The internet of things in healthcare: An overview

IoT in Healthcare
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ABSTRACT – IoT or the Internet of Things is considered as a powerful rising domain, which is associated with the
various type of embedded devices or sensors. This sensors or embedded devices have the capability of connecting
themselves and exchange the information over the internet. The use of the IoT devices are increasing day by day and the
data provided by this devices are also critical. For this reason, it is very essential to have certain security constraints,
which would be helping in the securing of the data along with special authentication schemes, which are not associated
with the consumption of the high computing as well as the energy resources. This paper would be mainly discussing
about the IoT healthcare usage. A literature review has been conducted in this report regarding the usage of the IoT in
healthcare besides this the report also discusses about the past and the present works done with the IoT in healthcare.
1. INTRODUCTION (15 MARKS)
Internet of things or the IoT can be considered as one of the
most common research topic. The growt of this technology
has been greatly favored by the various type of advancements
that has occurred in the field of electronics, IPv6 and the
wireless networks [1]. The use of IoT has greatly increased
and it is being used in various environments, which includes
the homes, healthcare, and many more. Besides this various
type of approached have been proposed which can be used for
eth purpose of controlling the IoT devices. The major concern
regarding the use of the IoT includes the various type of
security issues. The security concerns are to be kept in the
highest priority and should be first topic for the research [2].
The interest of body wearable is increasing day by day
which is acting as a powerful tool for different application of
healthcare and also the different devices. Different IoT
devices are available which are currently being used for
various purposes which mainly includes the personal
healthcare, awareness regarding various activities and fitness.
2. BACKGROUND/LITERATURE REVIEW
Various researchers have been associated with proposing
new techniques of clinical application of the IoT technology.
This technology has greatly helped in remote healthcare
monitoring along with functionalities for long-term recording
of the health statues [3]. It has been seen that most of the
remote health care frameworks, which has been proposed,
consists of three tiers and this includes the body sensor
network tier, communication and networking tier and lastly
the processing and the analyzing nodes. The first tier or the
body sensor network tier mainly includes the various wearable
sensors, which works like as the unit for data acquisition. The
second tier or the communication and the networking and the
services are associated with the collection of the data from the
sensors and then forward the data to the next tier [4][5]. The
last tier, which is associated with the processing and analyzing
of the nodes [6][7].
Most of the researchers have been facing a certain
challenges. The main challenges which the researcher are
facing while proposing new authentication mechanism but
also while proposing new authentication mechanism that
would be responsible for supporting the different kinds of IoT
devices [8]. The authentication standards that the smart
phones are having would be applicable for the smart devices
as well. By smart devices, we mainly mean the smart watches,
smart thermostat and many more [9].
The researchers have been capable of proposing two main
device identity security solutions, this mainly includes the
Physical protection solution, and the cryptography based
authentication solution [10]. The main purpose of designing
the physical protection approach is for protecting the device
from being damaged or attacked at the level of the physical
layer and this is mainly done application of the various
physical concepts [11]. Along with this, the cryptography
based authentication approach is mainly designed by making
use of the IoT Based RFID in the field of security. Besides
this it also consists of various features and different
algorithms has been proposed which are based upon the IoT
RFID [12].
There exists limited number of resources in the IoT devices
and all this are connected to the resources. This ultimately
makes the devices vulnerable to various kind of risks and the
devices become vulnerable to this attack [13]. In order to
guarantee the security and also to identify the identities
authentication is needed and this would be helping in
preventing the attackers and other type of malicious attacks
[14]. High resources are required for the processing in the
traditional authentication methods. Besides this, the IoT is
also considered as a constraint resource environment, which is
having a limited number of resources. Along with this, a
lightweight authentication approach assisted by the robust
security features which is generally required for preserving the
energy and to fit the processing capabilities [15][16].
Some of the latest authentication approach have been used
for the purpose of providing a secure communication. The
approaches have been associated with the use of the HTTP
protocol in order to authenticate the communication suffer
[17]. In addition, this is done from the high overhead, which is
resulted from the usage of the HTTP protocol. This HTTP
protocols are not at all optimized for the IoT environment,
which are having limited resources. Whereas the other
approaches are associated with the usage of the AES in order
to encrypt the communication [18]. The AES is associated
with the usage of the long encryption keys along with the
complex calculations which are ultimately resulting in the
high consumption of the power and are also not fitted for the
requirements of the IoT energy resources which are restricted
[19].
2.1 Related work
Various types of authentication has been proposed for the
purpose of providing the authentication that is required by the

