Security in IoMT Communications: A Survey

Enhancing the Internet of Medical Things (IoMT) Security with Meta-Learning: A Performance-Driven Approach for Ensemble Intrusion Detection Systems

This paper investigates the application of ensemble learning techniques, specifically meta-learning, in intrusion detection systems (IDS) for the Internet of Medical Things (IoMT). It underscores the existing challenges posed by the heterogeneous and dynamic nature of IoMT environments, which necessitate adaptive, robust security solutions. By harnessing meta-learning alongside various ensemble strategies such as stacking and bagging, the paper aims to refine IDS mechanisms to effectively counter evolving cyber threats. The study proposes a performance-driven weighted meta-learning technique for dynamic assignment of voting weights to classifiers based on accuracy, loss, and confidence levels. This approach significantly enhances the intrusion detection capabilities for the IoMT by dynamically optimizing ensemble IDS models. Extensive experiments demonstrate the proposed model's superior performance in terms of accuracy, detection rate, F1 score, and false positive rate compared to existing models, particularly when analyzing various sizes of input features. The findings highlight the potential of integrating meta-learning in ensemble-based IDS to enhance the security and integrity of IoMT networks, suggesting avenues for future research to further advance IDS performance in protecting sensitive medical data and IoT infrastructures.

Enhancing Internet of Medical Things security with artificial intelligence: A comprehensive review

Over the past five years, interest in the literature regarding the security of the Internet of Medical Things (IoMT) has increased. Due to the enhanced interconnectedness of IoMT devices, their susceptibility to cyber-attacks has proportionally escalated. Motivated by the promising potential of AI-related technologies to improve certain cybersecurity measures, we present a comprehensive review of this emerging field. In this review, we attempt to bridge the corresponding literature gap regarding modern cybersecurity technologies that deploy AI techniques to improve their performance and compensate for security and privacy vulnerabilities. In this direction, we have systematically gathered and classified the extensive research on this topic. Our findings highlight the fact that the integration of machine learning (ML) and deep learning (DL) techniques improves both the performance of cybersecurity measures and their speed, reliability, and effectiveness. This may be proven to be useful for improving the security and privacy of IoMT devices. Furthermore, by considering the numerous advantages of AI technologies as opposed to their core cybersecurity counterparts, including blockchain, anomaly detection, homomorphic encryption, differential privacy, federated learning, and so on, we provide a structured overview of the current scientific trends. We conclude with considerations for future research, emphasizing the promising potential of AI-driven cybersecurity in the IoMT landscape, especially in patient data protection and in data-driven healthcare.

A Systematic Review of Data-Driven Attack Detection Trends in IoT

The Internet of Things is perhaps a concept that the world cannot be imagined without today, having become intertwined in our everyday lives in the domestic, corporate and industrial spheres. However, irrespective of the convenience, ease and connectivity provided by the Internet of Things, the security issues and attacks faced by this technological framework are equally alarming and undeniable. In order to address these various security issues, researchers race against evolving technology, trends and attacker expertise. Though much work has been carried out on network security to date, it is still seen to be lagging in the field of Internet of Things networks. This study surveys the latest trends used in security measures for threat detection, primarily focusing on the machine learning and deep learning techniques applied to Internet of Things datasets. It aims to provide an overview of the IoT datasets available today, trends in machine learning and deep learning usage, and the efficiencies of these algorithms on a variety of relevant datasets. The results of this comprehensive survey can serve as a guide and resource for identifying the various datasets, experiments carried out and future research directions in this field.

