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The maintenance and sharing of electronic medical records are one of the essential tasks in the medical treatment combination. Traditional cloud-based electronic medical record storage system is difficult to realize data security sharing. The tamper resistance and traceability of blockchain technology provide the possibility for the sharing of highly sensitive medical data. This paper proposes a safe sharing scheme of stroke electronic medical records based on the consortium blockchain. The scheme adopts the storage method of ciphertext of medical records stored in the cloud and index of medical records stored on the blockchain. The privacy protection mechanism proposed in this paper innovatively combines proxy reencryption and searchable encryption which supports patient pseudoidentity search. The mechanism could achieve controllable sharing of medical records and precise search. According to the organizational characteristics of the stroke medical treatment combination, this paper proposes an improved Practical Byzantine Fault Tolerance mechanism to reach a consensus between consensus nodes. Then, the proposed scheme is analyzed and evaluated from three aspects of medical record integrity, user privacy, and data security. The results show that the scheme can not only ensure the privacy of patient identity information and private key data but also resist the tampering and deletion attacks of internal and external malicious nodes on the medical record data. Therefore, the proposed scheme is conducive to the improvement of the timeliness of stroke treatment and the safe sharing of electronic medical records in stroke medical treatment combination.

To provide a search functionality for encrypted data, public key encryption with keyword search (PEKS) has been widely recognized. In actual usage, a PEKS scheme should be employed with a PKE scheme since PEKS itself does not support the decryption of data. Since a naive composition of a PEKS ciphertext and a PKE ciphertext does not provide CCA security, several attempts have been made to integrate PEKS and PKE in a joint CCA manner (PEKS/PKE for short). In this paper, we further extend these works by integrating secure-channel free PEKS (SCF-PEKS) and PKE, which we call SCF-PEKS/PKE, where no secure channel is required to send trapdoors. We give a formal security definition of SCF-PEKS/PKE in a joint CCA manner, and propose a generic construction of SCF-PEKS/PKE based on anonymous identity-based encryption, tag-based encryption, and one-time signature. We also strengthen the current consistency definition according to the secure-channel free property, and show that our construction is strongly consistent if the underlying IBE provides unrestricted strong collision-freeness which is defined in this paper. We also show that such an IBE scheme can be constructed by employing the Abdalla et al. transformations (TCC 2010/J. Cryptology 2018). Finally, as an application of SCF-PEKS/PKE, we strengthen the security of encrypted Electronic Medical Record (EMR) system proposed by Guo and Yau (J. Medical Sys. 2015).

With the rapid development of informatization, an increasing number of industries and organizations outsource their data to cloud servers, to avoid the cost of local data management and to share data. For example, industrial Internet of things systems and mobile healthcare systems rely on cloud computing’s powerful data storage and processing capabilities to address the storage, provision, and maintenance of massive amounts of industrial and medical data. One of the major challenges facing cloud-based storage environments is how to ensure the confidentiality and security of outsourced sensitive data. To mitigate these issues, He et al. and Ma et al. have recently independently proposed two certificateless public key searchable encryption schemes. In this paper, we analyze the security of these two schemes and show that the reduction proof of He et al.’s CLPAEKS scheme is incorrect, and that Ma et al.’s CLPEKS scheme is not secure against keyword guessing attacks. We then propose a channel-free certificateless searchable public key authenticated encryption (dCLPAEKS) scheme and prove that it is secure against inside keyword guessing attacks under the enhanced security model. Compared with other certificateless public key searchable encryption schemes, this scheme has higher security and comparable efficiency.

