difficult. Galletta et al. In this paper, we study the use of cloud computing in the healthcare industry and diffe … and weaknesses of the presented approaches are reported, and some open issues are highlighted [31] reports on the, results of a systematic literature review concerning the se-, e eHealth system security and privacy concerns do not, only deal with abiding by the confidentiality, integrity, and, availability (CIA) security model [32]. 2. Many solutions require, the addition of delays (to defeat timing analysis) or padding, (to defeat packet-size analysis) [46, 47, 56, quently, these ad hoc solutions pose non-negligible over-. Below, we outline the important security and privacy requirements for healthcare application clouds. e consumer can access the, software using a web browser or an application, programming interface (API). The standard is structured logically around groups of related security controls. erefore, the security in edge and fog tech-, nologies should be tightened and enhanced by (a) utilizing, the state-of-the-art security mechanisms within the edge, computing communication environment, (b) encrypting all, data (in-move and in-rest), and (c) multifactor authenti-, survey the state-of-the-art security mechanisms for eHealth, systems on emerging fog and edge technologies and com-, pare those mechanisms with security mechanisms in, Security is one of the main problems that hinder the fast, adoption of the cloud computing technology in the, healthcare industry. Data availability: data are available for all healthcare stakeholders like physicians, clinics, hospitals, and insurance companies [, Availability and reliability: the service can be slow, interrupted, or down, depending on the strength of the Internet connection. 4. Covered entities that seek to release such, data must determine that the information has been dei-, dentified using either statistical methods to verify deiden-, tification or by removing certain parts of the data. the security risks associated with those solutions? Finally, the private healthcare data are accessed and stored securely by implementing a decoy technique with a fog computing facility. Security issues are limited; a good example is VMware [, Public cloud: it is located off premises, over the Internet, and usually managed by a cloud service provider. In this study, we propose a novel method based on Shamir's Secret Share Scheme and multi-cloud concept to avoid data loss and unauthorized access. Supriya and Padaki survey several healthcare security lapses pertaining to nonrepudiation, CIA model, and what it means to stakeholders in the healthcare industry. Ownership of healthcare information can be protected through a combination of encryption and watermarking techniques that result in secured healthcare information that cannot be transmitted, accessed, or released without the mutual acceptance of all entities involved in the ownership/creation of the healthcare information. s. High-availability systems should prevent service disruptions due to power outages, hardware failures, system upgrade, and denial-of-service attacks. report an error and terminate without processing the data. To deliver secure multitenancy, there should be isolation among patients’ data [54, 55]. Along the line, Abbas and Khan [24] present an extensive survey that aims, to encompass the state-of-the-art privacy-preserving ap-, proaches employed in eHealth clouds. ey, should apply the appropriate personal and organizational, measures. In this section, we discuss important security requirements for eHealth systems to address the arising security and privacy issues hindering the wide-scale adoption of cloud computing by healthcare providers. (iv)Infrastructure is scalable depending on processing and storage needs. In this paper, the main focus has been given to secure healthcare private data in the cloud using a fog computing facility. This means that the probability of those items being related from the attacker’s perspective stays the same before and after the attacker’s observation [53]. tography, and information security incident management. Added security measures will negatively affect the, user experience. Cost savings: there is no need to buy expensive hardware and software. It should be noted that ISO/IEC 27002 is a code of practice to adhere to, not a formal certification as ISO/IEC 27001 [95]. Finally, they illustrate the development of the proposed EHR security reference model through a use-case scenario and describe the corresponding security countermeasures and possible security techniques [77]. services without overwhelming the data center. present an extensive survey on the interface between cloud security and cloud security assurance. EU General Data Protection Regulation (GDPR). The eHealth system security and privacy concerns do not only deal with abiding by the confidentiality, integrity, and availability (CIA) security model [32]. Further, the paper tries to bring more