BFT-IoMT: A Blockchain-Based Trust Mechanism to Mitigate Sybil Attack Using Fuzzy Logic in the Internet of Medical Things

Numerous sensitive applications, such as healthcare and medical services, need reliable transmission as a prerequisite for the success of the new age of communications technology. Unfortunately, these systems are highly vulnerable to attacks like Sybil, where many false nodes are created and spread with deceitful intentions. Therefore, these false nodes must be instantly identified and isolated from the network due to security concerns and the sensitivity of data utilized in healthcare applications. Especially for life-threatening diseases like COVID-19, it is crucial to have devices connected to the Internet of Medical Things (IoMT) that can be believed to respond with high reliability and accuracy. Thus, trust-based security offers a safe environment for IoMT applications. This study proposes a blockchain-based fuzzy trust management framework (BFT-IoMT) to detect and isolate Sybil nodes in IoMT networks. The results demonstrate that the proposed BFT-IoMT framework is 25.43% and 12.64%, 12.54% and 6.65%, 37.85% and 19.08%, 17.40% and 8.72%, and 13.04% and 5.05% more efficient and effective in terms of energy consumption, attack detection, trust computation reliability, packet delivery ratio, and throughput, respectively, as compared to the other state-of-the-art frameworks available in the literature.

Security Risks and User Perception towards Adopting Wearable Internet of Medical Things

The Wearable Internet of Medical Things (WIoMT) is a collective term for all wearable medical devices connected to the internet to facilitate the collection and sharing of health data such as blood pressure, heart rate, oxygen level, and more. Standard wearable devices include smartwatches and fitness bands. This evolving phenomenon due to the IoT has become prevalent in managing health and poses severe security and privacy risks to personal information. For better implementation, performance, adoption, and secured wearable medical devices, observing users' perception is crucial. This study examined users' perspectives of trust in the WIoMT while also exploring the associated security risks. Data analysed from 189 participants indicated a significant variance (R² = 0.553) on intention to use WIoMT devices, which was determined by the significant predictors (95% Confidence Interval; p < 0.05) perceived usefulness, perceived ease of use, and perceived security and privacy. These were found to have important consequences, with WIoMT users intending to use the devices based on the trust factors of usefulness, easy to use, and security and privacy features. Further outcomes of the study identified how users' security matters while adopting the WIoMT and provided implications for the healthcare industry to ensure regulated devices that secure confidential data.

Fog-cloud architecture-driven Internet of Medical Things framework for healthcare monitoring

The new coronavirus disease (COVID-19) has increased the need for new technologies such as the Internet of Medical Things (IoMT), Wireless Body Area Networks (WBANs), and cloud computing in the health sector as well as in many areas. These technologies have also made it possible for billions of devices to connect to the internet and communicate with each other. In this study, an Internet of Medical Things (IoMT) framework consisting of Wireless Body Area Networks (WBANs) has been designed and the health big data from WBANs have been analyzed using fog and cloud computing technologies. Fog computing is used for fast and easy analysis, and cloud computing is used for time-consuming and complex analysis. The proposed IoMT framework is presented with a diabetes prediction scenario. The diabetes prediction process is carried out on fog with fuzzy logic decision-making and is achieved on cloud with support vector machine (SVM), random forest (RF), and artificial neural network (ANN) as machine learning algorithms. The dataset produced in WBANs is used for big data analysis in the scenario for both fuzzy logic and machine learning algorithm. The fuzzy logic gives 64% accuracy performance in fog and SVM, RF, and ANN have 89.5%, 88.4%, and 87.2% accuracy performance respectively in the cloud for diabetes prediction. In addition, the throughput and delay results of heterogeneous nodes with different priorities in the WBAN scenario created using the IEEE 802.15.6 standard and AODV routing protocol have been also analyzed. Fog-Cloud architecture-driven for IoMT networks • An IoMT framework is designed with important components and functions such as fog and cloud node capabilities. •Real-time data has been obtained from WBANs in Riverbed Modeler for a more realistic performance analysis of IoMT. •Fuzzy logic and machine learning algorithms (RF, SVM, and ANN) are used for diabetes predictions. •Intra and Inter-WBAN communications (IEEE 802.15.6 standard) are modeled as essential components of the IoMT framework with all functions.

