Emerging Threats and Countermeasures - Digital health is the convergence of digital technology in healthcare. The emerging technology and the use of innovations are needed in healthcare for advancements and better outcomes. With the use of innovations, new threats and challenges are emerging in the industry which needs to be managed for efficient operations.

1. DIGITAL HEALTH: DATA
PRIVACY AND SECURITY
WITH CLOUD COMPUTING
Akshay Mittal
Emerging Threats and Countermeasures
University of the Cumberlands

2. Abstract & Keywords
 The digital health is the convergence of digital technology in healthcare. The emerging
technology and the use of innovations are needed in the healthcare for advancements and
better outcomes. With the use of new innovations, new threats and challenges are emerging
in the industry which needs to be managed for efficient operations.
 Digital Health, Healthcare, Data Privacy in Healthcare, Cloud Computing, Data Security
in Healthcare and Cloud Computing

3. Introduction
 Digital Health
The most far-reaching trend in the Healthcare Industry is
Digital Health these days. It’s a broad array of the
technologies like mHealth (Mobile Health), HealthIT
(Health Information Technology), wearable devices and
mobile health applications, and telehealth and
telemedicine services.
 Digital Health in Cloud Computing
Transforming or using the technology to enter your
health concerns and symptoms into a web or mobile
application with the insurance details and accessing that
information from anywhere around the globe securely
and safely is digital health in cloud computing.

4. Cont. Introduction
The future healthcare industry will be information-
centric that allows us to manage complexities. With
clouds, electronic health records (EHRs) are
maintained. These records need to be protected.
Unauthorized access, data theft, data manipulation,
phishing, and denial-of-service (DoS) attacks are the
emerging threats of digital health with respect to
cloud computing (Maria, 2019). The confidential data
can be protected by securing the system with
authentication and authorization tools, transmitting
the data in encryption form, and using the trusted
cloud service providers.

5. Background and Literature
Review
 The healthcare industry is converging with digital technologies to
increase the efficiency in their practices and make medicine
personalized to deliver quality healthcare. The reason behind the
growing demand for diverse medical care and additional resources is
the dramatic increase in average life expectancy.
 The healthcare moved to cloud computing as they started generating
a significantly high amount of data on a regular basis. The data
generated by healthcare is important and needs to be preserved for
decision making and to provide good quality services to the patients.
 The implementation of cloud computing is cost-effective, minimizes
the operation cost, and facilitates real-time data collection, data
storage, and transmission of data forcing the healthcare to shift the
operations over the cloud and implementing cloud computing
services in their organizations. The high volume of data is exchanged
by the healthcare organization in a secure and efficient manner with
clouds (Aziz, 2016).

6. Background and Literature
Review
 Cloud computing in healthcare is a new concept and the use
of innovation and technology in this field could give rise to
emerging threats and challenges.
 Traditionally the data was stored on a physical system
giving access only to the organization in a location.
 To enhance the services there was a need to shift the data to
a more flexible system. Healthcare organizations decided to
opt for digital health and cloud computing and its
implementation provides flexibility in managing, accessing,
and transferring data on clouds.
 The information of healthcare contains critical data of
patients including name, address, and medical history which
need to be secured. Cloud computing manages the privacy
and security of the data with authentication and
authorization tools.

7. Presentation of the Main Contribution of the Paper
 The research is focused on the cloud computing and the emerging threats due to the
implementation of cloud in healthcare organizations.
 The organizations has implemented clouds for the data processing.
 The infrastructure as a service (IaaS), Platform as a service (PaaS), and software as a
service (SaaS) are the three service models provided by cloud computing. The use of cloud
computing not only speeds up operations with easy management but also requires less
maintenance and is cost-efficient. It brings attractive benefits like remote storage, flexible
on-demand access, universal data access, storage management, and avoiding extra capital
expenses. It does not need any special hardware or software for its implementation and
maintenance (Arunkumar, 2017).

8. Presentation of the Main Contribution of the Paper
Fig. 1 Cloud Architecture.

9. Presentation of the Main Contribution of the Paper
 The cloud architecture ensures a safe environment for creating, storing, processing,
communicating, and managing the patient’s data. It is the responsibility of healthcare to
educate consumers about their role in security.
 The security and privacy in healthcare are maintained by high-security measures,
government regulations, and rules, and comply with legislation to ensure the patient’s data
protection.
 The digital health service providers come with built-in security measures in EHR.
 The digital health includes tools to manage and monitor access in the system by creating
logs.

10. The below are few examples of the laws and enactments implemented in the different
countries:

11. Research Methodology
 Hypothesis:
1. Digital health care provides better facilities and also avoid complexities.
2. Cloud computing used to manage data like Electronic health records are the most
beneficial.
 Methods of data collection:
1. Primary sources: Questionnaires, Interview
2. Secondary Sources:
 Internet
 Books/Brochure
 Peer reviewed Articles
 Websites
 Applications

12. Research Methodology
 This research is aimed at studying the digital health which is the convergence of digital
technology in healthcare and also their advancements that are implemented in digital health
to provide better facilities.
 Expected Outcome from this research could be very beneficial as the future healthcare
industry will become diligent that will surely overcome all the complexities. The Records
will be saved on clouds and a better Electronic Health record would serve a patient in an
emergency. This research will lead to a positive outcome.

