Introduction
In the healthcare industry, security and privacy are not just buzzwords but the foundation upon which trust, patient care, and regulatory compliance are built. Consider a scenario where a medical device stores patient diagnostic data. This data is not just a collection of numbers and test results; it's a digital representation of a person's health, history, and potentially sensitive information. If this data were to fall into the wrong hands or be tampered with, the consequences could be dire. Unauthorized access or manipulation of such data could lead to misdiagnoses, inappropriate treatments, or even identity theft. The stakes are high, and so is the need for robust security measures.
TPM 2.0 can take the form of a discrete TPM chip, be integrated into a semiconductor package, or even be part of the firmware running in a trusted execution mode (for example Intel's Platform Trust Technology) which eliminates the cost of a physical part from the bill of materials (BOM).
You can even implement a TPM in software, which is great for learning but is not as secure as a hardware-enabled TPM.
So where are TPMs used in health?
Secure Medical Data Storage
Scenario: A medical device stores patient diagnostic data. A TPM can help ensure that all stored data is encrypted and accessed only with authorized credentials.
Secure Remote Monitoring
Scenario: IoT medical devices transmit patient data to remote servers for real-time monitoring. A TPM can help ensure the authenticity of data transmitted and prevent tampering during transmission.
Firmware and Software Updates
Scenario: Medical devices require regular updates to enhance functionality and security. A TPM can be used to ensure that the system is in a known condition and that only authorized firmware and software updates are installed.
Many TPM features are likely already in use behind the scenes on your system to power both the operating system and privacy functions. However, many more can be used in software development to ensure the security and integrity of medical devices during their deployment and use.
The table below breaks down a few of the use cases enabled by TPMs included in a medical system:
| Baseline TPM Capabilities | Key Storage & Management | Baseline capability |
| Secure Boot | Establish a chain of trust during system restart by verifying the integrity of the bootloader and firmware components, protecting against boot-level attacks. | |
| Platform Configuration | Securely stores and manages platform configuration settings, enhancing security and customization. | |
| Anti-Counterfeiting | Verify the authenticity of hardware components and detect counterfeit devices | |
| Firmware Update Verification | Verify the integrity of firmware and software updates before applying them, protecting against malicious updates | |
| Application Level Capabilities Enabled by TPM | Anti-hammering | Mechanisms to prevent brute force attacks by locking out access after several failed authentication attempts |
| Secure Random Number Generation | Provide a source of high-quality random numbers, which is essential for cryptographic operations. | |
| Security Event Logging | Record security events and audit logs, allowing for forensic analysis and compliance with security policies | |
| Secure Timekeeping | Some have features for secure timekeeping, ensuring accurate and tamper-resistant timestamps | |
| Platform Integrity Measurement | Measure the integrity of the system's software and firmware components. Any changes to these components are detectable | |
| Remote Attestation | Generate a signed attestation of the system's state, allowing remote parties to verify the system's integrity | |
| Sealing and Unsealing | Seal data to the current state of the system. The data can only be unsealed (decrypted) if the system is in the same state, ensuring data confidentiality | |
| Secure Authentication | Support secure authentication protocols, such as challenge-response, enabling secure user authentication | |
| Secure Storage | Protect secrets, certificates, and keys tamper-resistantly, preventing unauthorized access or theft of sensitive information | |
| Sealed Storage | Securely store data bound to the platform's state, ensuring data confidentiality even if the storage medium is physically removed | |
| Secure Remote Password (SRP) Protocol | Perform SRP-based authentication, enhancing the security of password-based authentication |
As we conclude our initial exploration of Trusted Platform Module (TPM) technology and its role in healthcare, it's clear that TPM offers a robust security solution for safeguarding sensitive patient data. From secure medical data storage to remote monitoring and firmware/software updates, TPMs ensure the confidentiality, integrity, and availability of critical healthcare information.
By selecting solutions that leverage TPM capabilities, healthcare organizations can stay ahead of emerging threats and ensure the highest standards of patient care and data protection.
What's Next?
This all sounds interesting, but how do we interact with a TPM? In the next post, we’ll dig in.
Reach out to Intel's Health and Life Sciences team at health.lifesciences@intel.com or learn more about security features at https://www.intel.com/health.
About the Author
Andrew Lamkin is a Health Security-focused AI Solutions Architect at Intel Health & Life Sciences, where he applies his background in mission-critical computing from the defense and aerospace industries to build a foundation for trusted computing in healthcare.
Links and Resources
Google’s TPM simulator: Intel TPM2 Software Stack, IBM TPM Simulator, Google BoringSSL
Trusted Computing Group’s resources on TPM 2.0
Microsoft’s Overview of TPM with Windows
Guide to TPM use in RTI DDS software for key storage
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