title: Cloud-based privacy-preserving remote ECG monitoring and surveillance.
abstract: BACKGROUND
  The number of technical solutions for monitoring patients in their daily activities is expected to increase significantly in the near future. Blood pressure, heart rate, temperature, BMI, oxygen saturation, and electrolytes are few of the physiologic factors that will soon be available to patients and their physicians almost continuously. The availability and transfer of this information from the patient to the health provider raises privacy concerns. Moreover, current data encryption approaches expose patient data during processing, therefore restricting their utility in applications requiring data analysis.
  
  
  METHODS
  We propose a system that couples health monitoring techniques with analytic methods to permit the extraction of relevant information from patient data without compromising privacy. This proposal is based on the concept of fully homomorphic encryption (FHE). Since this technique is known to be resource-heavy, we develop a proof-of-concept to assess its practicality. Results are presented from our prototype system, which mimics live QT monitoring and detection of drug-induced QT prolongation.
  
  
  RESULTS
  Transferring FHE-encrypted QT and RR samples requires about 2 Mbps of network bandwidth per patient. Comparing FHE-encrypted values--for example, comparing QTc to a given threshold-runs quickly enough on modest hardware to alert the doctor of important results in real-time.
  
  
  CONCLUSIONS
  We demonstrate that FHE could be used to securely transfer and analyze ambulatory health monitoring data. We present a unique concept that could represent a disruptive type of technology with broad applications to multiple monitoring devices. Future work will focus on performance optimizations to accelerate expansion to these other applications.
authors.affiliation: Electrical and Computer Engineering Department, University of Rochester, Rochester, NY.
authors.forename: Alex
authors.initials: A
authors.lastname: Page
authors.affiliation: Electrical and Computer Engineering Department, University of Rochester, Rochester, NY.
authors.forename: Ovunc
authors.initials: O
authors.lastname: Kocabas
authors.affiliation: Electrical and Computer Engineering Department, University of Rochester, Rochester, NY.
authors.forename: Tolga
authors.initials: T
authors.lastname: Soyata
authors.affiliation: Cardiology Department, University of Rochester Medical Center, Rochester, NY.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aktas
authors.affiliation: Heart Research Follow Up Program, University of Rochester Medical Center, Rochester, NY.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Couderc
mesh_terms: D016494:Computer Security / Q000592:standards*; D003198:Computer Simulation; D003219:Confidentiality; D015716:Electrocardiography, Ambulatory; D005240:Feasibility Studies; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis; D018907:Privacy; D017216:Telemedicine / Q000592:standards*
keywords: cybersecurity; e-health; electrocardiogram; telemedicine