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Cyber Security threats and mitigations in the Healthcare Sector with emphasis
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 1

Cyber Security threats and mitigations in the

Healthcare Sector

D.G.B.M.H.K Basnayaka
IT20206482
AIA – IE3022
Assignment 01
3rd year 1st semester
It20206482@my.sliit.lk

The abstract— the healthcare sector is the most often targeted
industry by hackers. In this review paper, we discuss various
threats, vulnerabilities of the e-health care sector, and threats and
vulnerabilities in iot used in the healthcare industry. And as
security measures and cryptographic countermeasures to mitigate
these threats and vulnerabilities in the e-healthcare environment.
Keywords—cyber security, threats in healthcare, phishing, IoT
security
1. INTRODUCTION
IoT is a bunch of physical devices that include sensors,
indicators, processing power, software, and many more
technologies interconnected via the Internet. Then it can work
as intelligent objects. For example, ECG machines, blood
sugar monitoring, heart rate capturing, AID ( automatic insulin
delivery machines ), etc. These smart devices can work more
efficiently than analog devices and human power. And this
cost-effective solution.[1]
More data breaches and cybercrimes are reported every year
in the healthcare sector. From 2009 to 2021, there have been
4419 data breaches in the healthcare sector reported to HHS –
Health and human services of the united states of America[2].
The Healthcare sector was the most cyber-attacked industry in
2015 [3].
Fig 1 shows the average data breach size from 2009 to 2021
The IoT depends largely on wireless connections &
communications to offer links for intelligent objects. Wireless
connections are required due to their flexibility needs.
However, its openness renders wireless connections subject to
numerous security dangers, eavesdropping, or other hazards.[1]
Throughout the last ten years, many data security events have
highlighted the rising threat confronting all sectors linked to
cyberspace (IoT) via communication networks.
While IoT information from brilliant articles and sensors
capturing wellness related information can be acquired and
examined determined to boost our regular day to day
existences, interchanges among smart gadgets might disclose
private data about patients. Assuming a patient wears an
intelligent sensor that addresses one more device in a
particular area, the connection between these two devices may
likewise be used for unsuitable objectives, similar to
monitoring the patient's versatility. Even though medical
services professionals, such as specialists, attendants,
paramedics, and so forth, are trusted and accepted to access
and distribute patients' data as intended, there is usually a
gamble that the data may turn out to be gotten to unapproved
people. For instance, whilst continual patient monitoring
indicates when the pulse is better than predicted or when the
patient may withstand a coronary event, such information
could also be recorded and discover other facts that could
make the patient feel uneasy or undermined. The IoT creates
distinctive substantial threats, with such uncountable devices
becoming coordinated. In essential locations, for example,
medical care, more frameworks are getting linked and
dazzling. The hazards in IoT-based fundamental frameworks
are growing increasingly substantial, and any disturbance or
defilement might bring up costly damage or deadly challenges.
[1]

