Secure user-driven pairing with implantable medical devices

Zhang, Mo ORCID: 0000-0002-7302-9088 (2025). Secure user-driven pairing with implantable medical devices. University of Birmingham. Ph.D.

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Abstract

Implantable Medical Devices (IMDs), such as pacemakers and insulin pumps, are widely deployed today and often use wireless communication with external devices. Establishing a secure communication channel with an IMD can be life-critical. However, this is challenging in practice due to the special properties and needs of these devices. To address this issue, researchers and medical device companies have developed various types of pairing techniques for IMDs, aiming to bootstrap a cryptographic key between an IMD and an external device to secure the subsequent wireless communications.
In this thesis, we investigate these techniques and analyze their security, usability, and deployability (i.e., whether the methods can be deployed in real-world devices) properties. Specifically, we highlight a worrying drawback in existing work: The pairing process with an IMD is always designed to be imperceptible to the patient. Assume a patient with a pacemaker is in a crowded public space (like a bus or a mall), a malicious adversary could potentially approach the patient and silently pair with their pacemaker without the patient noticing, which can lead to life-threatening consequences, e.g., changing their therapy.
To mitigate this concern, we introduce several novel user-driven IMD pairing techniques, where pairing can be completed only after the user conducts specific physical interactions with the patient's body, e.g., tapping on their body for a few times. Our approach makes the pairing process highly perceptible, and thus allows the patient to detect and stop the pairing at any time. We implement prototypes for our proposed techniques, and thoroughly evaluate them with human participants. Furthermore, we comprehensively validate whether our protocol can be potentially deployed in today's modern IMD products. The results demonstrate promising potential for our proposed pairing techniques. Our findings point out a new direction for future user-friendly design of security solutions for IMDs, and can provide value to both academia and medical device industry.

Type of Work:	Thesis (Doctorates > Ph.D.)
Award Type:	Doctorates > Ph.D.
Supervisor(s):	Supervisor(s) Email ORCID Oswald, David UNSPECIFIED orcid.org/0000-0001-8524-5282 Garcia, Flavio UNSPECIFIED orcid.org/0000-0001-8552-5962 Kostakos, Vassilis UNSPECIFIED orcid.org/0000-0003-2804-6038 Murray, Toby UNSPECIFIED orcid.org/0000-0002-8271-0289
Licence:	All rights reserved
College/Faculty:	Colleges > College of Engineering & Physical Sciences
School or Department:	School of Computer Science
Funders:	None/not applicable
Subjects:	Q Science > Q Science (General) T Technology > TA Engineering (General). Civil engineering (General)
URI:	http://etheses.bham.ac.uk/id/eprint/15678

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