Abstract
Wireless communications play an important role in ensuring ease of access to shared electronic health records (EHR) across health service providers which is essential and significant for prompt patients’ care, especially in cases of emergency medical conditions. With the need to support anytime, anywhere access to, potentially bandwidth hungry, medical records, electronic healthcare applications will continue to benefit from advanced wireless network technologies such as 5G and beyond. With sharing, it is crucial to provide patients with security and privacy guarantees, and allow them to certain control of access to their data. Existing solutions mostly assume that patients are available to authorize requests to access their EHR, which is impractical as the patient may be unconscious. This paper proposes a secure and privacy protecting protocol whereby the patient can pre-delegate the authorization for the access of his/her EHR. Our patient(user)-centric proposal combines Self-Sovereign Identity (SSI) concepts and model with Secure Multi-party Computation (SMPC) and Threshold Cryptography (TC) to enable secure identity and authorization verification. A block cipher encryption sharing approach is adopted for the threshold SMPC which extends the AES-GCM symmetric encryption model into a full-fledged cryptographic platform. Two mechanisms are implemented for the block cipher encryption, namely XOR and Cascade, and experiments are conducted to compare them. We conclude that the XOR mechanism can scale for larger thresholds, while Cascade performed better for a lower threshold (≤ 3). This paper also performs a threat analysis of the protocol and approach, and validates its correctness and complexity. We conclude that the approach can achieve the security and privacy protection of the patient’s personal EHR, as well as the autonomy of the patient to control the authorization for the access and sharing.
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References
Zhang, J., Liu, H., & Ni, L. (2020). A secure energy-saving communication and encrypted storage model based on RC4 for EHR. IEEE Access, 8, 38995–39012.
Liu, X., Lam, K. Y., Li, F., Zhao, J., Wang, L., & Durrani, T. S. (2021). Spectrum sharing for 6G integrated satellite-terrestrial communication networks based on NOMA and CR. IEEE Network Magazine, 35(4), 28–34.
Li, F., Lam, K. Y., Chen, H. W., & Zhao, N. (2019). Spectral efficiency enhancement in satellite mobile communications: A game-theoretical approach. IEEE Wireless Communications, 27, 200–205.
Li, F., Lam, K. Y., Zhao, N., Liu, X., Zhao, K., & Wang, L. (2018). Spectrum trading for satellite communication systems with dynamic bargaining. IEEE Transactions on Communications, 66(10), 4680–4693.
Wang, L., Lam, K.Y., Xiong, M., Li, F., Liu, X., and Wang, J., (2018) Spectrum pricing for cognitive radio networks with user's stochastic distribution. Wireless Networks, Springer US.
Li, F., Lam, K. Y., & Wang, L. (2018). Power allocation in cognitive radio networks over Rayleigh-fading channels with hybrid intelligent algorithms. Wireless Networks, 24(7), 2397–2407.
Chowdhury, M. Z., Shahjalal, M., Ahmed, S., & Jang, Y. M. (2020). 6G wireless communication systems: Applications, requirements, technologies, challenges, and research directions. IEEE Open Journal of the Communications Society, 1, 957–975.
Rabieh, K., Akkaya, K., Karabiyik, U., and Qamruddin, J., (2018) A secure and cloud-based medical records access scheme for on-road emergencies. In Proceedings of 15th IEEE Annual Consumer Communications & Networking Conference (CCNC), pp. 1–8.
Yi, X., Bouguettaya, A., Georgakopoulos, D., Song, A., & Willemson, J. (2016). Privacy protection for wireless medical sensor data. IEEE Transactions on Dependable and Secure Computing, 13(3), 369–380.
S. Arsheen, and K. Ahmad, "SLR: A systematic literature review on blockchain applications in healthcare," In Proceedings of 2021 International Conference on Information Science and Communications Technologies (ICISCT), pp. 1–6, 2021.
Tan, K.-L., Chi, C.-H., and Lam, K.-Y., (2022) Analysis of digital sovereignty and identity: From digitization to digitalization. arXiv preprint arXiv:2202.10069.
Wang, F., and De Filippi, P., (2020) Self-sovereign identity in a globalized world: Credentials-based identity systems as a driver for economic inclusion. Frontiers in Blockchain, vol. 2.
Zhao, X.-B., Lam, K.-Y., Chung, S.-L., Gu, M., and Sun, J.-G., (2004) Authorization mechanisms for virtual organizations in distributed computing systems. In Proceedings of Australasian Conference on Information Security and Privacy, pp. 414–426.