Cybersecurity Risk Management Framework for Blockchain Identity Management Systems in Health IoT

Blockchain (BC) has recently paved the way for developing Decentralized Identity Management (IdM) systems for different information systems. Researchers widely use it to develop decentralized IdM systems for the Health Internet of Things (HIoT). HIoT is considered a vulnerable system that produces and processes sensitive data. BC-based IdM systems have the potential to be more secure and privacy-aware than centralized IdM systems. However, many studies have shown potential security risks to using BC. A Systematic Literature Review (SLR) conducted by the authors on BC-based IdM systems in HIoT systems showed a lack of comprehensive security and risk management frameworks for BC-based IdM systems in HIoT. Conducting a further SLR focusing on risk management and supplemented by Grey Literature (GL), in this paper, a security taxonomy, security framework, and cybersecurity risk management framework for the HIoT BC-IdM systems are identified and proposed. The cybersecurity risk management framework will significantly assist developers, researchers, and organizations in developing a secure BC-based IdM to ensure HIoT users' data privacy and security.

Bioelectrical Impedance Spectroscopy for Monitoring Mammalian Cells and Tissues under Different Frequency Domains: A Review

Bioelectrical impedance analysis and bioelectrical impedance spectroscopy (BIA/BIS) of tissues reveal important information on molecular composition and physical structure that is useful in diagnostics and prognostics. The heterogeneity in structural elements of cells, tissues, organs, and the whole human body, the variability in molecular composition arising from the dynamics of biochemical reactions, and the contributions of inherently electroresponsive components, such as ions, proteins, and polarized membranes, have rendered bioimpedance challenging to interpret but also a powerful evaluation and monitoring technique in biomedicine. BIA/BIS has thus become the basis for a wide range of diagnostic and monitoring systems such as plethysmography and tomography. The use of BIA/BIS arises from (i) being a noninvasive and safe measurement modality, (ii) its ease of miniaturization, and (iii) multiple technological formats for its biomedical implementation. Considering the dependency of the absolute and relative values of impedance on frequency, and the uniqueness of the origins of the α-, β-, δ-, and γ-dispersions, this targeted review discusses biological events and underlying principles that are employed to analyze the impedance data based on the frequency range. The emergence of BIA/BIS in wearable devices and its relevance to the Internet of Medical Things (IoMT) are introduced and discussed.

An Effective Self-Configurable Ransomware Prevention Technique for IoMT

Remote healthcare systems and applications are being enabled via the Internet of Medical Things (IoMT), which is an automated system that facilitates the critical and emergency healthcare services in urban areas, in addition to, bridges the isolated rural communities for various healthcare services. Researchers and developers are, to date, considering the majority of the technological aspects and critical issues around the IoMT, e.g., security vulnerabilities and other cybercrimes. One of such major challenges IoMT has to face is widespread ransomware attacks; a malicious malware that encrypts the patients' critical data, restricts access to IoMT devices or entirely disable IoMT devices, or uses several combinations to compromise the overall system functionality, mainly for ransom. These ransomware attacks would have several devastating consequences, such as loss of life-threatening data and system functionality, ceasing emergency and life-saving services, wastage of several vital resources etc. This paper presents a ransomware analysis and identification architecture with the objective to detect and validate the ransomware attacks and to evaluate its accuracy using a comprehensive verification process. We first develop a comprehensive experimental environment, to simulate a real-time IoMT network, for experimenting various types of ransomware attacks. Following, we construct a comprehensive set of ransomware attacks and analyze their effects over an IoMT network devices. Furthermore, we develop an effective detection filter for detecting various ransomware attacks (e.g., static and dynamic attacks) and evaluate the degree of damages caused to the IoMT network devices. In addition, we develop a defense system to block the ransomware attacks and notify the backend control system. To evaluate the effectiveness of the proposed framework, we experimented our architecture with 194 various samples of malware and 46 variants, with a duration of sixty minutes for each sample, and thoroughly examined the network traffic data for malicious behaviors. The evaluation results show more than 95% of accuracy of detecting various ransomware attacks.

