PROXY ACCESS VERIFICATION ON HIDING SENSITIVE DATA IN EMERGENCY

PATIENT CASE

Abstract: This systematic study explores the use data is often required to provide life-saving care;
of Electronic Health Records (EHRs) to however, this can inadvertently expose sensitive
enhance interoperability among healthcare patient information, leading to potential privacy
institutions while ensuring patient privacy and breaches.
confidentiality. EHRs consist of structured
data, including text and images, designed with To address these concerns, this study proposes an
the objectives of decentralization, security, enhanced security framework for EHR systems,
transparency, and traceability. Utilizing utilizing cryptographic techniques such as data
cryptographic systems, the study examines hashing and Private Key Generators (PKGs) to
existing security and privacy measures in EHR facilitate secure proxy access to patient data.
implementations. However, challenges arise This framework ensures that critical medical
during data extraction on the proxy server side, information is accessible while sensitive details
as full decryption in emergency cases may remain protected, even in urgent circumstances.
inadvertently expose sensitive information. To By implementing a dual-layered security
address this, a solution is proposed that employs approach, including privacy-preserving
a data hashing algorithm and a Private Key algorithms and controlled access protocols, this
Generator (PKG) for proxy access to patient project aims to improve EHR system integrity
data in emergencies while concealing sensitive and address the current gaps in safeguarding
details. This approach enhances data security patient confidentiality. The proposed method not
by selectively masking sensitive information in only enhances data protection but also ensures
medical reports. The analysis reveals a gap in compliance with healthcare regulations, offering
the literature regarding the combined a comprehensive solution for secure and efficient
implementation of these security protocols, EHR management.
emphasizing the need for robust authentication,
authorization, and access control mechanisms, 2. LITERATURE SURVEY
as well as improved privacy protection for both Wenting Shen; Jing Qin; Jia Yu; Rong
data and images in EHR systems. Hao; Jiankun Hu [1] Cloud storage services
Keywords: Electronic Health Records, enable users to store and share data remotely, but
Structured Data, Cryptographic Systems, Proxy ensuring data integrity while protecting sensitive
Server Side, Data Hashing Algorithm, Privacy information remains a challenge. This paper
Protection. proposes a remote data integrity auditing scheme
that allows data sharing with hidden sensitive
1. INTRODUCTION information. The scheme uses a sanitizer to
modify sensitive data blocks and generate valid
The adoption of Electronic Health Records signatures for integrity verification, ensuring
(EHRs) has become a cornerstone for improving both secure data sharing and efficient integrity
healthcare interoperability and ensuring efficient auditing. By leveraging identity-based
management of patient health information across cryptography, the scheme simplifies certificate
medical institutions. EHR systems store management while maintaining security and
structured data, including textual and imaging performance.
records, with a focus on decentralization,
security, transparency, and traceability. Despite Yi-Hui Chen; Pei-Yu Lin [2] Cloud services,
significant advances in the development of while convenient, pose security risks such as
EHRs, ensuring robust privacy and security privacy breaches and unauthorized access. This
while maintaining accessibility during critical paper presents a reversible data embedding
medical situations remains a challenge. In scheme using Hamming coding for encrypted
emergency scenarios, full decryption of EHR images, allowing sensitive data to be securely
embedded and later extracted, with the image standard grayscale images, with the approach
fully restored to its original state. Compared to being equally applicable to color images.
existing methods, this scheme offers a higher
data hiding capacity, with experimental results Fatina Shukur; Ahmed Fatlawi [6] In recent
demonstrating its effectiveness. years, wearable devices have gained popularity
due to their ease of use, affordability, and wide
Himanshu Makkar; Durga Toshniwal; Shalini range of services. However, they collect sensitive
Jangra [3] Frequent item set mining identifies personal data, raising concerns about privacy and
associations and patterns in transactional datasets security. This research proposes a wearable
for decision-making, such as product co- security protocol designed to protect user identity
purchase and price optimization. However, and sensitive data without compromising data
sensitive patterns within these datasets may quality, ensuring privacy while enabling secure
expose confidential information, prompting the data processing across various applications.
need for Privacy Preserving Data Mining
(PPDM) techniques. This paper proposes two Amare Genetu; Tesfa Tegegne [7] Sensitive
heuristics-based algorithms, MaxRCSI and information, if disclosed, can harm its owner and
MinRCSI, for hiding sensitive patterns by requires detection and classification for
sanitizing closed sensitive itemsets, improving protection. Due to the linguistic uniqueness of
data utility. Parallelized on the Spark framework, Amharic, models from other languages cannot be
these algorithms show enhanced privacy directly applied. To address this, we proposed a
preservation and utility with lower execution model for detecting and classifying personal
time compared to traditional methods in real and sensitive information in Amharic texts,
synthetic datasets. experimenting with LSTM, BI-LSTM, and CNN.
The BI-LSTM achieved the highest accuracy,
V Vilasini; K Hariharan; Nethra Chezhian; D 90% for sensitivity classification and 93% for