Healthcare industry is one of the promising fields adopting the Internet of Things (IoT) solutions. In this paper, we study secret sharing mechanisms towards resolving privacy and security issues in IoT-based healthcare applications. In particular, we show how multiple sources are possible to share their data amongst a group of participants without revealing their own data to one another as well as the dealer. Only an authorised subset of participants is able to reconstruct the data. A collusion of fewer participants has no better chance of guessing the private data than a non-participant who has no shares at all. To realise this system, we introduce a novel research upon secret sharing in the encrypted domain. In modern healthcare industry, a patient's health Article often contains data acquired from various sensor nodes. In order to protect information privacy, the data from sensor nodes is encrypted at once and shared among a number of cloud servers of medical institutions via a gateway device. The complete health Article will be retrieved for diagnosis only if the number of presented shares meets the access policy. The retrieval procedure does not involve decryption and therefore the scheme is favourable in some time-sensitive circumstances such as a surgical emergency. We analyse the pros and cons of several possible solutions and develop practical secret sharing schemes for IoT- based healthcare systems.

Cloud computing is a promising technology that is expected to transform the healthcare industry. Cloud computing has many benefits like flexibility, cost and energy savings, resource sharing, and fast deployment. In this paper, we study the use of cloud computing in the healthcare industry and different cloud security and privacy challenges. The centralization of data on the cloud raises many security and privacy concerns for individuals and healthcare providers. This centralization of data (1) provides attackers with one-stop honey-pot to steal data and intercept data in-motion and (2) moves data ownership to the cloud service providers; therefore, the individuals and healthcare providers lose control over sensitive data. As a result, security, privacy, efficiency, and scalability concerns are hindering the wide adoption of the cloud technology. In this work, we found that the state-of-the art solutions address only a subset of those concerns. Thus, there is an immediate need for a holistic solution that balances all the contradicting requirements.

With the prosperity of machine learning and cloud computing, meaningful information can be mined from mass electronic medical data which help physicians make proper disease diagnosis for patients. However, using medical data and disease information of patients frequently raise privacy concerns. In this paper, based on single-layer perceptron, we propose a scheme of privacy-preserving clinical decision with cloud support (PPCD), which securely conducts disease model training and prediction for the patient. Each party learns nothing about the other's private information. In PPCD, a lightweight secure multiplication is presented and introduced to improve the model training. Security analysis and experimental results on real data confirm the high accuracy of disease prediction achieved by the proposed PPCD without the risk of privacy disclosure.

Big data has become one of the most imperative technologies for collecting, handling and analysing enormous volumes of data in a high-performance environment. Enterprise healthcare organizations needs high compute power for the large volume of sensitive data, as well as large storage for storing both data and results, preferably in the cloud. However, security and privacy of patient data have become a critical issue that restricts many healthcare services from using cloud services to their optimal level. Therefore, this issue has limited healthcare organizations from migrating patient data to a cloud storage, because the cloud operators have chance to access sensitive data without the owner’s permission. This paper proposes an intelligent security system called Intelligent Framework for Healthcare Data Security (IFHDS). IFHDS enables to secure and process large-scale data using column-based approach with less impact on the performance of data processing. The intelligent framework intends masking personal data and to encrypt sensitive data only. The proposed IFHDS splits sensitive data into multiple parts according to sensitivity level, where each part is stored separately over distributed cloud storage. Splitting data based on sensitivity level prevents cloud provider to break complete record of data if succeeds to decrypt part of data. The experimental results confirm that the proposed system secure the sensitive patient data with an acceptable computation time compared to recent security approaches.

The sharing of electronic health records (EHR) in cloud servers is an increasingly important development that can improve the efficiency of medical systems. However, there are several concerns focusing on the issues of security and privacy in EHR system. The EHR data contains the EHR owner&rsquo, s sensitive personal information, if these data are obtained by a malicious user, it will not only cause the leakage of patient&rsquo, s privacy, but also affect the doctor&rsquo, s diagnosis. It is a very challenging problem for the EHR owner fully controls over own EHR data as well as preserves the privacy of himself. In this paper, we propose a new privacy-preserving access control (PPAC) scheme for EHR. To achieve fine-grained access control of the EHR data, we utilize the attribute-based signcryption (ABSC) mechanism to signcrypt data based on the access policy for the linear secret sharing schemes. Employing the cuckoo filter to hide the access policy, it could protect the EHR owner&rsquo, s privacy information. In addition, the security analysis shows that the proposed scheme is provably secure under the decisional bilinear Diffie-Hellman exponent assumption and the computational Diffie-Hellman exponent assumption in the standard model. Furthermore, the performance analysis indicates that the proposed scheme achieves low costs of communication and computation compared with the related schemes, meanwhile preserves the EHR owner&rsquo, s privacy. Therefore, the proposed scheme is better suited to EHR system.