Authentication in the Internet of Medical Things: Taxonomy, Review, and Open Issues

The Internet of Medical Things (IoMT) has revolutionized the world of healthcare by remotely connecting patients to healthcare providers through medical devices connected over the Internet. IoMT devices collect patients’ medical data and share them with healthcare providers, who analyze it for early control of diseases. The security of patients’ data is of prime importance in IoMT. Authentication of users and devices is the first layer of security in IoMT. However, because of diverse and resource-constrained devices, authentication in IoMT is a challenging task. Several authentication schemes for IoMT have been proposed in the literature. However, each of them has its own pros and cons. To identify, evaluate and summarize the current literature on authentication in IoMT, we conducted a systematic review of 118 articles published between 2016 and 2021. We also established a taxonomy of authentication schemes in IoMT from seven different perspectives. We observed that most of the authentication schemes use a distributed architecture and public key infrastructure. It was also observed that hybrid cryptography approaches have become popular to overcome the shortcomings of single cryptographic approaches. Authentication schemes in IoMT need to support end-to-end, cross-layer, and cross-domain authentication. Finally, we discuss some open issues and future directions.

Implementation of Combined Machine Learning with the Big Data Model in IoMT Systems for the Prediction of Network Resource Consumption and Improving the Data Delivery

In recent years, health applications based on the internet of medical things have exploded in popularity in smart cities (IoMT). Many real-time systems help both patients and professionals by allowing remote data access and appropriate responses. The major research problems include making timely medical judgments and efficiently managing massive data utilising IoT-based resources. Furthermore, in many proposed solutions, the dispersed nature of data processing openly raises the risk of information leakage and compromises network integrity. Medical sensors are burdened by such solutions, which reduce the stability of real-time transmission systems. As a result, this study provides a machine-learning approach with SDN-enabled security to forecast network resource usage and enhance sensor data delivery. With a low administration cost, the software define network (SDN) design allows the network to resist dangers among installed sensors. It provides an unsupervised machine learning approach that reduces IoT network communication overheads and uses dynamic measurements to anticipate link status and refines its tactics utilising SDN architecture. Finally, the SDN controller employs a security mechanism to efficiently regulate the consumption of IoT nodes while also protecting them against unidentified events. When the number of nodes and data production rate varies, the suggested approach enhances network speed. As a result, to organise the nodes in a cluster, the suggested model uses an iterative centroid technique. By balancing network demand via durable connections, the multihop transmission technique for routing IoT data improves speed while simultaneously lowering the energy hole problem.

A survey on COVID-19 impact in the healthcare domain: worldwide market implementation, applications, security and privacy issues, challenges and future prospects

Extensive research has been conducted on healthcare technology and service advancements during the last decade. The Internet of Medical Things (IoMT) has demonstrated the ability to connect various medical apparatus, sensors, and healthcare specialists to ensure the best medical treatment in a distant location. Patient safety has improved, healthcare prices have decreased dramatically, healthcare services have become more approachable, and the operational efficiency of the healthcare industry has increased. This research paper offers a recent review of current and future healthcare applications, security, market trends, and IoMT-based technology implementation. This research paper analyses the advancement of IoMT implementation in addressing various healthcare concerns from the perspectives of enabling technologies, healthcare applications, and services. The potential obstacles and issues of the IoMT system are also discussed. Finally, the survey includes a comprehensive overview of different disciplines of IoMT to empower future researchers who are eager to work on and make advances in the field to obtain a better understanding of the domain.