Kaviyarasu [4] In today's digital age, the domain classification, outperforming the other
increasing volume of data underscores the need models.
for robust security measures to protect sensitive
information from cyber threats. This project Lulu Xue; Jiani Li; Kejia Zhang; Tianqiu Yu [8]
implements a two-level authentication system for Existing multi-authority attribute-based
secure data storage, utilizing Auth for first-level encryption (MA-ABE) schemes with policy
authentication to offer convenient access and hiding rely on a centralized authority (CA) to
Advanced Encryption Standard (AES) with user- manage attributes and generate partial decryption
generated patterns as a hidden encryption layer keys, which raises security concerns. This paper
for the second level. This combination enhances introduces a decentralized MA-ABE scheme that
data security by ensuring confidentiality and eliminates the need for a CA by distributing
integrity during storage and access. attribute management across multiple attribute
authorities (AAs), enhancing security. The
Boyang Li [5] Current reversible data hiding proposed scheme incorporates an exponential
methods often have fixed data capacity when operation during encryption and key generation,
applied to a specific host media, lacking improving protection of sensitive data while
scalability. To address this, this paper introduces maintaining full security, as validated through
a fusion of reversible image data hiding with performance analysis.
lightweight encryption to securely hide multiple Asha S; Punitha. K; Tanmay Joshi [9] As data
types of sensitive data, offering scalable growth makes local storage challenging, many
capacity. By dividing images into non- users opt for cloud storage, which enables remote
overlapping sub-blocks and applying histogram data access. In scenarios like healthcare,
shifting on each block, the scheme efficiently sensitive data stored in the cloud should not be
hides data with minimal impact on image shared openly. This paper proposes a solution
fidelity, as demonstrated in experiments using that uses a sanitizer to hide sensitive data by
modifying related data blocks and signatures
while allowing secure data sharing and efficient protected and usable within healthcare
integrity auditing. Built on identity-based environments.
cryptography, the proposed method simplifies
certificate management and demonstrates strong
security and efficiency in performance analysis.
Janaki Sivakumar; Mazhar Malik; Arun Sekar
Rajasekaran [10] Cloud storage services enable 4. PROPOSED SYSTEM
users to store and share data, but ensuring data
integrity, particularly for sensitive information, is This project proposes a secure cloud storage
crucial. In systems like electronic health records, system that addresses the challenge of data
encrypting entire files protects privacy but sharing with sensitive information hiding in
restricts access for others. This method sanitizes Electronic Health Record (EHR) systems while
sensitive data blocks and updates signatures for supporting remote data integrity auditing. The
secure sharing while still allowing efficient system introduces a privacy-preserving public
remote integrity audits without exposing private auditing scheme that allows users to share data
information. without revealing sensitive information. To
achieve this, the system selectively encrypts
3. EXISTING SYSTEM sensitive portions of the shared file, ensuring that
non-sensitive data remains accessible, while
In the current system, patient medical records are sensitive information is hidden from
secured using cryptographic techniques to ensure unauthorized users.
confidentiality and integrity. This approach
The proposed framework integrates a Third-
minimizes Third-Party Auditor (TPA) access and
Party Auditor (TPA) to verify the integrity of
safeguards patient health data by encrypting the
outsourced data without compromising user
entire medical record before storing it in the
privacy or imposing additional burdens on the
database. However, the challenge of preserving
user. The TPA can efficiently conduct audits for
patient privacy in Electronic Health Record
multiple users concurrently, thereby enhancing
(EHR) systems extends beyond simple
scalability and efficiency. Moreover, the system
encryption. Effective security must incorporate
incorporates performance optimization
both encryption and access control mechanisms.
techniques, particularly focusing on the selection
Furthermore, enabling patients to generate and
of optimal parameter values to minimize
manage their own encryption keys enhances
computational costs for both clients and cloud
privacy protection, even in cases where the host
service providers. The proposed solution
data center may be compromised.
significantly reduces computation and
communication overheads compared to non-
A common concern is that encryption may cooperative approaches, improving both system
impede the functionality of EHR systems, efficiency and security. This dual emphasis on
particularly in scenarios where data sharing or privacy and performance optimization ensures a
search capabilities are required. However, it is practical, robust solution for secure cloud-based
possible to develop an efficient system that EHR data sharing and integrity verification.
allows patients to selectively share access rights
while still performing search operations on their
encrypted records. To address these challenges,
we define the requirements for a Patient-
Controlled Encryption (PCE) scheme, which
leverages established cryptographic protocols to
balance privacy with system functionality.
Various implementations of this scheme are
explored, each offering a different set of security
properties to ensure patient data remains both
 hashing algorithm alongside a Private Key
Generator (PKG). This methodology enables
Signature
proxy access to patient data during emergencies
while effectively concealing sensitive elements
Doctor EHR within medical reports.
Level 1 security Sanitizer