IT20206482 – Basnayaka D.G.B.M.H.K


Fig 1.[2]
2. WHY TARGET HEALTHCARE? & THREATS
90% of healthcare sector institutes have been hacked in the
world.[4] Additionally, the consequence of poor security is
growing. At the 2018 RSA Conference in the United States of
America, hackers "killed" (simulation model) patients without
physicians realizing the operating room had already been
hijacked.[5]There is a significant rise in 30-day mortality rates
as a consequence of ambulance delays owing to rerouting
around the marathon.[6] Suppose individuals died as a result
of a 4.5-minute average gain in the duration of the ambulance
journey. In that case, it is reasonable to assume that people
died as a result of the big hospital ransomware-caused
downtime in the United Kingdom.[7] other hospital assaults,
such as the one at Hollywood Presbyterian Hospital, when
ambulances were diverted to other hospitals due to heavy
traffic or similar incidents at other hospitals[8]. Why target
healthcare?
• They were gathering patient information because there
worth a lot of money. Then hackers can misuse them. [9]
Hospitals keep a lot of patient data. Hackers are increasingly
targeting the business because of its valuable confidential data.
These businesses must safeguard patient data. With GDPR
going into effect this year, hospitals must keep their data safe.
Figure 2 [10]
2
Payment for data recovery from ransomware or charges for
non-compliance with GDPR is a serious and worrisome
thought for a healthcare business struggling to fund everyday
job needs. Data security solutions such as multifactor
authentication are proving cheaper than ransomware assaults.
When a user logs in, MFA produces an OTP - one-time
passcode using many pieces of information. This makes
stealing credentials and other data much more difficult. Check
figure 2.
• Medical IoT devices are an accessible endpoint for
hackers
Nowadays, medical technology improvements have few
drawbacks. X-rays, insulin pumps, and heart monitors are
modern medical equipment. These new gadgets provide
additional attack vectors regarding internet security and
patient information protection. It is not uncommon for
healthcare gadgets to be used for just one function. They aren't
built for safety. While the devices may not contain the desired
patient data, they may be utilized to attack a server. In the
worst instance, attackers may entirely control medical
equipment, stopping healthcare providers from giving
essential life-saving therapy. Hackers know that healthcare
gadgets do not save patient data. Unsecure equipment like
laptops and PCs are seen as simple targets by hackers. Medical
device threats may pose issues for healthcare organizations by
allowing the attacker to take other network components or
execute ransomware. Keeping network components secure
helps reduce the harm caused by medical device attacks.[11]
• Employees access databases remotely – more opportunity
for hackers
Collaboration is crucial to providing the perfect option for
each patient in the healthcare business. Those that need to
access data aren't constantly at their desks but instead using
several devices. Remote server access to new devices is
problematic since not all devices are secure. Also, health
workers aren't always trained in cybersecurity. Infected
devices mustn't get network connectivity since one infected
device might expose an entire company. RBA - risk-based
authentication is one solution for organizations with mobile
workers. This technology simplifies risk assessment by
helping IT employees create rules that assess a product's risk
depending on characteristics like the user, location, and more.
Abnormal behaviour is notified to avoid exposing important
patient information to hazardous equipment. [11]
• Lack of information security knowledge
Medical experts are educated to cope with many situations,
but not cyber dangers. Due to budget, assets, and time
limitations, all health professionals cannot be proficient in
cybersecurity best practices. Solutions for cyber security must
be complicated yet easy to use. Health care workers need a
security system that is simple to use. They need the assurance
 3

that patient records are secure so they may concentrate on

their work. Technologies like MFA - multifactor
authentication and SSO - single sign-on are gaining popularity
since users only need to know their personal login
information. [11]

• Using outdated technologies

Despite remarkable developments in medical technologies, not

all aspects of healthcare have caught up. Budget constraints
and a reluctance to learn new techniques mean that much
medical equipment is obsolete. Hospitals utilizing systems that
still provide updates should maintain all software up to
date. These generally comprise security patches and bug
fixes. But programs will ultimately reach end-of-life, and
suppliers will cease updating. Where it is not feasible to
update to more secure software – or even where healthcare
experts do not want the trouble – further layers of protection
may reduce the danger of intrusions. If one system is hacked,
and Authentication solution such as multifactor Figure 3. security incidents 2016
authentication may prevent a hacker from logging into other
protected environments. Healthcare organizations must According to the Information Commissioner's Office, data
respond quickly to new cyber risks to protect patient data. leaks in the healthcare sector increased by two between 2013
Budgeting and investing in the correct solution for your and 2014. One hundred eighty-three data breaches were
business are critical. Keep up with emerging dangers because disclosed to the information security agency in the first half of
you fight to safeguard all your equipment once your systems 2014, compared to 91 violations at the same time in 2013.
become obsolete. [11] between October 2014 and September 2015, there was a rise
in the number of security incidents in the healthcare sector.
The proliferation of Web-based healthcare apps has resulted in Since last quarter, there has been a 44% increase in data
various hazards to the confidentiality and security of security incidents in the healthcare industry ( from 193 in Q1
patient health information. Malicious programs and illegal to 278 in Q2 2015 ). The magnitude of this rise is in line with
activities constitute a significant danger to the protection of the general increase in security incidents involving sensitive
EPHI - Electronic Patient Healthcare Information[12], data. As a result, the health industry's share of total cases has
particularly those intended to commit medical identity fraud not changed from the past quarter. [13]
and healthcare fraud. The development of mobile devices,
such as cellphones, has created an atmosphere where patients'
wireless conversations and emails from healthcare
professionals may be monitored, further complicating matters.
The absence of adequate rules and security protocols by
healthcare service providers creates a security risk regarding
the availability of patient data, which may include genuine
diagnostic and treatment details and other confidential
material. Such issues might significantly influence patients'
well-being and the correct administration of their medications
and treatments. The N3 NHS network comprises twelve large
data centres that offer local and national services and two
other data centres that provide identification and access
monitoring for the network's users. The web is meant to
maintain data security and integrity via authenticated user
connectivity to the N3 network and is available through
network redundancy. Several physical and organizational
security measures have been implemented to reduce
intercepting data. These measures include establishing policies
and regulations to regulate user behaviour. [10] Figure 3. healthcare sector data breaches over time 2016
 4