An Overview of Medical Electronic Hardware Security and Emerging Solutions

Electronic healthcare technology is widespread around the world and creates massive potential to improve clinical outcomes and transform care delivery. However, there are increasing concerns with respect to the cyber vulnerabilities of medical tools, malicious medical errors, and security attacks on healthcare data and devices. Increased connectivity to existing computer networks has exposed the medical devices/systems and their communicating data to new cybersecurity vulnerabilities. Adversaries leverage the state-of-the-art technologies, in particular artificial intelligence and computer vision-based techniques, in order to launch stronger and more detrimental attacks on the medical targets. The medical domain is an attractive area for cybercrimes for two fundamental reasons: (a) it is rich resource of valuable and sensitive data; and (b) its protection and defensive mechanisms are weak and ineffective. The attacks aim to steal health information from the patients, manipulate the medical information and queries, maliciously change the medical diagnosis, decisions, and prescriptions, etc. A successful attack in the medical domain causes serious damage to the patient’s health and even death. Therefore, cybersecurity is critical to patient safety and every aspect of the medical domain, while it has not been studied sufficiently. To tackle this problem, new human- and computer-based countermeasures are researched and proposed for medical attacks using the most effective software and hardware technologies, such as artificial intelligence and computer vision. This review provides insights to the novel and existing solutions in the literature that mitigate cyber risks, errors, damage, and threats in the medical domain. We have performed a scoping review analyzing the four major elements in this area (in order from a medical perspective): (1) medical errors; (2) security weaknesses of medical devices at software- and hardware-level; (3) artificial intelligence and/or computer vision in medical applications; and (4) cyber attacks and defenses in the medical domain. Meanwhile, artificial intelligence and computer vision are key topics in this review and their usage in all these four elements are discussed. The review outcome delivers the solutions through building and evaluating the connections among these elements in order to serve as a beneficial guideline for medical electronic hardware security.

Visual management of medical things with an advanced color-change RFID tag

This paper proposes a visual management scheme of medical things with a color-change radio frequency identification (RFID) tag. The color-change RFID tag employs a specific RFID tag integrated circuit (IC) and a laminated pH-indicating paper. The IC has energy harvesting and switched ground functions, which enable it to generate electricity to the laminated pH-indicating paper. This phenomenon causes electrolysis of NaCl solution absorbed in the laminated pH-indicating paper. Electrolysis generates alkaline matter to change the color of the pH-indicating paper. This paper gives a new and sensitive structure of the laminated pH-indicating paper. The proposed advanced color-change RFID tag with new laminated pH-indicating paper succeeds in changing its color noticeably at a 1 m distance using an RFID reader radiating 1 W radio waves. The color change was observed 3-5 s after starting radio wave irradiation. The results of this experiment also confirm that the changed color can be held for over 24 h. Furthermore, two demonstrations of the visual management system of medical things (patient clothes and sanitizers) are presented.

Challenges of Malware Detection in the IoT and a Review of Artificial Immune System Approaches

The fast growth of the Internet of Things (IoT) and its diverse applications increase the risk of cyberattacks, one type of which is malware attacks. Due to the IoT devices’ different capabilities and the dynamic and ever-evolving environment, applying complex security measures is challenging, and applying only basic security standards is risky. Artificial Immune Systems (AIS) are intrusion-detecting algorithms inspired by the human body’s adaptive immune system techniques. Most of these algorithms imitate the human’s body B-cell and T-cell defensive mechanisms. They are lightweight, adaptive, and able to detect malware attacks without prior knowledge. In this work, we review the recent advances in employing AIS for the improved detection of malware in IoT networks. We present a critical analysis that highlights the limitations of the state-of-the-art in AIS research and offer insights into promising new research directions.

Recent Technologies, Security Countermeasure and Ongoing Challenges of Industrial Internet of Things (IIoT): A Survey

The inherent complexities of Industrial Internet of Things (IIoT) architecture make its security and privacy issues becoming critically challenging. Numerous surveys have been published to review IoT security issues and challenges. The studies gave a general overview of IIoT security threats or a detailed analysis that explicitly focuses on specific technologies. However, recent studies fail to analyze the gap between security requirements of these technologies and their deployed countermeasure in the industry recently. Whether recent industry countermeasure is still adequate to address the security challenges of IIoT environment are questionable. This article presents a comprehensive survey of IIoT security and provides insight into today’s industry countermeasure, current research proposals and ongoing challenges. We classify IIoT technologies into the four-layer security architecture, examine the deployed countermeasure based on CIA+ security requirements, report the deficiencies of today’s countermeasure, and highlight the remaining open issues and challenges. As no single solution can fix the entire IIoT ecosystem, IIoT security architecture with a higher abstraction level using the bottom-up approach is needed. Moving towards a data-centric approach that assures data protection whenever and wherever it goes could potentially solve the challenges of industry deployment.

