Smart health systems, involving a large number of complex and heterogeneous devices and entities, may present risks from a security and privacy perspective unless properly considered. Every information system or communication network is hence virtually prone to be attacked by cybernetic criminals or suffer from irreparable damages because of unintentional human errors. Despite security safeguards, the history of both communication networks as well as that of the Internet encompasses countless security flaws, vulnerable cryptographic protocols and threatening data breaches. Moreover, the high value that such data might generate in the black market motivates attackers to infiltrate themselves into the information systems. Medical data, such as electronic health records, biomedical signals and physiological parameters, are highly sensitive and must be handled with the highest security and privacy standards. However, a number of challenges could arise from these communications in terms of throughput, latency, reliability, availability and security.Ĭoncerning the latter, data security stands as one of the most important features in the healthcare domain. In this scope, wireless sensor networks (WSNs) and wireless body area networks (WBANs) emerged and attracted the attention of many stakeholders from very different industries, namely healthcare, sport, entertainment, environmental, transportation or manufacturing, among others. More specifically, such devices are topologically organised as networks, mostly wireless to endow the system with major flexibility and cost-effectiveness. These sensing devices, able to collect and transmit data from multiple physical locations, are paramount to enable the contextualisation of smart environments, such as smart homes, smart hospitals and smart cities. Nowadays, there exists an overwhelming number and variety of devices with sensing capabilities, with different features, technologies, complexities, dimensions and costs. To properly deploy efficient smart healthcare services, stakeholders must be aware of all the concerns surrounding the management of sensor data, including its collection, storage, transmission, analysis and presentation. Unlike previous paradigms, s-health was the first paradigm that considered the contextual perspective, so it is seen as a particular case of the e-health and m-health paradigms.

The meaningful exploitation of user-centric data in combination with contextual data opened the door to smart healthcare services, aiming to acquire advanced high-level knowledge and providing more effective, cost-efficient, personalised and sustainable healthcare models. The ubiquity and communication capabilities of these environments lead to context-awareness, i.e., environments capable of adapting themselves to users’ needs. As a result of the progressive integration of sensors in our daily lives, homes, buildings and transportation systems, healthcare facilities and cities as a whole are provided with smart and cognitive capabilities able to collect and analyse vast amounts of heterogeneous data under real-time constraints.

With the steady implementation of ICTs in the healthcare domain, cities have also started equipping their infrastructures with ICTs to face important demographic challenges such as the growth of the world’s population and the increase in life expectancy. As a result, we provide practitioners with a comprehensive overview of the existing vulnerabilities and solutions in the technical side of smart healthcare.

To this aim, this article provides a thorough technical review on the deployment of secure smart health services, ranging from the very collection of sensors data (either related to the medical conditions of individuals or to their immediate context), the transmission of these data through wireless communication networks, to the final storage and analysis of such information in the appropriate health information systems. However, the large number, variety and complexity of devices and systems involved in smart health systems involve a number of challenging considerations to be considered, particularly from security and privacy perspectives. In particular, smart healthcare, regarded as the natural evolution of electronic health and mobile health, contributes to enhance medical services and people’s welfare, while shortening waiting times and decreasing healthcare expenditure. These context-aware environments have opened the door to numerous opportunities for providing added-value, accurate and personalised services to citizens. The advances in the miniaturisation of electronic devices and the deployment of cheaper and faster data networks have propelled environments augmented with contextual and real-time information, such as smart homes and smart cities.

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