Security and privacy issues in e-health cloud-based system: A comprehensive content analysis

The recent advancement in Information and Communication Technology (ICT) has undoubtedly improved services in all sectors in the world. Specifically, Information Technology (IT) has led to a very vital innovation in health sector called electronic health (e-Health). In order to optimize full and excellent benefits of this innovation, its implementation in a cloud-based environment is important. However, with noticeable and numerous benefits inherent from e-Health in a cloud computing, its full utilization is still being hampered by challenges of security and privacy. In this paper, we focused on extensive review of current and existing literatures of various approaches and mechanisms being used to handle security and privacy related matters in e-Health. Strengths and weaknesses of some of these approaches were enunciated. The literature review was carried out after selecting over One Hundred and Ten (1 1 0) original articles and figured out several models adopted in their solutions. After comparing models used, we arrived at the reviewed articles. Reviewed articles were narrowed down to the current number because of similarity observed in the models adopted by some researchers. Also, we give an acceptable and standard definition of e-Health. Effort was made to classify cloud-based models. Security and privacy requirements as recommended by Health Insurance Portability and Accountability Act (HIPAA) were also discussed and provided. Remarks and recommendations were made regarding the review process and future directions on security and privacy of e-Health in cloud computing was also provided. Finally, authors propose a secured and dependable architecture for electronic health that could guarantee efficiency, reliability and regulated access framework to health information. The architecture, though is currently under implementation, will guarantee absolute security and privacy between healthcare providers and the patients. (C) 2018 Production and hosting by Elsevier B.V. on behalf of Faculty of Computers and Information, Cairo University.