An Intrusion Detection Mechanism for Secured IoMT framework based on Swarm-Neural Network

The seamless integration of medical sensors and the Internet of Things (IoT) in smart healthcare has leveraged an intelligent Internet of Medical Things (IoMT) framework to detect the criticality of the patients. However, due to the limited storage capacity and computation power of the local IoT devices, patient's health data needs to transfer to remote computing devices for analysis, which can easily result in privacy leakage due to lack of control over the patient's health data and the vulnerability of the network for various types of attacks. Motivated by this, in this paper, an Empirical Intelligent Agent (EIA) based on a unique Swarm-Neural Network (Swarm-NN) method is proposed to identify attackers in the edge-centric IoMT framework. The major outcome of the proposed strategy is to identify the attacks during data transmission through a network and analyze the health data efficiently at the edge of the network with higher accuracy. The proposed Swarm-NN strategy is evaluated with a real-time secured dataset, namely the ToN-IoT dataset that collected Telemetry, Operating systems, and Network data for IoT application and compares the performance over the standard classification models using various performance metrics. The test results demonstrate that the proposed Swarm-NN strategy achieves 99.5% accuracy over the ToN-IoT dataset.

A Scoping Review of Pressure Measurements in Prosthetic Sockets of Transfemoral Amputees during Ambulation: Key Considerations for Sensor Design

Sensor systems to measure pressure at the stump–socket interface of transfemoral amputees are receiving increasing attention as they allow monitoring to evaluate patient comfort and socket fit. However, transfemoral amputees have many unique characteristics, and it is unclear whether existing research on sensor systems take these sufficiently into account or if it is conducted in ways likely to lead to substantial breakthroughs. This investigation addresses these concerns through a scoping review to profile research regarding sensors in transfemoral sockets with the aim of advancing and improving prosthetic socket design, comfort and fit for transfemoral amputees. Publications found from searching four scientific databases were screened, and 17 papers were found relating to the aim of this review. After quality assessment, 12 articles were finally selected for analysis. Three main contributions are provided: a de facto methodology for experimental studies on the implications of intra-socket pressure sensor use for transfemoral amputees; the suggestion that associated sensor design breakthroughs would be more likely if pressure sensors were developed in close combination with other types of sensors and in closer cooperation with those in possession of an in-depth domain knowledge in prosthetics; and that this research would be facilitated by increased interdisciplinary cooperation and open research data generation.

Advances in triboelectric nanogenerators for biomedical sensing

Biomedical sensors have been essential in improving healthcare outcomes over the past 30 years, though limited power source access and user wearability restraints have prevented them from taking a constant and active biomedical sensing role in our daily lives. Triboelectric nanogenerators (TENGs) have demonstrated exceptional capabilities and versatility in delivering self-powered and wear-optimized biomedical sensors, and are paving the way for a novel platform technology able to fully integrate into the developing 5G/Internet-of-Things ecosystem. This novel paradigm of TENG-based biomedical sensors aspires to provide ubiquitous and omnipresent real-time biomedical sensing for us all. In this review, we cover the remarkable developments in TENG-based biomedical sensing which have arisen in the last octennium, focusing on both in-body and on-body biomedical sensing solutions. We begin by covering TENG as biomedical sensors in the most relevant, mortality-associated clinical fields of pneumology and cardiology, as well as other organ-related biomedical sensing abilities including ambulation. We also include an overview of ambient biomedical sensing as a field of growing interest in occupational health monitoring. Finally, we explore TENGs as power sources for third party biomedical sensors in a number of fields, and conclude our review by focusing on the future perspectives of TENG biomedical sensors, highlighting key areas of attention to fully translate TENG-based biomedical sensors into clinically and commercially viable digital and wireless consumer and health products.