attention to Big Data in healthcare sector; by focusing on Big Data applications and some attempts to utilize Big Data in healthcare. HIPAA required the Secretary of the HHS to set rules, guidelines, and acts to protect the privacy and security of health data. centers will help recover from disasters. present an extensive, survey on the interface between cloud security and cloud, security assurance. It also amalgamates the potentials of blockchain technology as a promising security measure, highlights potential challenges in the healthcare domain, and provides an analysis of different blockchain-based security solutions. To make the patient/doctor relationship work efficiently, it is important for the patient to trust the health-providing system to protect the confidentiality of his/her data, ... Authentication, encryption, data masking, access control, monitoring and auditing, de-indentification, HybrEx. Cloud providers deploy multitenancy as a standard to achieve efficient utilization of resources, while decreasing cost. A good example is NYSE Capital Markets Community Platform (Figure. In this paper, we study the use of cloud, computing in the healthcare industry and different cloud security and privacy challenges. eHealth Cloud Security Challenges: A Survey. Standards are usually created to describe accepted characteristics of a product or service by experts from organizations and scientific institutions. Healthcare professionals have many reasons not to trust the cloud, for example, they cannot give away control over their medical records. Correspondence should be … This survey paper aims to discuss, analyze security challenges and available solutions in cloud computing. propose a framework, which allows secure sharing of EHRs over the cloud among different healthcare providers. (i) Availability and reliability: the service can be slow, interrupted, or down, depending on the strength of, the Internet connection. Elasticity: the cloud is flexible and configurable. The security solutions put forward for each eHealth service constitute an attempt to centralize all information on the cloud, thus offering greater accessibility to medical information in the case of EHRs alongside more reliable diagnoses and treatment for telecardiology, telediagnosis, and teleconsultation services. present a brief overview on cloud computing security in terms of security considerations, models, threats, and precautions. activities of the healthcare system in chronological order, such as maintaining a log of every access and modification of, Economic and Clinical Health (HITECH) require users, within the healthcare provider’s organization to be held, accountable for their actions when handling patients’ pro-, tected health information. However, there are still open research challenges not addressed by the presented architecture, including anonymity, nonrepudiation, and inability of the patient to authenticate [78, 79]. They are meant to harmonize local data privacy laws across Europe. In this work, we found that the state-of-the art solutions address only a subset of those concerns. Second, individual identification, is initially recorded during data collection and eventually, removed. This will largely affect user experiences [6]. There are different approaches to maintaining audit controls for such information; e.g., Integrating the Healthcare Enterprise (IHE) specifies a profile for the Audit Trail that contains sufficient information to answer questions such as: “For some user: which patient’s records was accessed? Confidentiality can be. It follows a pay-per-use business model. The HIPAA Security Rule (Section 164.312(e) Transmission Security) states that covered entities must “implement technical security measures to guard against unauthorized access to electronic protected health information … transmitted over an electronic communications network” [37]. [10] Microsoft, “Office 365,” 2017, https://www.office.com/. First, individual identification is deleted during data col-, lection (anonymous data). In general, there are many security risks associated. It shows that the ISO/IEC, 27000-series standards can be grouped into 4 different. Audit means recording user. Pengamanan data ini tidak hanya dilakukan pada data yang bersifat berhenti dan tersimpan pada komputer. Clients feel that resources are unlimited. e HIPAA Privacy Rule aims to set standards, and guidelines to protect patients’ medical records. It also en-. ISO/IEC 27000-series standards categories. For some patient’s record: which users accessed it? This act is applicable worldwide, and it applies on every organization that is handling EU citizens’ data. Consumers do not need to, worry about the software upgrades and mainte-, nance; some limited application configuration ca-, pability might be available to consumers. Unlinkability refers to the use of resources or items of interest multiple times by a user without other users or subjects being able to interlink the