IoT devices [20]. An enhances mutual authentication model
was proposed by [18] for the IoT environment. Besides this,
they were also associated with providing a some suggestions
regarding the improvement of the algorithm associated with
authenticating the RFID authentication protocol, which is
based upon the challenge response present in the distributed
database environment. This ultimately resulted in making the
proposed architecture much more suitable for the IoT control
system environment [21]. Three main steps are included in
this approach and this includes the add backup device for
each terminal devices used for controlling, add monitor
devices to follow and monitor terminal devices and finally add
a push in alarm mechanism for alarming for any failed
authentication process.
Whereas a Two-Phase Authentication Protocol was
proposed by [22] for the Wireless Sensor Network present in
the Distributed IoT application. This protocol can be stated as
the certificate based authentication approach. The two phase
authentication is associated allowing both the IoT devices as
wella s the control station in order to authenticate and
recognize each other. Besides this a secure connection was
also established and the transfer of the data was done in a
secure way. They were also associated with using the protocol
supports resources limitation of the sensor nodes and had also
considered the network scalability and heterogeneity. Besides
this the CA or the Certificate authority was used for the
purpose of issuing the certificates. Once a certificate is
received then the existing nodes would be capable of moving
and changing their location. The CA would also be helping in
the validation of the identity of the sensors and
communicating with the other entities present at the network.
Before initializing a connection the team members need to
connect to the CA first in order to confirm the identity of the
destination. The approach has also been considered as an end-
to-end application layer authentication approach and is also
dependent on the other security features present at the lower
layer.
A light weight mutual authentication schema was proposed
by [23] in order to validate the identities in the IoT devices
which are associated with participating in the environment
before participating in the network. Along with this they also
proposed a decreased communication overhead. They were
also associated with choosing a Constrained Application
Protocol (CoAP) as a under layer protocol in order to provide
communication that exists between the various IoT devices.
The process of authentication has been completed by making
use of the 128-bit AES or the Advanced Encryption Standard.
After this an identification of the client and the server is done
at the first step. Followed by this is the providing of different
resources to the clients which are based upon certain
conditions that are determined according to the request. The
transmission of the condition specific data is associated with
minimizing the number of transmitted packets. The ultimate
result is the reduction of the energy consumption and the
computation.
A secure authentication schema for the IoT was proposed
by the [24] which was mainly dependent on the ECC or the
Elliptical Curve Cryptography based algorithm which is
associated with supporting the security solutions which are
better. This happens when it is compared with the other type
of PKC or the Public Key cryptography algorithm due to the
small size of the keys [25]. Besides this the authentication
protocol is used by the EEC for the embedded devices which
in turn makes use of the HTTP protocol. By making use of the
cookies of the HTTP authentication of the smart devices are
done and this a novel approach. All these devices needs to be
configured by making use of the TCP/IP. The Proposed
Authentication Protocol was designed for the purpose of using
the HTTP cookies which are to be implemented in order to fit
the embedded devices which are having the constrain
environment and are controlled by the cloud servers. Three
phases are included in the proposed protocol and the phase
includes the phase of registration, phase of the pre-
computation and the phase of login. The phase of registration
mainly includes the embedded devices which registers
themselves with the cloud servers and this in turn is associated
with sending back of the cookies that are generally stored in
the embedded devices. Whereas in the pre-computational and
the login phase the devices have been associated with
connecting with the server and they need to send a request for
login [26]. Lastly, in the authentication phase the embedded
devices as well the cloud servers have to mutually
authenticate themselves by making use of the EEC algorithm.
Instead of having small encryption key this has been
associated with increasing the size of the encrypted message
in a significant way. Besides this the ECC algorithm is very
much complex along with being difficult for implementation
when compared with the other cryptographic algorithms and
they also require much more processing resources.
A Threshold Cryptography-based Group Authentication or
the TCGA was proposed for the IoT in [27]. This model has
been associated with providing an authenticity for the IoT
devices which is mainly based upon the communication model
of the group. Besides this the TCGA is also designed for the
purpose of implementing it in the Wi-Fi environment. Besides
this it is also associated with creating a secret channel or
session keys for authenticating each group and this in turn can
be used for the purpose of group applications. There exists a
group head in each group and they are responsible for the
generation of the keys and followed by the distribution of the
new keys every time whenever a new member gets added for
the purpose of preserving the leakage of the group keys. This
group head is generally referred to as the group authority.
There exists five main modules and this mainly includes the
distribution of the keys, updating of the keys, generation of
the group credits, authenticating the listener and decryption of
the messages.
According to [28] SEA or the Secure and Efficient
Authentication and Authorization Architecture for the IoT
based healthcare was proposed by making use of the Smart
Gateways. This architecture was mainly based upon the
certificate-based DTLS handshake protocol. The following
parts have been included in the Architecture and this mainly
includes the medical sensors network which are associated

with the gathering of the information from the body of the
patients or from a room of the patient which would be
followed by helping in the process of treatment and medical
diagnosis. The second component mainly includes the Smart
e-Health Gateway which is associated with enabling the
various systems responsible for communication which would
be acting as an immediate for the MSN and also for the
internet. Lastly the third part includes the Back-end system
which are associated with receiving, processing and storing of
the information which are collected.
New CoAP option was proposed by [29]. This CoAP is
associated with working at the application layer which is
associated with providing the ability of retrieving the data
from devices. This data might include the metadata and the
measurement of the sensors. This information are used by
different real-time applications. However, sometimes it is a
security requirement to not retrieve the raw communication
data. However only the abstractions, which also includes the
high level state of the observed entities. Additionally along
with the nature of the resource constrained devices might be
accesses by anyone by making use of the internet, reduction of
the consumption of energy also plays a vital role. The
proposed option would be helping in reducing the messages
numbers while observing the sensor resources and this would
be resulting in the reduced consumption of the energy along
with increasing the lifetime of the devices.
The highest concern in the developing mainly includes the
prevention of the exhaustion of the resources. This resources
are responsible for the restriction of the nature of the IoT
environment devices and mainly requires authentication
mechanisms which would be fitting the limited memory,
processing and the energy of the IoT devices [30]. The
research proposal is associated with providing an
authentication mechanism which is mainly dependent on the
CoAP and the Elliptic Curve Cryptography or the ECC [30].
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