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To facilitate monitoring and management, modern Implantable Medical Devices(IMDs) are often equipped with wireless capabilities, which raise the risk ofmalicious access to IMDs. Although schemes are proposed to secure the IMDaccess, some issues are still open. First, pre-sharing a long-term key betweena patient's IMD and a doctor's programmer is vulnerable since once the doctor'sprogrammer is compromised, all of her patients suffer; establishing a temporarykey by leveraging proximity gets rid of pre-shared keys, but as the approachlacks real authentication, it can be exploited by nearby adversaries or throughman-in-the-middle attacks. Second, while prolonging the lifetime of IMDs is oneof the most important design goals, few schemes explore to lower thecommunication and computation overhead all at once. Finally, how to safelyrecord the commands issued by doctors for the purpose of forensics, which canbe the last measure to protect the patients' rights, is commonly omitted in theexisting literature. Motivated by these important yet open problems, we proposean innovative scheme e-SAFE, which significantly improves security and safety,reduces the communication overhead and enables IMD-access forensics. We presenta novel lightweight compressive sensing based encryption algorithm to encryptand compress the IMD data simultaneously, reducing the data transmissionoverhead by over 50% while ensuring high data confidentiality and usability.Furthermore, we provide a suite of protocols regarding device pairing,dual-factor authentication, and accountability-enabled access. The securityanalysis and performance evaluation show the validity and efficiency of theproposed scheme.

e-SAFE: Secure, Efficient and Forensics-Enabled Access to Implantable Medical Devices