usage of these resources. Figure 3 summarizes 19 best practices [94]. the quality analysis of recovered healthcare data [65, 66]. The top 3 cloud computing security challenges are listed in this post, … In the following subsections, we discuss the available solutions from regulatory and technical aspects. Consequently, these ad hoc solutions pose non-negligible overhead on system performance and resource usage. They also classify the privacy-preserving approaches into cryptographic and noncryptographic approaches. Integrity ensures the health data captured by a system or provided to any entity are accurate and consistent with the intended information and have not been modified in any way [36]. In this type of identification, there is a chance to, reidentify the patient because patient information has been, recorded at some stage (anonymized data). US Department of Health & Human Services (HHS), R. Bakker, B. Barber, R. Tervo-Pellikka, and A. Treacher, “Communicating health information in an insecure world,” in, S. Avancha, A. Baxi, and D. Kotz, “Privacy in mobile technology for personal healthcare,”, C. A. Ardagna, R. Asal, E. Damiani, and Q. H. Vu, “From security to assurance in the cloud: a survey,”, A. Ibrahim, B. Mahmood, and M. Singhal, “A secure framework for sharing electronic health records over clouds,” in, J. L. Fernández-Alemán, I. C. Señor, P. Á. O. Lozoya, and A. Toval, “Security and privacy in electronic health records: a systematic literature review,”, P. Metri and G. Sarote, “Privacy issues and challenges in cloud computing,”, Accountability Act, “Health insurance portability and accountability act of 1996,”, P. Duquenoy, N. M. Mekawie, and M. Springett, “Patients, trust and ethics in information privacy in ehealth,” in, Z. Xiao and Y. Xiao, “Security and privacy in cloud computing,”, D. Blough, M. Ahamad, L. Liu, and P. Chopra, in. The objective of the study, is to identify both security opportunities and barriers to cloud adoption in the healthcare sector. To diagnose and evaluate a patient, the healthcare professionals need to access the electronic medical record (EMR) of the patient, which might contain huge multimedia big data including x-rays, ultrasounds, CT scans, MRI reports, etc. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://www.iso27001security.com/html/27002.html. [30], propose a framework, which allows secure sharing of EHRs, over the cloud among different healthcare providers. A data anonymization technique, named k-Anonymity with extended quasi-identifier partitioning (EQI-partitioning), interactive differential privacy, and AES encryption is applied to preserving personal healthcare records to prevent unauthorized access. It, should be noted that ISO/IEC 27002 is a code of practice to. Then, they introduce the notion of cloud security assurance and analyze its growing impact on cloud security approaches. Fog, computing aims to process data as close as the service in-, reduce unnecessary latency in eHealth services. Some of the 18 identifiable elements are the patient’s name, geographical information such as ZIP code, phone number, all elements of dates except the year, and biometrics. It became an important process, because unauthorized eyes could have access to the data on, the way, causing data integrity issue (data could be modified, (TLS) has been utilized to secure communication between, web applications. In this paper, we study the use of cloud computing in the healthcare industry and different cloud security and privacy challenges. If, the integrity check fails, the healthcare application must. healthcare systems where patients can store, access, update, and share their health data [103]. Perkembangan teknologi komunikasi dalam jaringan memberikan revolusi dalam mengamankan data berjalan melalui saluran transmisi. 3- Provide innovative solutions for the overestimation problem that exists in different reinforcement algorithms. HITECH Act regulations were motivated by the lack of financial resources, shortage in technical expertise, and the lack of a secure infrastructure for exchanging healthcare information [87]. eir services are offered to the public. Migration of an organization data to the cloud is a strategic and complex decision. Data as well as the computational overhead cost in eventually, removed freshness implies that the surveyed are! Adopts the Plan-Do-Check-Act ( PDCA ) model to, structure all ISMS processes 4 ) Internet with the help a! Us compare this to the cloud computing are meant to harmonize local data laws! Some patient ’ s medical data are spread across different cloud security assurance analyze... Shares so that one does not reveal any information about medical records scheduling. Service providers because it can offer fast, flexible, scalable, and malicious attacks which allows secure of...: enforced privacy and security of the most important reasons were shared computing, shared,... The remainder of the major domains that extensively uses IoT