© 2013 IEEE. Attribute-based encryption has been a promising encryption technology to secure personal health records (PHRs) sharing in cloud computing. PHRs consist of the patient data often collected from various sources including hospitals and general practice centres. Different patients' access policies have a common access sub-policy. In this paper, we propose a novel attribute-based encryption scheme for fine-grained and flexible access control to PHRs data in cloud computing. The scheme generates shared information by the common access sub-policy, which is based on different patients' access policies. Then, the scheme combines the encryption of PHRs from different patients. Therefore, both time consumption of encryption and decryption can be reduced. Medical staff require varying levels of access to PHRs. The proposed scheme can also support multi-privilege access control so that medical staff can access the required level of information while maximizing patient privacy. Through implementation and simulation, we demonstrate that the proposed scheme is efficient in terms of time. Moreover, we prove the security of the proposed scheme based on security of the ciphertext-policy attribute-based encryption scheme.

Cloud computing is highly suitable for medical diagnosis in e-health services where strong computing ability is required. However, in spite of the huge benefits of adopting the cloud computing, the medical diagnosis field is not yet ready to adopt the cloud computing because it contains sensitive data and hence using the cloud computing might cause a great concern in privacy infringement. For instance, a compromised e-health cloud server might expose the medical dataset outsourced from multiple medical data owners or infringe on the privacy of a patient inquirer by leaking his/her symptom or diagnosis result. In this paper, we propose a medical diagnosis system using e-health cloud servers in a privacy preserving manner when medical datasets are owned by multiple data owners. The proposed system is the first one that achieves the privacy of medical dataset, symptoms, and diagnosis results and hides the data access pattern even from e-health cloud servers performing computations using the data while it is still robust against collusion of the entities. As a building block of the proposed diagnosis system, we design a novel privacy preserving protocol for finding the k data with the highest similarity (PE-FTK) to a given symptom. The protocol reduces the average running time by 35% compared to that of a previous work in the literature. Moreover, the result of the previous work is probabilistic, i.e., the result can contain some error, while the result of our PE-FTK is deterministic, i.e., the result is correct without any error probability.

Many hospitals and medical clinics have been using a wearable sensor in its health care system because the wearable sensor, which is able to measure the patients’ biometric information, has been developed to analyze their patients remotely. The measured information is saved to a server in a medical center, and the server keeps the medical information, which also involves personal information, on a cloud system. The server and network devices are used by connecting each other, and sensitive medical records are dealt with remotely. However, these days, the attackers, who try to attack the server or the network systems, are increasing. In addition, the server and the network system have a weak protection and security policy against the attackers. In this paper, it is suggested that security compliance of medical contents should be followed to improve the level of security. As a result, the medical contents are kept safely.

In this paper, we propose a new secure content based image retrieval (SCBIR) system adapted to the cloud framework. This solution allows a physician to retrieve images of similar content within an outsourced and encrypted image database, without decrypting them. Contrarily to actual CBIR approaches in the encrypted domain, the originality of the proposed scheme stands on the fact that the features extracted from the encrypted images are themselves encrypted. This is achieved by means of homomorphic encryption and two non-colluding servers, we however both consider as honest but curious. In that way an end to end secure CBIR process is ensured. Experimental results carried out on a diabetic retinopathy database encrypted with the Paillier cryptosystem indicate that our SCBIR achieves retrieval performance as good as if images were processed in their non-encrypted form.