3. HEALTHCARE IOT SECURITY may be complex; therefore, having a comprehensive grasp of

Online healthcare apps linked to hospital systems allow for the the underlying architecture. Figure 1 depicts the Internet of
exchange of patient-specific data and medical info regardless Things' linked networks and levels. Consider how each
of where a patient is located. Patient-worn sensors collect and property provides a possible vulnerability and entrance points
transmit data about their vital signs, such as their body into the network. This might be the 'object' that interacts with
thermometer and heart rate, to the medical systems at the users via input (for example, software collecting healthcare
facility where they are being treated. Weak authentication sector related information) or a sensor that collects data about
techniques, such as those found in embedded web servers a physical environment.[14]
across the hospital might be exploited by an attacker to access
critical systems. As a result, the attacker may be able to Table 1. IoT ecosystem and vulnerabilities of each layer [15]
disable health systems, obtain access to confidential patient
data, and pass past sensors to target specific patients. The Layer Threat and vulnerability
implications of a security breach might spiral out of control Acquisition • Endpoint attack
and even end in the patient's death if a hacked sensor is • Eavesdropping attack
attached to the patient. There is a logical implication here that • Jamming
these gadgets need to be protected. Hospitals may use the data • Tampering (physically damage )
collected by IoT sensing devices to help their patients as part • Authenticity
of their healthcare monitoring and data analysis. The sensors • Device common vulnerabilities (
themselves are intended to gather data continually. New operating system vulnerabilities,
vulnerabilities may arise due to integrating IoT-based medical malware, weak encryption )
infrastructure with conventional IT systems and operations.
Many security issues will appear due to the IoT's undefined Network • Data interruption
range of capabilities. IoT smartness is challenging to define, • Dos and DDoS
and it's not clear whether the existing Internet of things ( IoT • Eavesdropping
) is smart enough to be considered a clever technology. A • Jamming
security viewpoint points out the difficulty of implementing • Tampering
good security without identifying what functions the system • Misconfiguration
might have or whether or not the procedure may be changed • Rogue access points
on-the-fly. The main fear is that current IT security policies
may not be enough to deal with future IoT security threats. integration • Data interruption
The IoT's decentralized approach, which necessitates patient
• MITM – man in the middle attacks
engagement with several devices and involvement in the
healthcare process, is seen as a potentially unmanageable • Spoofing
danger. Human behaviour and a fully automated real-time • Relay attacks
system appear to interact in ways that are hard to predict. [14] • Lack of encryption

Analytics • Lack of encryption

• MITM – man in the middle attacks
Software • XSS – cross-site scripting
• Data corruption
• Data loss
• Dos and DDoS
• SQL injections
• Lack of authentication
• Lack of encryption
• Buffer overflow
• Remote code execution
• Phishing
• Heap overflow

Device-specific vulnerabilities have been documented in the

Figure 4. network interconnection with IoT devices.
Intelligent technologies, powered by the Internet of Things
(IoT) and AI - artificial intelligence, will revolutionize
healthcare in the following years. Despite the many benefits of
this integration, the numerous underlying security risks still
have to be addressed. Data security in the Internet of Things
relevant literature. However, they are often neglected by
security researchers. In a similar vein, the rising usage of
standard Wi-Fi and router credentials and the use of weak
passwords is a significant concern. Weak or hardcoded
passwords are the most common IoT device vulnerability,
according to OWASP [7] research. Users often neglect to
modify credentials on Internet of Things devices or do not