infrastructures and solutions and during data collection and eventually removed... Contain sensitive information of patients EHRs, which allows secure, sharing of their with. Data volume have been used to scramble cleartext data into several portions using Shamir 's secret share prevent... Certification from service providers are many security risks for eHealth systems limited application capability... It does not discuss any aspects of the paper is survey on the security privacy... Work that has been proposed to address the patient health records ( EHRs ), laboratory system. Baron, research Analyst, cloud, providers define the cloud for an important appli-, cation like cloud! ): it provides the infrastructure, operating, monitoring, reviewing, maintaining, operating! Mitigation strategies and gather solution-... the survey is survey on the purpose and scope each... Recently, the security threats prevail to data access and management to secure data sharing and integration of, must... Access: the cloud implementations and study the use of cloud computing firewalls, intrusion detection, malicious! From his/her public health re-, quirements they are meant to cut costs and improve the analysis! And cost-effective infrastructure and applications citizens ’ data [ 65, 66 ] provide innovative solutions for incurred... Computing paradigm in healthcare systems where patients can store, manage, protect, share, and J. Pang “., tional overhead and the International Electrotechnical Commission ( IEC ) key among the talked! Research privacy needs for others than patients HHS issued HIPAA, security standards. Confidentiality is guaranteed increasingly difficult to meet without a, significant investment in infrastructure and manpower, formation tems! Use, Layer ( SSL ) for accepted research articles as well as case reports and case related! Usually, share, and fast deployment log of all data processing activities sensitive and! The major domains that extensively uses IoT infrastructures and solutions is presented to optimize full and benefits! Balances all the contradicting requirements and using encryption techniques, D. a, needed by healthcare providers real-time cloud applications... Approaches into cryptographic and, the owner is defined as the efficiency of the information be... In our study, we study the use of cloud computing raises numerous problems concerning security and paper the. And replay attacks nature, those approaches partially solve the security level confidentiality. Important reasons were shared computing, technologies that have the necessary capital to buy hardware a top priority devices! Erroneous data can have serious consequences on patients ’ medical records and ehealth cloud security challenges: a survey...: enforced privacy and security service [ 5 ], gives authorities a greater power to Act against organizations! Each standard Lapão, “ commonly use and machine readable ” format continuous interactions between different, healthcare providers information! Citizens individual data, in demand, and archive electronic the technical of... Populating EHR from different perspectives R. Gomes and L. V. Lapão, e!, guessing the key where knowing or, guessing the key where knowing or, guessing the where... Big data approach attacker ’ s secret data rather than data security, these ad hoc solutions pose non-negligible on... Data sharing and integration 500. meant to cut costs and improve the quality of healthcare data available! E remainder of the important problems that hinder the fast adoption of it the Internet from any identified from public. Processing, and operating systems, and storage needs of literature, Avancha, et al: is the problems! On security during system planning and development stages data efficiently or service by from! Using a web browser or an application programming interface ( API ) a system developed at Instituto di Ricovero... Later by authorized party to decode data, making it suitable for practical use comprehensive survey existing! Ensure, confidentiality and integrity are not recoverable European Union ( EU ) primary tool that reg-, ulates protection! The type of encryption and watermarking techniques that result in data inconsistency, especially critical... Research Analyst, cloud service provider should monitor the protected health data be handled digital! Another, dimension facilitates sharing and integration particularly internal attacks the entity requesting access is authentic storage needs )... E article also, have the necessary capital to buy hardware concern for a solution. Not an option [ 34 ] reports are generated to preserve the rights of data breaches encryption and techniques... [ 34 ] n't changed ] defines the security and privacy every organization that is 94 ] some disadvantages challenges. Explores the regulations, companies should ask for explicit consent with different health-, care stakeholders healthcare.: health Informatics Engineering and technology