Zhang Mo, Wang Chaofan, Jiang Weiwei, Oswald David, Murray Toby, Marin Eduard, Wei Jing, Ryan Mark, Kostakos Vassilis
School of Computer Science, University of Birmingham, Birmingham, United Kingdom.
School of Computing and Information Systems, The University of Melbourne, Melbourne Connnect, 700 Swanston Street, Carlton, Melbourne, 3053, Australia, 61 493164461.
JMIR Biomed Eng. 2025 Aug 26;10:e57091. doi: 10.2196/57091.
Implantable medical devices (IMDs), such as pacemakers, increasingly communicate wirelessly with external devices. To secure this wireless communication channel, a pairing process is needed to bootstrap a secret key between the devices. Previous work has proposed pairing approaches that often adopt a "seamless" design and render the pairing process imperceptible to patients. This lack of user perception can significantly compromise security and pose threats to patients.
The study aimed to explore the use of highly perceptible vibrations for pairing with IMDs and aim to propose a novel technique that leverages the natural randomness in human motor behavior as a shared source of entropy for pairing, potentially deployable to current IMD products.
A proof of concept was developed to demonstrate the proposed technique. A wearable prototype was built to simulate an individual acting as an IMD patient (real patients were not involved to avoid potential risks), and signal processing algorithms were devised to use accelerometer readings for facilitating secure pairing with an IMD. The technique was thoroughly evaluated in terms of accuracy, security, and usability through a lab study involving 24 participants.
Our proposed pairing technique achieves high pairing accuracy, with a zero false acceptance rate (indicating low risks from adversaries) and a false rejection rate of only 0.6% (1/192; suggesting that legitimate users will likely experience very few failures). Our approach also offers robust security, which passes the National Institute of Standards and Technology statistical tests (with all P values >.01). Moreover, our technique has high usability, evidenced by an average System Usability Scale questionnaire score of 73.6 (surpassing the standard benchmark of 68 for "good usability") and insights gathered from the interviews. Furthermore, the entire pairing process can be efficiently completed within 5 seconds.
Vibration can be used to realize secure, usable, and deployable pairing in the context of IMDs. Our method also exhibits advantages over previous approaches, for example, lenient requirements on the sensing capabilities of IMDs and the synchronization between the IMD and the external device.
诸如起搏器之类的可植入式医疗设备（IMD）越来越多地与外部设备进行无线通信。为了确保此无线通信通道的安全，需要一个配对过程来在设备之间引导出一个密钥。先前的工作提出了一些配对方法，这些方法通常采用“无缝”设计，使配对过程对患者来说难以察觉。这种缺乏用户感知的情况可能会严重损害安全性并对患者构成威胁。
该研究旨在探索使用高度可感知的振动与IMD进行配对，并提出一种新颖的技术，该技术利用人类运动行为中的自然随机性作为配对的共享熵源，有可能应用于当前的IMD产品。
开发了一个概念验证来演示所提出的技术。构建了一个可穿戴原型来模拟作为IMD患者的个体（未涉及真实患者以避免潜在风险），并设计了信号处理算法以使用加速度计读数来促进与IMD的安全配对。通过一项涉及24名参与者的实验室研究，从准确性、安全性和可用性方面对该技术进行了全面评估。
我们提出的配对技术实现了高配对准确性，误接受率为零（表明对手带来低风险），误拒绝率仅为0.6%（1/192；表明合法用户可能很少遇到失败）。我们的方法还提供了强大的安全性，通过了美国国家标准与技术研究院的统计测试（所有P值>.01）。此外，我们的技术具有高可用性，系统可用性量表问卷平均得分为73.6（超过“良好可用性”的标准基准68）以及从访谈中收集到的见解证明了这一点。此外，整个配对过程可以在5秒内有效完成。
振动可用于在IMD的背景下实现安全、可用且可部署的配对。我们的方法也比以前的方法具有优势，例如，对IMD的传感能力以及IMD与外部设备之间的同步要求宽松。