adhere to best practices for creating strong and secure
passwords. Even while the Internet of Things (IoT) offers
socio-economic progress and health-related well-being, the
security concerns are just as substantial as the advantages. [16]
4. SECURITY VULNERABILITIES IN THE HEALTHCARE
INDUSTRY
Healthcare apps are extremely vital services. Healthcare data
are more significant and complicated to be safe than other
information and applications since it has to be well guarded
[17] Numerous hazards may challenge the medical apps,
which vary in their sources and range. Most of these security
concerns are mentioned in the study. These security dangers
include eavesdropping attacks, impersonation, message
alteration, and Man-in-the-middle attacks.
A. Eavesdropping
Eavesdropping occurs when hackers monitor network
communication moving via pcs, servers, routers,
switches, portable devices, and IoT IoT
devices. Eavesdropping can be named AKA network sniffing.
This happens when hostile actors use insecure or susceptible
connections to access or illegal access as it flows among two
or more devices. Eavesdropping is especially prevalent in
wireless technology. this is a type of MITM - man in the
middle attack
B. Impersonation attacks
This type of phishing and impersonation attack is an actual
fraud when an intruder acts as a legitimate individual to extort
stuff or confidential material from an organization. Typically,
these sorts of assaults originate from people targeting high-
level persons such as CEOs, directors etc. The purpose of
these criminal characters is to deposit the money into a bogus
account, disclose confidential material, or divulge login details
to breach an organization's network.
C. MITM – Man in the middle attacks
A man-in-the-middle assault is a form of eavesdropping when
attackers disrupt an existing communication or data
transmission. After placing themself in the "between" of the
message, the attackers appear to be both legal parties, as
shown in figure 6. This allows the attacker to intercept data
and information from either side while simultaneously
providing malicious sites or other details to both legit parties
in a manner that may not be discovered when it is too late.
You might think of this form of assault as comparable to the
game of telephone, where one person's remarks are passed
from participation to participant until it has altered by the time
they hit the last person. In a man-in-the-middle assault, the
middle person tries to manipulate the communication
unbeknownst to either of the two genuine parties, acting to
obtain personal data and otherwise do harm. [18]
5
Figure 6. MITM
D. Jamming
Jamming is an assault in which a hacker purposely sends radio
interference on a wireless connection. Consequently, it
reduces the frequency ratio at the recipient side and disturbs
current wireless connectivity.
E. Spoofing
Spoofing is a general word for the activity that includes a
cybercriminal posing as a trustworthy organization or device
to persuade you to perform something valuable to the attacker
— and harmful to you. Any moment an online fraudster
camouflages their identities as something other than, it's
spoofing.
Spoofing may become applicable to many communication
channels and require varying technological sophistication.
Spoofing assaults frequently incorporate a component of
social engineering when fraudsters psychologically mislead
potential targets by playing on human failings, including
anxiety, greed, or lack of technological understanding. [19]
F. XSS – Cross-site scripting
XSS - Cross-Site Scripting assaults are a sort of injections
during which harmful programs are inserted into otherwise
innocent and trustworthy websites. Cross-site scripting
happens when a hacker uses an online application to deliver a
malicious script to a separate end user, often in a client-based
program. Flaws that enable these operations to succeed are
ubiquitous and occur whenever a web application takes input
from the user inside the output it creates without verifying or
encrypting it.
An attacker may use XSS to transmit a malicious program to
an unwary user. The end consumer browser seems to have no
way to acknowledge that now the program should never be
believed and will run the script. Because it believes the script
originated from a trustworthy source, the malicious program
may acquire the session cookies, authentication information,

