A review of security issues and solutions for precision health in Internet-of-Medical-Things systems

Precision medicine provides a holistic perspective of an individual’s health, including genetic, environmental, and lifestyle aspects to realize individualized therapy. The development of the internet of things (IoT) devices, the widespread emergence of electronic medical records (EMR), and the rapid progress of cloud computing and artificial intelligence provide an opportunity to collect healthcare big data throughout the lifespan and analyze the disease risk at all stages of life. Thus, the focus of precision medicine is shifting from treatment toward prediction and prevention, i.e., precision health. To this end, various types of data such as omics, imaging, EMR, continuous physiological monitoring, lifestyle, and environmental information, need to be collected, tracked, managed and shared. Thus, internet-of-medical things (IoMT) is crucial for assimilating the health systems, applications, services, and devices that can improve the speed and accuracy of diagnosis and treatments along with real-time monitoring and modification of patient behavior as well as health status. However, security has emerged as a growing concern owing to the proliferation of IoMT devices. The increasing interconnectivity of IoMT-enabled devices with health data reception, transmission, and processing significantly increases the number of potential vulnerabilities within a system. To address the security issues of precision health in IoMT systems, this study reviews the state-of-the-art techniques and schemes from the perspective of a hierarchical system architecture. We present an IoMT system model comprising three layers: the sensing layer, network layer, and cloud infrastructure layer. In particular, we discuss the vulnerabilities and threats to security in each layer and review the existing security techniques and schemes corresponding to the system components along with their functionalities. Owing to the unique nature of biometric features in medical and health services, we highlight the biometrics-based technologies applied in IoMT systems, which contribute toward a considerable difference between the security solutions of existing IoT systems. Furthermore, we summarize the challenges and future research directions of IoMT systems to ensure an improved and more secure future of precision health.