13. Results and Findings
 It was found that the implementation of the cloud computing in the healthcare reduced the
time and operation cost of the organization.
 Flexibility in providing services was achieved as it allowed universal access.
 It provides access to the patients securely via unique identification number.
 The EHR combined with cloud computing manage the complete information of the
patient’s resolving “Big data” problems.
 The patient’s complete medical records are obtained and stored in a uniform manner that
reduces the wait time by making the reports available remotely

14. Results and Findings
 The doctors, physicians, researchers, and statisticians, all can access the patients report
simultaneously even if they are miles apart to provide a better, secure, and faster service.
 The data is stored on the networks in encrypted form.
 The EHR uses different algorithm like AES, and homomorphic encryption algorithm to
encrypt the data stored in EHR.
 Based on several permutation and linear transformations, the data is executed on blocks
transferring the plain text into encrypted text.
 The AES is the standard for the government standards and high security system
(Arunkumar, 2017).
 These algorithms can also be used to encrypt the medical images.

15. Results and Findings
Fig. 2 Original Health Record VS Encrypted Health Record (Arunkumar, 2017)

16. Limitations
 Network connection dependency
 Security and privacy of the cloud computing
 Vulnerability
 Limited control and flexibility to cloud
 Customer lock-in Handle big data flood with intensive security and with highly skilled
hands in digital health. s
 The awareness regarding digital healthcare is low when compared to other technologies.
 Technological problems can cease the on-going process which may result in huge problems
in times of emergency cases.
 Minor concerns like power cuts, power outages, loss of internet connectivity resulting in
disconnection with the cloud can also occur in such cases.

17. Conclusion
 With cloud computing and digital health, numerous opportunities are offered to drive
health research, digitalization of healthcare industry and so on.
 Privacy and security of the sensitive data of the patient is an utmost priority and a highly
secure connection costs a lot of expense to any healthcare organization.
 various methods are used to prevent patient's privacy in healthcare including Attribute-
based encryption Access Control (AES), and Homomorphic encryption.
 It provides effective solutions to the problem in digital health care and data security.

18. Conclusion
 The digitalization of the healthcare industry promises to deliver many benefits, on the
contrary, it also raises some barriers and challenges.
 It enables the organization to control the resources and provide the services accordingly as
full administration, or role-based access control.
 Different cloud models like private, public, or hybrid clouds can be implemented based on
the requirement.
 The digital health resolves the storage issue, security, privacy, flexibility, reliability, and
availability of data between the patients and the healthcare organization.

19. Conclusion
Fig. 3 Cloud computing usage in medical image display (Aziz, 2016)

20. References
 Aruna Devi. S and Manju.A, “Enhancing Security Features in Cloud Computing for Healthcare using Cipher and Inter Cloud”,
International Journal of Research in Engineering and Technology (IJRET), Volume 03 , Issue 03, Pages 200-203, Mar-2014
 Arunkumar, R. J. & Anbuselvi. (2017). Enhancement of cloud computing security in health care sector. IJCSMC, Vol. 6, Issue. 8, August
2017, pg.23 – 31. Retrieved from https://www.ijcsmc.com/docs/papers/August2017/V6I8201705.pdf
 Andrew, L. (2019). Disadvantages of cloud computing. Retrieved from https://cloudacademy.com/blog/disadvantages-of-cloud-
computing/
 Aziz HA, Guled A (2016) Cloud Computing and Healthcare Services. J Biosens Bioelectron 7: 220. doi: 10.4172/2155-6210.1000220
 Divya, R. & Jangale, S. (2016). Cloud based information security and privacy in healthcare. International Journal of Computer
Applications (0975 – 8887) Volume 150 – No.4, September 2016.
 Jonah, C. (2018). Why healthcare data may be more secure with cloud computing. Retrieved from
https://www.mobihealthnews.com/content/why-healthcare-data-may-be-more-secure-cloud-computing
 Kingsford, K. M., Fengli, Z., & Komlam, G. (2017). Patient knowledge and data privacy in healthcare records system. Published in: 2017
2nd International Conference on Communication Systems, Computing and IT Applications (CSCITA).
DOI: 10.1109/CSCITA.2017.8066543
 Lina, A. A., Wa’ed, S. Ahmed, A. (2016). Privacy preserving data mining on published data in healthcare: A survey. Published in: 2016 7th
International Conference on Computer Science and Information Technology (CSIT). Retrieved from
https://ieeexplore.ieee.org/document/7549444?arnumber=7549444
 Maria, L. (2019). eHealth cloud security challenges: a survey. Retrieved from https://new.hindawi.com/journals/jhe/2019/7516035/