or other confidential material kept by the browser and utilized
with that site. These programs may even change the text of the
Webpage. [20]
Figure 5. how XSS working
G. Buffer overflow
Hackers can exploit buffer overflow flaws by overwriting a
program's buffer (memory). This modifies the execution route
of the application, prompting a reaction that destroys data or
exposes confidential information. For example, an intruder
may insert more code, delivering new instructions to the
program to obtain access to The target system.
Suppose intruders know the ram structure of a programme.
They may purposefully feed information that the buffers
cannot contain and overwrite sections that house executable
files, changing it with their script. For instance, a hacker may
rewrite a pointer (an item that refers to another location in
memory) and direct this to exploit payloads to take control
over the system. [21]
H. DOS & DDOS
DDOS - distributed denial of service & DOS - denial of
service attack is a destructive effort to interrupt the regular
traffic of a specific server, service or system by overloading
the victim or its surrounding territory with a torrent of Internet
traffic.
DDoS assaults acquire efficacy by employing numerous
hacked computer networks as a source of malicious traffic.
Exploited machines may include pcs and other connected
assets, including IoT devices. [22]
I. Relay attacks
A relay attack in information security is a sort of hacking
method related to MITM - man in middle attack and replay
attacks. In a traditional man-in-the-middle assault, an intruder
intercepts and tries to manipulate communication systems
between two parties started by one of the participants [23]
6
Figure 6. How relay attacks work. Example of vehicle theft
5. LITERATURE REVIEW
Due to the rapid advancement of technology, several studies
have highlighted the difficulties. Also, to provide answers and
techniques to these problems. Since technology has permeated
many facets of existence, many studies are recommended to
ensure data security and privacy in IoT applications, notably
in healthcare applications. [24] Proposed an end-to-end
security approach for the health care Internet of Things (IoT).
As illustrated in Fig. 7, the proposed design includes end-user
authentication and authorization. Then end-to-end encryption.
Finally, an intelligent gateway between sensor and cloud
service. They created hardware and software to emulate their
suggested schema. This study reduces the communication
cost. They also discovered that this model is 97% quicker than
other schemas they tested.
The author of [25] devised a technique to secure current IoT-
based medical systems using body sensor networks. This study
addressed the security concerns body sensor networks systems
posed and developed a solution to address these difficulties.
They reduced the execution time by 42% compared to
previous methods. The authors presented an identification
Figure 7. SEA architecture of e-health
Architecture for safeguarding medical systems [25] Two
security procedures have been suggested. The coexistence

proof schema for multi-tagged items and the identification
schema for IoT-based medical systems. Their schema enabled
robust and secure communication. They used their plan to
assure success. In [26], researchers established an architecture
for centralized data storage that gathered data from several
sensing devices.
This study tries to ensure system security, privacy, and
confidentiality. They employed two cryptography systems.
The combination of attribute-based and functional encryption
approaches.
Proposed framework architecture [26] In [27], a cloud-based
architecture for safe healthcare applications leveraging
Wireless Body Area Networks was developed (WBAN). They
employed a multi-biometric key generation scheme to secure
inter-sensor communication. They also connected the EHR
centrally kept on the health industry cloud. Their approach
developed a secure cloud-based architecture that protected
communication processes and patient data confidentiality and
privacy. [28]
Figure 8. e-health architecture
Proposed a lightweight attribute-based encryption (ABE)
system to secure stored data, device connectivity, and data
exchange in the IoT framework. Traditional (ABE) used to be
a broad IoT schema. They employed a cryptographic
algorithm (ECC) for data privacy and security. They used
matrices to assess their schema's communications and
processing costs. Although the suggested schema has
significant limitations, the results demonstrate that it is
cheaper and faster than the present schema.
6. SECURITY COUNTERMEASURES
Numerous security measures are employed to address security
threats. Several solutions are used to tackle different sorts of
dangers. Some of the alternatives include Cryptography,
Identification and Authorization to safeguard the data held
from various attacks. This document concentrates on
Cryptography algorithms for defending data from different
types of security risks, but not all of the companions were. In
some scenarios, cryptography and authentication technique is
needed for safeguarding data, particularly on the Internet - of -
things structure, as it is a flexible framework.
7
However, conventional cybersecurity controls cannot be used
directly for Internet-of-the-thick kinds of applications, and
they are utilized as a base for newly generated approaches.
Some of the most prevalent symmetric Encryption techniques
will be reviewed in this study. These techniques include DES,
3DES, Bluefish and AES.
A. Data encryption standard – DES
Data Encryption Standard: DES technique was established
in 1977 by IBM. This technique is used to encrypt a stream
fixed-length of bits of plaintext. Then this plaintext is
converted to cypher-text of the identical size. The length of
each block is 64 bits, where 56-bits for the algorithm as key
size and the remaining 8 bits are utilized for the checking
party. This technique is characterized as an extremely slow
cryptographic algorithm. [29]
Figure 9. DES Structure
B. Blowfish
This algorithm was created in 1993. It employs a block
length of 64 bits and a key length of 32 to 448 bits. It was
introduced to replace the DES algorithm optionally. It operates
a changeable key size to be quicker and much more secure.
That is an open-source algorithm that is publicly accessible to
all users. It is claimed to perform faster and more reliable than
DES & 3DES. [30]
C. Triple data encryption – 3DES
In 1998 3DES Standard was launched as an upgrade of DES.
This method performed the DES 3 times. It also employs the
same block size, 64 bits, where 56 bits are for crucial length.
This method is quicker than DES, but it is also believed to be
a sluggish algorithm as it requires executing DES three times.
It is more excellent efficient than DES. [31]