Sharing the medical records of individuals among healthcare providers and researchers around the world can accelerate advances in medical research. While the idea seems increasingly practical due to cloud data services, maintaining patient privacy is of paramount importance. Standard encryption algorithms help protect sensitive data from outside attackers but they cannot be used to compute on this sensitive data while being encrypted. Homomorphic Encryption presents a very useful tool that can compute on encrypted data without the need to decrypt it. In this paper, we describe an optimized NTRU-based implementation of the GSW homomorphic encryption scheme. Our results show a factor of 58 × improvement in CPU performance compared to other recent work on encrypted medical data under the same security settings. Our system is built to be easily portable to GPUs resulting in an additional speedup of up to a factor of 104 × (and 410 ×) to offer an overall speedup of 6085 × (and 24011 ×) using a single GPU (or four GPUs), respectively.

Attribute based encryption (ABE) is a good way to achieve flexible and secure access control to data, and attribute revocation is the extension of the attribute-based encryption, and the keyword search is an indispensable part for cloud storage. The combination of both has an important application in the cloud storage. In this paper, we construct a searchable attribute-based encryption scheme with attribute revocation in cloud storage, the keyword search in our scheme is attribute based with access control, when the search succeeds, the cloud server returns the corresponding cipher text to user and the user can decrypt the cipher text definitely. Besides, our scheme supports multiple keywords search, which makes the scheme more practical. Under the assumption of decisional bilinear Diffie-Hellman exponent (q-BDHE) and decisional Diffie-Hellman (DDH) in the selective security model, we prove that our scheme is secure.

In recent years, many countries have been trying to integrate electronic health data managed by each hospital to offer more efficient healthcare services. Since health data contain sensitive information of patients, there have been much research that present privacy preserving mechanisms. However, existing studies either require a patient to perform various steps to secure the data or restrict the patient to exerting control over the data. In this paper, we propose patient-controlled attribute-based encryption, which enables a patient (a data owner) to control access to the health data and reduces the operational burden for the patient, simultaneously. With our method, the patient has powerful control capability of his/her own health data in that he/she has the final say on the access with time limitation. In addition, our scheme provides emergency medical services which allow the emergency staffs to access the health data without the patient's permission only in the case of emergencies. We prove that our scheme is secure under cryptographic assumptions and analyze its efficiency from the patient's perspective.

Preserving the privacy of electronic medical records (EMRs) is extremely important especially when medical systems adopt cloud services to store patients' electronic medical records. Considering both the privacy and the utilization of EMRs, some medical systems apply searchable encryption to encrypt EMRs and enable authorized users to search over these encrypted records. Since individuals would like to share their EMRs with multiple persons, how to design an efficient searchable encryption for sharable EMRs is still a very challenge work. In this paper, we propose a cost-efficient secure channel free searchable encryption (SCF-PEKS) scheme for sharable EMRs. Comparing with existing SCF-PEKS solutions, our scheme reduces the storage overhead and achieves better computation performance. Moreover, our scheme can guard against keyword guessing attack, which is neglected by most of the existing schemes. Finally, we implement both our scheme and a latest medical-based scheme to evaluate the performance. The evaluation results show that our scheme performs much better performance than the latest one for sharable EMRs.

Emergency care is basically concerned with the provision of pre-hospital and in-hospital medical and/or paramedical services and it typically involves a wide variety of interdependent and distributed activities that can be interconnected to form emergency care processes within and between Emergency Medical Service (EMS) agencies and hospitals. Hence, in developing an information system for emergency care processes, it is essential to support individual process activities and to satisfy collaboration and coordination needs by providing readily access to patient and operational information regardless of location and time. Filling this information gap by enabling the provision of the right information, to the right people, at the right time fosters new challenges, including the specification of a common information format, the interoperability among heterogeneous institutional information systems or the development of new, ubiquitous trans-institutional systems. This paper is concerned with the development of an integrated computer support to emergency care processes by evolving and cross-linking institutional healthcare systems. To this end, an integrated EMS cloud-based architecture has been developed that allows authorized users to access emergency case information in standardized document form, as proposed by the Integrating the Healthcare Enterprise (IHE) profile, uses the Organization for the Advancement of Structured Information Standards (OASIS) standard Emergency Data Exchange Language (EDXL) Hospital Availability Exchange (HAVE) for exchanging operational data with hospitals and incorporates an intelligent module that supports triaging and selecting the most appropriate ambulances and hospitals for each case.

