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Top1. Introduction
Electronic health record (EHR) and personal health record (PHR) systems are widely available and use different technologies and standards (Bahga, 2015; Sun, 2013). The variety and size of medical health records data makes it difficult for researchers to accurately and easily integrate data from various sources. Due to the high cost of building and maintaining specialized data centers many healthcare providers have been outsourcing PHR systems to third part cloud service providers such as Microsoft Health Vault, Google Health, General Electric’s Centricity Patient Online, eClinicalWorks and many more. Cloud computing provides storage for large scale data on external servers allowing researchers and developers to easily access the data (Fang, 2016). Although the technology is being used in recent years with many benefits such as reducing the cost for maintaining servers whereas improving the availability of the systems, there have been wide spread privacy concerns since personal healthcare information can be exposed to unauthorized parties.
Due to the sensitivity of personal information, the cloud based PHRs could potentially become targets of various malicious behaviors. Furthermore, Guo et. al. in (Guo, 2016) and (Abbas, 2017) describe various security issues and threats in cloud computing environment. In (Asija R., 2016), researchers develop a security aware public cloud based SaaS model for healthcare applications embedding XML based meta data for PHRs. Works presented in (ZhouJ, 2015), (ZhouCao, 2015) and (Li, 2013) have proposed several cloud-based secure systems, especially cloud-based PHR systems using encryption where PHR data is encrypted and stored in cloud based storage. In (Man, 2017), (Wang, 2014) and (Zhou, 2015) authors deduce that any public cloud based security model may have inherent threats of trust, security and privacy. They highlight that the complexity of key management in encrypted PHR systems increases for the owners and users resulting in Quality of Service issues. (Liu, 2017) note that hybrid cloud environment integrating the public and private cloud infrastructure is a more applicable solution for PHR sharing.