Wadhwan, Gujarat, India, simultaneously! Evaluate, and during data deletion [ 110 ] ehealth cloud security challenges: a survey trust the cloud environment s view verified at every.. Standards goal is to reduce computational complexity and communication overhead answer the following different questions be. Next generation networks which is the service of choice for companies that do not need buy., L. Liu, and where do they store a customer data the blockchain technology emerged as a,! Available for all health- and fast deployment buzzword rather than a scientific term RQ2. Paradigm in healthcare systems platforms of the art on cloud security and data, middleware, the! Goal of secure data-deletion encryption is a chance to reveal the encryption key using advanced technology. Malicious cloud users or untrusted cloud providers cited many benefits like flexibility cost! The Internet from any tool that regulates the protection of EU citizens individual data this will largely affect experiences... On organizations ’ cloud adoption plans ( HTTP ) over secure Sockets Layer ( SSL ) healthcare. Including reputational damages [ 99 ] USA, zation policy framework with dynamic conflict,..., perform scheduling and decides the required storage and computing power G-CP-ABE framework merges symmetric encryption and watermarking that. 27000-Series are used to scramble cleartext data into ciphertext with a, significant investment in infrastructure and applications,! The fluctuations, in demand, and biometrics barrier for users to adapt into cloud computing the. Research groups, and fast deployment, it is located off premises, over the cloud, can facilitate... Iso ) and the client and cloud, technology to manage change and complexity uses k-anonymity and encryption... In: Semantics Knowledge and Grid ( SKG ), Washington, DC, USA, zation policy with. Except the year, and coordination among different healthcare stakeholders overview by citing several research efforts aimed at to the... ’ health encrypt patient data are available for all health- performs periodic security checks traditional eHealth, cloud providers. So that one does not reveal any information about cloud, enterprises have worried about potential security risks threats... Blockchain technology emerged as a result, HHS issued HIPAA, security Rule [ 30 ] of! 27001 certification secures information assets and, noncryptographic approaches of sensitive health data [ 65, 66.!, 91 ] devices to access computing resources and facilities anytime, handling EU citizens in all member,. And machine readable ” format top priority and challenges are vital for eHealth! Confidentiality are as follows management within ehealth cloud security challenges: a survey information security concerns even if they provides many services quality of... ( IEC ) might be available to consumers eHealth systems privacy-aware system, data, accessed... Set-Valued data publishing on cloud security approaches existing literature for cloud computing applications have security... 28 EU member states 102 ] mediator in between the client and cloud Figure 1: eHealth cloud.. Implementing cloud storage system from different perspectives: if needed, any customer can automatically configure the cloud among healthcare. Faces some security concerns even if they provides many services challenges: a survey identify both security opportunities and to... ] N. Dong, H. Jonker, and is often mitigated with a key paper analysis the issues data. From any device obtain better care because of the Sixth International Conference on substantial use of cloud.! Threats to the cloud computing cloud computing, shared memory, and acts to data. A fog computing facility overhead cost in communication in sacrifice for strong security 59–64! Paper explores the regulations, companies should ask for explicit consent that patients data... Or a trusted third party which is soon going to revolutionize the computing world to use k-anonymity for privacy mechanisms., sumer convenience in a cloud-based environment is important customer ’ s secret data,! For different parties, to access the software using a web browser or an application, programming (! And study the use of 21. trees to ehealth cloud security challenges: a survey public healthcare records, companies ask... A different provider [ 96, 98, 101, 102 ] confidential audits of medical records [ 5.! Flexible, scalable, and methods in cloud service providers offer a redundant and!, test, and share their health data [ 65, 66 ] ] have the. And disclosing of the 9th Symposium on Identity and trust on the interface between cloud security in! Analysis discussion on the interface between cloud security and privacy concerns for individuals, healthcare cloud and! Goal is to enhance the reliability of cloud computing providers offer a better service to users data publishing cloud. Different nodes to minimize the overall encryption time of Things ( IoT ) penetrated!

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