Yong, J.-P., Lam, K.-Y., Chung, S.-L., Gu, M., and Sun, J.-G., (2004) Enhancing the scalability of the community authorization service for virtual organizations. In Proceedings of Advanced Workshop on Content Computing, pp. 182–193.
Microsoft (2021) The STRIDE Threat Model," https://docs.microsoft.com/en-us/previous-versions/commerce-server/ee823878(v=cs.20)?redirectedfrom=MSDN.
D. R. Group (2022) LINDDUN privacy engineering. https://www.linddun.org/.
Guo, H., Li, W., Nejad, M., and Shen, C.-C., (2019) Access control for electronic health records with hybrid blockchain-edge architecture. In Proceedings of 2019 IEEE International Conference on Blockchain (Blockchain), pp. 44–51.
Yue, X., Wang, H., Jin, D., Li, M., & Jiang, W. (2016). Healthcare data gateways: Found healthcare intelligence on blockchain with novel privacy risk control. Journal of Medical Systems, 40(10), 1–8.
Liang, X., Zhao, J., Shetty, S., Liu, J., and Li, D., (2017) Integrating blockchain for data sharing and collaboration in mobile healthcare applications. In Proceedings of 2017 IEEE 28th annual international symposium on personal, indoor, and mobile radio communications (PIMRC), pp. 1–5.
Xia, Q., Sifah, E. B., Asamoah, K. O., Gao, J., Du, X., & Guizani, M. (2017). MeDShare: Trust-less medical data sharing among cloud service providers via blockchain. IEEE Access, 5, 14757–14767.
Rabieh, K., Akkaya, K., Karabiyik, U., and Qamruddin, J., (2018) A secure and cloud-based medical records access scheme for on-road emergencies. In Proceedings of 2018 15th IEEE Annual Consumer Communications & Networking Conference (CCNC), pp. 1–8.
Zhang, J., Xue, N., & Huang, X. (2016). A secure system for pervasive social network-based healthcare. IEEE Access, 4, 9239–9250.
Dubovitskaya, A., Novotny, P., Xu, Z., & Wang, F. (2020). Applications of blockchain technology for data-sharing in oncology: Results from a systematic literature review. Oncology, 98(6), 403–411.
Guo, H., Li, W., Meamari, E., Shen, C.-C., and Nejad, M., (2020) Attribute-based multi-signature and encryption for EHR management: A blockchain-based solution. In Proceedings of 2020 IEEE International Conference on Blockchain and Cryptocurrency (ICBC), pp. 1–5.
Sun, Y., Zhang, R., Wang, X., Gao, K., and Liu, L., (2018) A decentralizing attribute-based signature for healthcare blockchain. In Proceedings of 2018 27th International conference on computer communication and networks (ICCCN), pp. 1–9.
Vora, J., Italiya, P., Tanwar, S., Tyagi, S., Kumar, N., Obaidat, M. S., and Hsiao, K.-F., (2018) Ensuring privacy and security in e-health records. In Proceedings of 2018 International conference on computer, information and telecommunication systems (CITS), pp. 1–5.
Guo, R., Shi, H., Zhao, Q., & Zheng, D. (2018). Secure attribute-based signature scheme with multiple authorities for blockchain in electronic health records systems. IEEE Access, 6, 11676–11686.
Wang, H., & Song, Y. (2018). Secure cloud-based EHR system using attribute-based cryptosystem and blockchain. Journal of Medical Systems, 42(8), 1–9.
Chen, L., Lee, W.-K., Chang, C.-C., Choo, K.-K.R., & Zhang, N. (2019). Blockchain based searchable encryption for electronic health record sharing. Future Generation Computer Systems, 95, 420–429.
Wang, Y., Zhang, A., Zhang, P., & Wang, H. (2019). Cloud-assisted EHR sharing with security and privacy preservation via consortium blockchain. IEEE Access, 7, 136704–136719.
Benaloh, J., Chase, M., Horvitz, E., and Lauter, K., (2009) Patient controlled encryption: ensuring privacy of electronic medical records. In Proceedings of Proceedings of the 2009 ACM workshop on Cloud computing security, pp. 103–114.
Liu, X., Zheng, Y., Yuan, X., and Yi, X., (2021) Towards secure and lightweight deep learning as a medical diagnostic service. In European Symposium on Research in Computer Security, pp. 519–541. Springer, Cham.
