Medical Internet of Things: A Survey of the Current Threat and Vulnerability Landscape

Abstract

The Internet of things (IoT) is a system that utilizes the Internet to facilitate communication between sensors and devices. Given the ubiquitous nature of IoT devices, it is seemingly inevitable that IoT would be used as a conduit to transform healthcare. One such medical IoT (mIoT) device that is revolutionizing healthcare is the medical implant device. These mIoT implant devices which control insulin pumps, cardioverter defibrillators and bone growth stimulators have redefined the way patient data is accessed, and healthcare is delivered. These implant devices are a double-edged sword. While they allow for the effective and efficient noninvasive treatment of patients, this external communication makes the medical implants vulnerable to cyberattacks synonymous with IoT devices. As a result, privacy and security vulnerabilities have surfaced as pronounced challenges for mIoT devices. This work summarizes and synthesizes the inherent vulnerabilities associated with mIoT devices and the implications regarding patient safety.

Information Security Risk for Welfare Technology and Personal Healthcare Devices

“…Literature demonstrates the once technology is connected to internet, the potential risk increases due to an increase in attack surface. Meaning that devices that are connected to either share or transfer information through network connectivity can be more vulnerable towards cyber threats [12,14,15,16,18,19,20,22]. In a future scenario where healthcare services rely on welfare technology, the consequences if a risk materializes increases [28].…”

“…In a future scenario where healthcare services rely on welfare technology, the consequences if a risk materializes increases [28]. Also, imagining a closer interconnectivity between welfare technologies, IoMTs and medical devices will introduce new risks [15,16]. Currently, there are several known risks related to medical devices, like those for pacemakers, implantable cardiac devices and insulin pumps [9,14,19].…”

“…[12] highlight IoMT system risks and specific attacks that can threaten IoMT devices, such as physical attacks and network attacks. The most frequently mentioned network attack is DDoS, MITM, replay attack and brute force attack [12,13,14,15] reviews the threat and vulnerability landscape for IoMT, where cardiac devices, implantable brain devices and pacemakers are examined. The authors stress the potential of blind and targeted attacks.…”

Uncovering Security Vulnerabilities in Electronic Medical Record Systems: A Comprehensive Review of Threats and Recommendations for Enhancement

“…The landscape of cyber threats against healthcare systems is constantly evolving. As systems become more digitized and interconnected, they are exposed to risks from increasingly sophisticated threats [37]. Advanced persistent threats that employ tactics such as social engineering and zero-day exploits can bypass traditional signature-based defenses.…”

On The Verge of the Hybrid Mind

“…The world of hybrid bodies offers a good example. Proof of principle attacks on both various implanted devices such as cardiac pacemakers have been reported (McGowan, Sittig & Andel, 2021), and the U.S. Food and Drug Administration (FDA) recently recalled certain insulin pumps due to cybersecurity risks (FDA 2019). The possibility of teleprogramming DBS devices was already being discussed before the COVID-19 pandemic, but may accelerate with the general demonstration during the pandemic of the utility of distance medicine (Lin et al, 2020).…”