Key Findings:
Signature Server
Enhanced Security Mechanisms: The proposed
approach demonstrates a significant
Medical record improvement in data security by selectively
masking sensitive information, thereby reducing
the risk of unauthorized disclosure.

Interoperability Gaps: The study highlights

Level 2 security existing barriers to interoperability among
Private Key Generator
healthcare systems, which can impede the
Third party auditing seamless sharing and exchange of EHRs.
Third Party Access
Robust Privacy Protections: The findings
underscore the critical need for advanced
Fig 1 System architecture of the proposed authentication, authorization, and access control
solution mechanisms to safeguard patient privacy
effectively.
5. EXPERIMENTAL RESULTS
AND ANALYSIS Accura Reca Precisi F1-
cy ll on measur
This systematic investigation focuses on the es
utilization of Electronic Health Records (EHRs)
to enhance interoperability across healthcare Existin
institutions while ensuring stringent patient g 85 70 75 72
privacy and confidentiality. EHRs encompass system
structured data types, including both textual and
imaging data, aimed at achieving Propos 92 89 88 90
decentralization, security, transparency, and ed
traceability. Through the application of system
cryptographic systems, the study critically
evaluates the existing security and privacy Table 1 The accuracy classification of existing
measures employed in current EHR and proposed
implementations.
Identified Gaps in Literature:
Challenges Identified:
The analysis reveals a deficiency in the literature
During the analysis, notable challenges were concerning the integrated implementation of
observed in the data extraction phase on the security protocols that protect both textual and
proxy server side. Specifically, the necessity for imaging data within EHR systems. This gap
full decryption in emergency scenarios can emphasizes the necessity for further
inadvertently expose sensitive patient advancements in privacy protection strategies,
information, thereby compromising ensuring that sensitive patient information
confidentiality. To address this vulnerability, a remains secure during critical data access,
novel solution is proposed that integrates a data particularly in emergency situations.
The insights gleaned from this research highlight 7. REFERENCES
the urgent need for comprehensive frameworks
that not only bolster the security of EHRs but [1] Wenting Shen; Jing Qin; Jia Yu; Rong
also facilitate effective interoperability while Hao; Jiankun Hu, Enabling Identity-Based
preserving patient confidentiality. The proposed Integrity Auditing and Data Sharing With
solution serves as a foundation for future Sensitive Information Hiding for Secure Cloud
investigations into advanced cryptographic Storage, Transactions on Information Forensics
techniques and their applicability in enhancing and Security, 2019
the integrity and security of EHR systems.
[2] Yi-Hui Chen; Pei-Yu Lin, Integrated
Hamming Coding Operation to Reversible Data
Hiding Scheme for Encrypted Images, 22nd
International Conference on Software
Proposed F1-measures
Engineering, Artificial Intelligence, Networking
system Precision and Parallel/Distributed Computing (SNPD),
Recall
2021

