e-SAFE: Secure, Efficient and Forensics-Enabled Access to Implantable Medical Devices.

To facilitate monitoring and management, modern Implantable Medical Devices (IMDs) are often equipped with wireless capabilities, which raise the risk of malicious access to IMDs. Although schemes are proposed to secure the IMD access, some issues are still open. First, pre-sharing a long-term key between a patient's IMD and a doctor's programmer is vulnerable since once the doctor's programmer is compromised, all of her patients suffer; establishing a temporary key by leveraging proximity gets rid of pre-shared keys, but as the approach lacks real authentication, it can be exploited by nearby adversaries or through man-in-the-middle attacks. Second, while prolonging the lifetime of IMDs is one of the most important design goals, few schemes explore to lower the communication and computation overhead all at once. Finally, how to safely record the commands issued by doctors for the purpose of forensics, which can be the last measure to protect the patients' rights, is commonly omitted in the existing literature. Motivated by these important yet open problems, we propose an innovative scheme e-SAFE, which significantly improves security and safety, reduces the communication overhead and enables IMD-access forensics. We present a novel lightweight compressive sensing based encryption algorithm to encrypt and compress the IMD data simultaneously, reducing the data transmission overhead by over 50% while ensuring high data confidentiality and usability. Furthermore, we provide a suite of protocols regarding device pairing, dual-factor authentication, and accountability-enabled access. The security analysis and performance evaluation show the validity and efficiency of the proposed scheme.