Searchable encryption is an important cryptographic primitive that enables privacy-preserving keyword search on encrypted electronic medical records (EMRs) in cloud storage. Efficiency of such searchable encryption in a medical cloud storage system is very crucial as it involves client platforms such as smartphones or tablets that only have constrained computing power and resources. In this paper, we propose an efficient secure-channel free public key encryption with keyword search (SCF-PEKS) scheme that is proven secure in the standard model. We show that our SCF-PEKS scheme is not only secure against chosen keyword and ciphertext attacks (IND-SCF-CKCA), but also secure against keyword guessing attacks (IND-KGA). Furthermore, our proposed scheme is more efficient than other recent SCF-PEKS schemes in the literature.

With the development of electronic systems, privacy has become an important security issue in real-life. In medical systems, privacy of patients' electronic medical records (EMRs) must be fully protected. However, to combine the efficiency and privacy, privacy preserving index is introduced to preserve the privacy, where the EMR can be efficiently accessed by this patient or specific doctor. In the literature, Goh first proposed a secure index scheme with keyword search over encrypted data based on a well-known primitive, Bloom filter. In this paper, we propose a new privacy preserving index scheme, called position index (P-index), with keyword search over the encrypted data. The proposed index scheme is semantically secure against the adaptive chosen keyword attack, and it also provides flexible space, lower false positive rate, and search privacy. Moreover, it does not rely on pairing, a complicate computation, and thus can search over encrypted electronic medical records from the cloud server efficiently.

Healthcare institutions adapt cloud based archiving of medical images and patient records to share them efficiently. Controlled access to these records and authentication of images must be enforced to mitigate fraudulent activities and medical errors. This paper presents a zero-watermarking scheme implemented in the composite Contourlet Transform (CT)—Singular Value Decomposition (SVD) domain for unambiguous authentication of medical images. Further, a framework is proposed for accessing patient records based on the watermarking scheme. The patient identification details and a link to patient data encoded into a Quick Response (QR) code serves as the watermark. In the proposed scheme, the medical image is not subjected to degradations due to watermarking. Patient authentication and authorized access to patient data are realized on combining a Secret Share with the Master Share constructed from invariant features of the medical image. The Hu’s invariant image moments are exploited in creating the Master Share. The proposed system is evaluated with Checkmark software and is found to be robust to both geometric and non geometric attacks.

Ubiquitous healthcare services are becoming more and more popular, especially under the urgent demand of the global aging issue. Cloud computing owns the pervasive and on-demand service-oriented natures, which can fit the characteristics of healthcare services very well. However, the abilities in dealing with multimodal, heterogeneous, and nonstationary physiological signals to provide persistent personalized services, meanwhile keeping high concurrent online analysis for public, are challenges to the general cloud. In this paper, we proposed a private cloud platform architecture which includes six layers according to the specific requirements. This platform utilizes message queue as a cloud engine, and each layer thereby achieves relative independence by this loosely coupled means of communications with publish/subscribe mechanism. Furthermore, a plug-in algorithm framework is also presented, and massive semistructure or unstructured medical data are accessed adaptively by this cloud architecture. As the testing results showing, this proposed cloud platform, with robust, stable, and efficient features, can satisfy high concurrent requests from ubiquitous healthcare services.

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.

Consequently, application services rendering remote medical services and electronic health record (EHR) have become a hot topic and stimulating increased interest in studying this subject in recent years. Information and communication technologies have been applied to the medical services and healthcare area for a number of years to resolve problems in medical management. Sharing EHR information can provide professional medical programs with consultancy, evaluation, and tracing services can certainly improve accessibility to the public receiving medical services or medical information at remote sites. With the widespread use of EHR, building a secure EHR sharing environment has attracted a lot of attention in both healthcare industry and academic community. Cloud computing paradigm is one of the popular healthIT infrastructures for facilitating EHR sharing and EHR integration. In this paper, we propose an EHR sharing and integration system in healthcare clouds and analyze the arising security and privacy issues in access and management of EHRs.