Existing Accuracy [3] V Vilasini; K Hariharan; Nethra Chezhian; D

system Kaviyarasu, Secured Data Storage Using OAuth
0 50 100 and Encryption of Data Using AES with Patterns
and Hidden Layer, International Conference on
Smart Systems for Electrical, Electronics,
Fig 2 shows the accuracy chart of the
Communication and Computer Engineering,
compared existing and proposed system 2024
6. CONCLUSION AND FUTURE [4] Himanshu Makkar; Durga
ENHANCEMENT
Toshniwal; Shalini Jangra, Closed Itemset
The proposed identity-based data hiding scheme based Sensitive Pattern Hiding for Improved
with information integrity auditing offers a Data Utility and Scalability, International
robust solution for securing cloud storage while Conference on Big Data (Big Data), 2020
facilitating the sharing of sensitive information.
This scheme allows users to share files without [5] Boyang Li, Secure Reversible Data Hiding
exposing confidential data, ensuring that remote in Images with Scalable Capacity, Asia
integrity auditing can be performed seamlessly Symposium on Image Processing (ASIP), 2023
and efficiently. The security analysis, along with
experimental findings, underscores the scheme's [6] Fatina Shukur; Ahmed Fatlawi, Privacy and
effectiveness and reliability. The established Security Awareness for Sensitive/Non-sensitive
objectives of the system have been successfully Data based Wearable Devices, International
achieved, demonstrating promising results Conference on Emerging Trends in Smart
throughout the implementation process. Technologies (ICETST), 2022

Furthermore, the solution ensures secure storage [7] Amare Genetu; Tesfa Tegegne, Designing
and retrieval of records in the cloud, employing Sensitive Personal Information Detection and
encryption and decryption techniques to uphold Classification Model for Amharic Text,
data confidentiality. As the project progresses, International Conference on Information and
future research may focus on further Communication Technology for Development
optimizations to enhance system performance for Africa , 2021
and functionality, potentially leading to more
advanced security measures and improved user [8] Janaki Sivakumar; Mazhar Malik; Arun
experience in cloud environments. Sekar Rajasekaran, Integrity Auditing for Secure
Cloud Storage on Sensitive Data Protection,
IEEE 2nd International Conference on Mobile
Networks and Wireless Communications, 2022

[9] Lulu Xue; Jiani Li; Kejia Zhang; Tianqiu

Yu, Decentralized Multi-Authority Ciphertext-
Policy Attribute-Based Encryption with Hidden
Policy for Cloud Data Sharing, International
Conference on Computer Engineering and
Intelligent Control , 2023

[10] Asha S; Punitha. K; Tanmay Joshi,

Enabling Identity-Based Integrity Auditing and
Data Sharing with Sensitive Information Hiding
for Secure Cloud Storage, Third International
Conference on Intelligent Computing
Instrumentation and Control Technologies,2022