A Review on Security Issues and Solutions for Precision Health in Internet-of-Medical-Things Systems

Precision medicine provides a holistic view of a person’s health that combines genes, environment and lifestyle, aiming at realizing the individualized therapy. With the developing of Internet of Things (IOT) devices, widespread emergence of Electronic Medical Records (EMR), booming of cloud computing and artificial intelligence, it provides an opportunity to collect the healthcare big data throughout the lifespan and analyze the disease risk at all stages of life. Thus, precision medicine is shifting to the focus from treatment to prediction and prevention, namely precision health. To achieve this goal, different types of data, such as omics, imaging, EMR, continuous physiological monitoring, lifestyle, and environmental information need to be collected, tracked, managed and shared. For this purpose, Internet-of-Medical Things (IoMT) is playing a vital role in bringing together the health systems, applications, services and devices, that can improve the speed and accuracy of diagnosis and treatments, and monitor and modify patient behaviour and health status in real time. However, due to the proliferation of IoMT devices, security has become a growing concern. The increasing interconnectivity of IoMT-enabled devices with the health data reception, transmission, and processing significantly increases the number of potential vulnerabilities within a system. 
To address the security issues for precision health in IoMT systems, in this article, we review the state-of-the-art techniques and schemes from the perspective of a hierarchical system architecture. We present an IoMT system model consisting of three layers: the sensing layer, the network layer and the cloud infrastructure layer. In each layer, we discuss the security vulnerabilities and threats, and review the existing security techniques and schemes corresponding to the system components and their functionalities. Due to the unique nature of biometric features in medical and health services, we highlight the biometrics-based technologies applied in IoMT systems, which makes a great difference from the security solutions in other existing IoT systems. Finally, we summarize the challenges and future research directions in IoMT systems for a better and more secure future of precision health.