Figure 10. 3DES Diagram
D. Advanced encryption standard – AES
Advanced Encryption Standard: AES basically this is a
symmetric block cypher adopted by the USA government to
safeguard sensitive information. AES - Advanced Encryption
Standard is employed in hardware and software around the
globe to secure critical data. It is crucial to governmental
information security and electronic information protection.
NIST - National Institute of Standards and Technology
initiated research on AES in 1997 when it highlighted a need
for a replacement to a Des - data encryption standard which
was beginning to become susceptible to brute-force
cyberattacks. [32]
Figure 11. Advanced encryption standard – AES
structure.
As Information security is a critical concern in Intelligent
Healthcare, subsequent proactive actions may be implemented
to strengthen the level of security of the Healthcare
Information networks.
A. Deployment of security professionals.
An adequate amount of internet security professionals must be
placed in medical and Intelligent Healthcare systems to
constantly monitor, update and safeguard the linked devices to
a network. This will strive to decrease the It divide in an
Intelligent Healthcare setting. The clinics must be prepared
with expert teams, including adequate incident response
strategies to address problems.[33]
8
B. Inventory maintenance.
The Internet of things ( IoT) must contain inventories of all the
objects linked to the network. Their activities must be
monitored regularly, including that of the bandwidth and
interconnections. A Vulnerability database must be built, and
it must be updated with the newest vulnerability reports
relating to the goods used in the connection.
Related equipment must be upgraded using the necessary
patches supplied by their suppliers. [33]
C. Compliance
The IoT equipment must be tested before deployment to
conform with safety regulations such as ISO/IEC 82304,
ISO/IEC 62304 and other applicable health goods standards
[13]. The devices should be checked for the capacity to
execute security updates. The data collecting and
dissemination must conform with the statutory terms and
restrictions. [33]
E. Secure update
The update should be permitted from approved IPs, and any
communication established with unauthorized IPs must be
viewed as unwanted traffic. Connectivity efforts for security
patches must be performed only via specific ports and must be
permanently closed after the update. Connectivity must be
done solely with allowed listed IPs. [33]
F. Product security
The network must be built as much as possible by employing
devices made by identical manufacturers. The maker must aim
to minimize the usage of 3rd parties products in their
architecture to decrease the danger of supply chain attacks.
The default password of the devices must be modified before
installation into the system. It is usually advisable to deploy
specific application-focused devices in a healthcare context
rather than 3rd party generic IoT devices. [33]
G. Network segmentation
Micro-segmentation may lock the essential devices from every
unauthorized disclosure outside the network. It needs to be
assured that equipment in the network is flexibly connected,
so the malfunction of one appliance may well not influence
the total operation of the network. [33]
H. Data Integrity
The data saved in the storage media should be given access to
only the authenticated person, and all the data should not be
given access to the public. The gadget must acquire just the
necessary details, and it must be verified that it does not
capture any extraneous information [34]. Periodical backup of
information must be established to minimize any
unprecedented assault. [33]