Liu, X., and Yi, X., (2019) Privacy-preserving collaborative medical time series analysis based on dynamic time warping. In European Symposium on Research in Computer Security, pp. 439–460. Springer, Cham.
Marwan, M., Kartit, A., and Ouahmane, H., (2016) Applying secure multi-party computation to improve collaboration in healthcare cloud. In Proceedings of Third International Conference on Systems of Collaboration (SysCo), 2016, pp. 1-6.
Shen, B., Guo, J., & Yang, Y. (2019). MedChain: Efficient healthcare data sharing via blockchain. Applied Sciences, 9(6), 1207.
Zhuang, Y., Sheets, L. R., Chen, Y.-W., Shae, Z.-Y., Tsai, J. J., & Shyu, C.-R. (2020). A patient-centric health information exchange framework using blockchain technology. IEEE Journal of Biomedical and Health Informatics, 24(8), 2169–2176.
Blobel, B. (2004). Authorisation and access control for electronic health record systems. International Journal of Medical Informatics, 73(3), 251–257.
Khan, M. F. F., and Sakamura, K., (2020) A distributed approach to delegation of access rights for electronic health records. In Proceedings of 2020 International Conference on Electronics, Information, and Communication (ICEIC), pp. 1–6.
Joshi, M., Joshi, K. P., and Finin, T., (2019) Delegated authorization framework for EHR services using attribute based encryption. IEEE Transactions on Services Computing.
Liang, X., Shetty, S., Zhao, J., Bowden, D., Li, D., and Liu, J., (2017) Towards decentralized accountability and self-sovereignty in healthcare systems. In Proceedings of International Conference on Information and Communications Security, pp. 387–398.
Siqueira, A., Da Conceição, A. F., and Rocha, V., (2021) Blockchains and self-sovereign identities applied to healthcare solutions: A systematic review. arXiv preprint arXiv:2104.12298.
W.-W. W. Consortium, “W3C DID Primer for Introduction, “ https://github.com/w3c-ccg/did-primer. 2021
Ge, M., and Lam, K.-Y., (2009) Self-initialized distributed certificate authority for mobile ad hoc network. In Proceedings of International Conference on Information Security and Assurance, pp. 392–401.
Dunphy, P., & Petitcolas, F. A. (2018). A first look at identity management schemes on the blockchain. IEEE Security & Privacy, 16(4), 20–29.
Crépeau, C., Graaf, J. V. D., and Tapp, A., (1995) Committed oblivious transfer and private multi-party computation. In Proceedings of Annual International Cryptology Conference, pp. 110–123.
Yi, X., Paulet, R., and Bertino, E., (2014) Homomorphic encryption. Homomorphic Encryption and Applications, pp. 27–46: Springer.
Shamir, A. (1979). How to share a secret. Communications of the ACM, 22(11), 612–613.
Martin, K. M., Safavi-Naini, R., Wang, H., & Wild, P. R. (2005). Distributing the encryption and decryption of a block cipher. Designs, Codes and Cryptography, 36(3), 263–287.
Sudarsan, S. V., Schelén, O., and Bodin, U., (2020) A model for signatories in cyber-physical systems. In Proceedings of 2020 25th IEEE International Conference on Emerging Technologies and Factory Automation (ETFA), pp. 15–21.
Nuñez, D., Agudo, I., & Lopez, J. (2017). Proxy re-encryption: Analysis of constructions and its application to secure access delegation. Journal of Network and Computer Applications, 87, 193–209.
McGrew, D., & Viega, J. (2004). The Galois/counter mode of operation (GCM). NIST Modes of Operation Process, 20, 0278–70.
Brandão, L. T., Mouha, N., and Vassilev, A., (2018) Threshold schemes for cryptographic primitives: challenges and opportunities in standardization and validation of threshold cryptography. National Institute of Standards and Technology.
Brickell, E., Crescenzo, G. D., and Frankel, Y., (2000) Sharing block ciphers. In Proceedings of Australasian Conference on Information Security and Privacy, pp. 457–470.
Maurer, U. M., & Massey, J. L. (1993). Cascade ciphers: The importance of being first. Journal of Cryptology, 6(1), 55–61.
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This work was supported by the National Research Foundation, Singapore under its Strategic Capability Research Centres Funding Initiative.
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Tan, KL., Chi, CH. & Lam, KY. Secure and privacy-preserving sharing of personal health records with multi-party pre-authorization verification. Wireless Netw (2022). https://doi.org/10.1007/s11276-022-03114-6
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DOI: https://doi.org/10.1007/s11276-022-03114-6