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智能医疗诊断系统(IMDS)的攻击和防御途径。

Attacking and defence pathways for Intelligent Medical Diagnosis System (IMDS).

机构信息

School of Computer Science, University of Nottingham, Nottingham NG8 1BB, United Kingdom.

School of Computer Science and Informatics, De Montfort University, Leicester LE1 9BH, United Kingdom.

出版信息

Int J Med Inform. 2021 Apr;148:104415. doi: 10.1016/j.ijmedinf.2021.104415. Epub 2021 Feb 11.

Abstract

BACKGROUND

The Intelligent Medical Diagnosis System (IMDS) has been targeted by the cyber attackers, who aim to damage the Healthcare Critical National Infrastructure (CNI). This research is motivated by the recent cyber attacks happened worldwide that have resulted in the compromise of medical diagnosis records. This study was conducted to demonstrate how the IMDS could be attacked and diagnosis records compromised (i.e. heart disease) and suggest a list of security defence strategies to prevent against such attacks.

METHODS

This research developed an IMDS simulation platform by implementing the OpenEMR system. A Cardiac Diagnosis Component is then added to the IMDS. The IMDS is fed with the ECG data (retrieved from the PhysioNet/Computing in Cardiology Challenge 2017). This research then launched systematic ethical hacking, which was tailored to target IMDS diagnosis records. The systematic hacking was based on the NIST ethical hacking method and followed an attack pathway, starting from identifying the entry points of the medical websites, then propagating to gain access to the server, with the ultimate aim of modifying the heart disease diagnosis records.

RESULTS

The hacking was successful. Four major vulnerabilities (i.e. broken authentication, broken access control, security misconfiguration and using components with known vulnerabilities) were identified in the simulated IMDS and the cardiac diagnosis records were compromised. This research then proposed a list of security defence strategies to prevent such attacks at each possible attacking points along the attacking pathway.

CONCLUSIONS

This research demonstrated a systematic ethical hacking to the IMDS, identified four major vulnerabilities and proposed the security defence pathways. It provided novel insights into the protection of IMDS and will benefit researchers in the community to conduct further research in security defence of IMDS.

摘要

背景

智能医疗诊断系统(IMDS)已成为网络攻击者的目标,他们旨在破坏医疗保健关键国家基础设施(CNI)。本研究的动机是最近在全球范围内发生的网络攻击,这些攻击导致了医疗诊断记录的泄露。本研究旨在展示 IMDS 如何受到攻击,以及诊断记录如何被泄露(例如心脏病),并提出一系列安全防御策略来防止此类攻击。

方法

本研究通过实现 OpenEMR 系统开发了一个 IMDS 模拟平台。然后在 IMDS 中添加了一个心脏诊断组件。将 IMDS 输入 ECG 数据(从 PhysioNet/Computing in Cardiology Challenge 2017 中检索)。然后,本研究进行了系统的道德黑客攻击,专门针对 IMDS 诊断记录。系统黑客攻击基于 NIST 道德黑客攻击方法,并遵循攻击路径,从识别医疗网站的入口点开始,然后传播以访问服务器,最终目的是修改心脏病诊断记录。

结果

黑客攻击成功。在模拟的 IMDS 和心脏诊断记录中发现了四个主要漏洞(即身份验证中断、访问控制中断、安全配置错误和使用具有已知漏洞的组件)。然后,本研究提出了一系列安全防御策略,以防止在攻击路径的每个可能攻击点发生此类攻击。

结论

本研究对 IMDS 进行了系统的道德黑客攻击,确定了四个主要漏洞,并提出了安全防御途径。它为 IMDS 的保护提供了新的见解,并将使社区中的研究人员受益,以进一步研究 IMDS 的安全防御。

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