I. Security audit
3rd parties audits must be undertaken frequently on the
system, and the vulnerabilities existing in the networks must
be examined. The new devices must replace ones that cannot
be upgraded with updates. [33]
7. FUTURE RESEARCH
There are so many various kind of researches available for
this topic“ Cyber Security threats and mitigations in the
Healthcare Sector “ e-healthcare sector security very
huge and many more things to study and research.
8. CONCLUSION
Smart Healthcare provides several benefits such as quicker
diagnosis, effective decision-making and active treatment.
Internet security is a fundamental aspect of such networks.
However, most E - healthcare networks are susceptible to
assaults due to various variables. This paper evaluates the
characteristics included in Intelligent Health systems and
computer security problems. The proactive actions that may be
performed to enhance the security of E - healthcare systems
are also addressed. The given proactive strategies may be
utilized as best practice standards for building a secure Smart
Healthcare. This research analyzed numerous forms of
security concerns in the healthcare industry. And it addressed
many of the defensive remedies for such sorts of attacks. In
literature, Cryptography is regarded to become the greatest
essential countermeasure. Also, this publication discussed
several of the top prevalent encryption techniques.
9. REFERENCES
[1] N. S. Abouzakhar, A. Jones, and O. Angelopoulou,
"Internet of Things Security: A Review of Risks and
Threats to Healthcare Sector," in Proceedings - 2017
IEEE International Conference on Internet of Things,
IEEE Green Computing and Communications, IEEE
Cyber, Physical and Social Computing, IEEE Smart
Data, iThings-GreenCom-CPSCom-SmartData 2017,
Jan. 2018, vol. 2018-January, pp. 373–378. doi:
10.1109/iThings-GreenCom-CPSCom-
SmartData.2017.62.
[2] HIPAA Journal, "Healthcare Data Breach Statistics,"
hipaajournal.com.
https://www.hipaajournal.com/healthcare-data-breach-
statistics/ (accessed Mar. 22, 2022).
[3] SecurityWeek News, "Healthcare Was Most Attacked
Industry in 2015: IBM | SecurityWeek.Com,"
securityweek, 2016.
IT20206482 – Basnayaka D.G.B.M.H.K
9
https://www.securityweek.com/healthcare-was-most-
attacked-industry-2015-ibm (accessed Mar. 23, 2022).
[4] E. D. Perakslis, "Cybersecurity in Health Care," New
England Journal of Medicine, vol. 371, no. 5, pp.
395–397, Jul. 2014, doi: 10.1056/NEJMP1404358.
[5] D. Sparrell, "Cyber-Safety in Healthcare IOT," 11th
Academic Conference ITU Kaleidoscope: ICT for
Health: Networks, Standards and Innovation, ITU K
2019, Dec. 2019, doi:
10.23919/ITUK48006.2019.8996148.
[6] A. B. Jena, N. C. Mann, L. N. Wedlund, and A.
Olenski, "Delays in Emergency Care and Mortality
during Major U.S. Marathons," N Engl J Med, vol.
376, no. 15, pp. 1441–1450, Apr. 2017, doi:
10.1056/NEJMSA1614073.
[7] A. Morse, "Investigation: WannaCry cyber attack on
the NHS," UK National Audit Office, vol. 414, no.
April 2018, p. 6, 2017, Accessed: Mar. 25, 2022.
[Online]. Available: https://www.nao.org.uk/wp-
content/uploads/2017/10/Investigation-WannaCry-
cyber-attack-and-the-NHS.pdf
[8] K. Chinthapalli, "The hackers holding hospitals to
ransom."
https://scholar.google.co.uk/citations?view_op=view_
citation&hl=en&user=v8j0Eo4AAAAJ&citation_for_
view=v8j0Eo4AAAAJ:M05iB0D1s5AC (accessed
Mar. 25, 2022).
[9] S. M. Muzammal et al., "Counter measuring
conceivable security threats on smart healthcare
devices," IEEE Access, vol. 6, pp. 20722–20733, Apr.
2018, doi: 10.1109/ACCESS.2018.2826225.
[10] "Healthcare Data Security: How to Protect Patient
Health Information?"
https://www.ekransystem.com/en/blog/healthcare-
data-protection-solutions-monitor-and-audit-your-
software (accessed Mar. 25, 2022).
[11] "9 Reasons Healthcare is the Biggest Target for
Cyberattacks."
https://swivelsecure.com/solutions/healthcare/healthca
re-is-the-biggest-target-for-cyberattacks/ (accessed
Mar. 25, 2022).
[12] “What is electronic protected health information
(ePHI)? - Definition from WhatIs.com.”
https://searchhealthit.techtarget.com/definition/electro
nic-protected-health-information-ePHI (accessed Mar.
28, 2022).
[13] itpro, "data protection | IT PRO."
https://www.itpro.co.uk/data-protection-0 (accessed
Mar. 28, 2022).
[14] IEEE Communications Society, A. H. & S. N. T. C.
IEEE Communications Society. Internet of Things,
IEEE Internet of Things (Initiative), and Institute of
Electrical and Electronics Engineers, GIoTS, Global
IoT Summit : 2020 conference proceedings.
[15] "IoT Ecosystem."
https://www.tutorialandexample.com/iot-ecosystem
(accessed Mar. 29, 2022).
 10

