Security of Cloud-Based Medical Internet of Things (MIoTs): A Survey

Introduction

E-healthcare has developed as one of the most important service areas in the last decade, attracting the attention of the academic community worldwide (Habibzadeh et al., 2019). The healthcare industry is expanding at an exponential rate as a result of new data transmission and automation technologies; the Medical Internet of Things (MIoT) is the result of this development. MIoT evolved from the Internet of Things (IoT), which allows physicians and patients to communicate and collect, analyze, and distribute health-related data via wireless media (Hossain, 2015; Lin et al., 2020). MIoTs can monitor and improve a patient's health in real time, while also increasing their physical flexibility and mobility. MIoTs are capable of tracking a patient's overall health, as well as their physical mobility and flexibility, in real time, as represented in Figure 1. Patients can improve their health by using equipment such as heart monitoring sensors or remote sleep monitoring sensors. According to predictions, there will be about 50 billion MioT in circulation by 2025 (Kumar & Chouhan, 2021). MIoT used a number of technologies, including IoS, CPS, AI, and big data, to handle large amounts of data (Dourado et al., 2020; Li et al., 2018; Parah et al., 2020; C. Zhu et al., 2018).

There are many problems that will impede the broad implementation of MIoT, such as privacy and security concerns regarding patient data and personal information (AlZu’bi et al., 2019; Masud et al., 2020). Several malicious attacks are conceivable with MIoT devices, including eavesdropping, data leak, DDoS (Gaurav, Gupta, Hsu, Peraković, et al., 2021; Gaurav, Gupta, Hsu, Yamaguchi, et al., 2021; Gaurav & Singh, 2017), and denial of service (DoS) (Gaba et al., 2020; Y. Sun et al., 2019). At the same time, there is a security issue for the medical user and the manufacturer due to the inadequate use of security protocols (A. Rahman et al., 2020). Hackers are more interested in MIoT than most other systems since it has a significant amount of computing capacity. Because of this, electronic medical records of patients, home health data, and other types of data are the prime targets of data breach (Hossain & Muhammad, 2017; Muhammad et al., 2020). Data breaches are increasing at an alarming rate as a consequence of hacking. Due to the many flaws and vulnerabilities in the current healthcare sector software, in 2019, almost 41.4 million records were exposed (Parah et al., 2020). The number of breaches almost quadrupled between 2017 and 2018, with 15 million data exposed in 2018 compared to the previous year (Kira, 2020). In 2020, everything will be pretty much the same. The Florida Orthopedic Institute has reportedly said that it has discovered a data breach that affects approximately 640,000 patient information. In June 2020, “elite emergency physicians” discovered a similar security problem, which ultimately led to the theft of 550,000 patient records (Davis, 2020). Inadequate authentication or authorisation, lack of encryption of data transmission, unencrypted interfaces, insecure software, and privacy concerns were highlighted as security flaws in the 10 most popular smartwatches (at the time) in a 2015 HP Fortify study (Rawlinson, 2015; Y. Sun et al., 2019).