The time interval between consecutive heartbeats (interpulse interval, IPI) has previously been suggested for securing mobile-health solutions. This time interval is known to contain a degree of randomness, permitting the generation of a time- and person-specific identifier. It is commonly assumed that only devices trusted by a person can make physical contact with him/her, and that this physical contact allows each device to generate a similar identifier based on its own cardiac recordings. Under these conditions, the identifiers generated by different trusted devices can facilitate secure authentication. Recently, a wide range of techniques have been proposed for measuring heartbeats remotely, a prominent example of which is remote photoplethysmography (rPPG). These techniques may pose a significant threat to heartbeat-based security, as an adversary may pretend to be a trusted device by generating a similar identifier without physical contact, thus bypassing one of the core security conditions. In this paper, we assess the feasibility of such remote attacks using state-of-the-art rPPG methods. Our evaluation shows that rPPG has similar accuracy as contact PPG and, thus, forms a substantial threat to heartbeat-based-security systems that permit trusted devices to obtain their identifiers from contact PPG recordings. Conversely, rPPG cannot obtain an accurate representation of an identifier generated from electrical cardiac signals, making the latter invulnerable to state-of-the-art remote attacks.

In heart-beat-based security, a security key is derived from the time difference between consecutive heart beats (the inter-pulse interval, IPI), which may, subsequently, be used to enable secure communication. While heart-beat-based security holds promise in mobile health (mHealth) applications, there currently exists no work that provides a detailed characterization of the delivered security in a real system. In this paper, we evaluate the strength of IPI-based security keys in the context of entity authentication. We investigate several aspects that should be considered in practice, including subjects with reduced heart-rate variability (HRV), different sensor-sampling frequencies, intersensor variability (i.e., how accurate each entity may measure heart beats) as well as average and worst-case-authentication time. Contrary to the current state of the art, our evaluation demonstrates that authentication using multiple, less-entropic keys may actually increase the key strength by reducing the effects of intersensor variability. Moreover, we find that the maximal key strength of a 60-bit key varies between 29.2 bits and only 5.7 bits, depending on the subject's HRV. To improve security, we introduce the inter-multi-pulse interval (ImPI), a novel method of extracting entropy from the heart by considering the time difference between nonconsecutive heart beats. Given the same authentication time, using the ImPI for key generation increases key strength by up to 3.4 × (+19.2 bits) for subjects with limited HRV, at the cost of an extended key-generation time of 4.8 × (+45 s).

Secure and energy-efficient communication between Implantable Medical Devices (IMDs) and authorized external users is attracting increasing attention these days. However, there currently exists no systematic approach to the problem, while solutions from neighboring fields, such as wireless sensor networks, are not directly transferable due to the peculiarities of the IMD domain. This work describes an original, efficient solution for secure IMD communication. A new implant system architecture is proposed, where security and main-implant functionality are made completely decoupled by running the tasks onto two separate cores. Wireless communication goes through a custom security ASIP, called SISC (Smart-Implant Security Core), which runs an energy-efficient security protocol. The security core is powered by RF-harvested energy until it performs external-reader authentication, providing an elegant defense mechanism against battery Denial-of-Service (DoS) and other, more common attacks. The system has been evaluated based on a realistic case study involving an artificial pancreas implant. When synthesized for a UMC 90nm CMOS ASIC technology, our system architecture achieves defense against unauthorized accesses having zero energy cost , running entity authentication through harvesting only 7.45μ J of RF energy from the requesting entity. In all other successfully authenticated accesses, our architecture achieves secure data exchange without affecting the performance of the main IMD functionality, adding less than 1‰ (1.3 mJ ) to the daily energy consumption of a typical implant. Compared to a singe-core, secure reference IMD, which would still be more vulnerable to some types of attacks, our secure system on chip (SoC) achieves high security levels at 56% energy savings and at an area overhead of less than 15%.