[16] "Preparing to Release the OWASP IoT Top 10 2018 Gaithersburg, MD, 2007. doi: 10.6028/NIST.SP.800-
(Updated: Released) - Daniel Miessler." 45ver2.
https://danielmiessler.com/blog/preparing-to-release- [32] "Advanced Encryption Standard (AES) -
the-owasp-iot-top-10-2018/ (accessed Mar. 29, 2022). GeeksforGeeks."
[17] A. J. Burns, M. E. Johnson, and P. Honeyman, "A https://www.geeksforgeeks.org/advanced-encryption-
brief chronology of medical device security," Commun standard-aes/ (accessed Apr. 05, 2022).
ACM, vol. 59, no. 10, pp. 66–72, Sep. 2016, doi: [33] R. Marshal, K. Gobinath, and V. V. Rao, "Proactive
10.1145/2890488. measures to mitigate cyber security challenges in IoT
[18] "Man in the Middle Attack: Tutorial & Examples | based smart healthcare networks," Apr. 2021. doi:
Veracode." https://www.veracode.com/security/man- 10.1109/IEMTRONICS52119.2021.9422615.
middle-attack (accessed Mar. 29, 2022). [34] M. Elhoseny et al., "Security and Privacy Issues in
[19] "What is Spoofing & How to Prevent it." Medical Internet of Things: Overview,
https://www.kaspersky.com/resource- Countermeasures, Challenges and Future Directions,"
center/definitions/spoofing (accessed Mar. 29, 2022). Sustainability, vol. 13, no. 21, p. 11645, Oct. 2021,
[20] "Cross Site Scripting (XSS) Software Attack | doi: 10.3390/su132111645.
OWASP Foundation." https://owasp.org/www-
community/attacks/xss/ (accessed Mar. 29, 2022).
[21] "Buffer overflow."
https://www.imperva.com/learn/application-
security/buffer-overflow/ (accessed Mar. 29, 2022). 10. AUTHOR PROFILE
[22] "What is a distributed denial-of-service (DDoS)
attack? | Cloudflare." https://www.cloudflare.com/en-
gb/learning/ddos/what-is-a-ddos-attack/ (accessed
Mar. 29, 2022).
[23] "Relay attack - Wikipedia."
https://en.wikipedia.org/wiki/Relay_attack (accessed
Mar. 29, 2022).
[24] S. R. Moosavi et al., "End-to-end security scheme for
mobility enabled healthcare Internet of Things,"
Future Generation Computer Systems, vol. 64, pp.
108–124, Nov. 2016, doi:
10.1016/j.future.2016.02.020.
[25] P. Gope and T. Hwang, "A Realistic Lightweight
D.G.B.M Heshan Keshawa Basnayaka
Anonymous Authentication Protocol for Securing
Cyber security researcher
Real-Time Application Data Access in Wireless
Undergraduate at SLIIT
Sensor Networks," IEEE Transactions on Industrial
Electronics, vol. 63, no. 11, pp. 7124–7132, Nov.
2016, doi: 10.1109/TIE.2016.2585081.
[26] J.-L. Hou and K.-H. Yeh, "Novel Authentication
Schemes for IoT Based Healthcare Systems,"
International Journal of Distributed Sensor Networks,
vol. 11, no. 11, p. 183659, Nov. 2015, doi:
10.1155/2015/183659.
[27] D. Sharma and D. Jinwala, "Functional Encryption in
IoT E-Health Care System," 2015, pp. 345–363. doi:
10.1007/978-3-319-26961-0_21.
[28] F. A. Khan, A. Ali, H. Abbas, and N. A. H. Haldar, "A
Cloud-based Healthcare Framework for Security and
Patients' Data Privacy Using Wireless Body Area
Networks," Procedia Computer Science, vol. 34, pp.
511–517, 2014, doi: 10.1016/j.procs.2014.07.058.
[29] "Data Encryption Standard."
https://www.tutorialspoint.com/cryptography/data_enc
ryption_standard.htm (accessed Apr. 05, 2022).
[30] "What is Blowfish and how is it used in
cryptography?"
https://www.techtarget.com/searchsecurity/definition/
Blowfish (accessed Apr. 05, 2022).
[31] M. C. Tracy, W. Jansen, K. A. Scarfone, and J.
Butterfield, "Guidelines on electronic mail security,"

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