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Content for  TR 22.826  Word version:  17.1.0

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6  Security AspectsWord‑p. 51

6.1  Introduction

The healthcare industry is currently undergoing many changes, not only in medicine but also in the information technology that serves as the underpinning of healthcare delivery. In fact, advancement in IT and electronic health records (EHRs), as well as reinforcement of professional collaboration (mentoring) and of telemedicine is leading to numerous new complexities. Electronic information is everywhere, often in more than one place at a time, and shall be accessed from everywhere thus making increasingly difficult to keep sensitive healthcare information well protected.
This has led regulatory bodies in every part of the world to iron out new regulatory texts which businesses in the healthcare industry shall be compliant with. Among them, one can cite the following regulations that already cover a broad range of rules impacting the privacy and security of healthcare data. e.g.:
  • Health Information Patient Accountability Act (HIPAA) see [25]
  • Health Information Technology for Economic and Clinical Health (HITECH) see [26]
  • General Data Protection Regulation (GDPR) see [24]
A strong underlying principle in those regulations, is that natural persons, whatever their nationality or residence, have fundamental rights and freedoms, in particular the right to the protection of their personal data.
A good level of protection is provided when privacy is ensured by design or default, meaning that data protection measures are implemented across all data processing activities and endpoints and in accordance to the level of criticality of that data. As an example, "medical health," "genetic data" and "biometric data" are subject to a higher standard of protection than personal data in general.
Then, security traditionally includes the attributes of "Confidentiality", "Integrity" and "Availability" but recently has been also focused on "Auditability" to demonstrate to regulators that patient safety and privacy is maintained throughout entire processing and transporting chain. Compliance and regulatory expectations demand that data access and transfer be therefore well defined and documented.
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6.2  Actors and Responsibilities

In the field of data security, the following roles are often defined:
  • Controllers: natural or legal person that is responsible for handling the whole data life cycle and will have to establish or amend technical and organizational measures to ensure and prove that the processing of personal data fully complies with regulatory requirements. In practise, controllers can be e.g. hospitals, health houses or physicians…
  • Processors: natural or legal person that processes medical data. A processor is required to maintain records of all its processing activities and to maintain disclosure readiness of this information to show compliance. A processor could be for instance a cloud provider offering services to a controller for data storage and processing.
In the process of transporting medical data over a 5G network, in particular if the mobile operator is responsible for any key material that can be used to decrypt the medical data, or is otherwise involved in storing or adjusting the data, then this would involve assigning a processor role to telecom operators. Also, if the operator did not provide sufficient safeguards to protect data loss or if the operator lacks behind in fixing known security holes and vulnerabilities, they may be held accountable by health data controllers and processors.
Interactions between data subjects, regulators, controllers and processors are shown on the picture below:
Reproduction of 3GPP TS 22.826, Figure 6.2-1: Role model on personal data security
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For more information on general data requirements from regulatory bodies, see Annex A.

6.3  Potential RequirementsWord‑p. 52

6.3.1  Existing features partly or fully covering the functionality

Reference number Requirement text Application / Transport Comment
8.9The 5G system shall support data integrity protection and confidentiality methods that serve URLLC and energy constrained devices.TRequirement taken from TS 22.261, however need to add "high data rates" to the requirement text.
8.2, 8.3All requirements related to security management in private slicesTSee TS 22.261
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6.3.2  Potential New Requirements

Reference number Requirement text Application / Transport Comment
6.3.3-1The 5G system shall support security self-assessment of network functions involved in rendering communication services in order to detect malicious cyber activity or compromised systems in the operator's network.T
6.3.3-2The 5G system shall provide suitable APIs to allow an authorized third party to consult security related metrics for the network slices dedicated to that third party, and any report on security breach or malicious activity that would have been self-detected.T
6.3.3-3The 5G system shall allow the operator to authorize a 3rd party to create and modify network slices having appropriate security policies (e.g. user data privacy handling, slices isolation, enhanced logging …) subject to an agreement between the 3rd party and the network operator.T
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7  Consolidated potential requirementsWord‑p. 53

7.1  Security requirements

[7.1-1]
The 5G system shall provide suitable means to allow use of a trusted and authorized 3rd party provided integrity protection mechanism for data exchanged between an authorized UE served by a private slice and a core network entity in that private slice.
[7.1-2]
The 5G system shall provide suitable means to allow use of a trusted and authorized 3rd party provided integrity protection mechanism for data exchanged between an authorized UE served by a non-public network and a core network entity in that non-public network.
[7.1-3]
Based on operator policy, a 5G network shall provide suitable means to allow a trusted and authorized 3rd party to create and modify network slices used for the 3rd party with appropriate security policies (e.g. user data privacy handling, slices isolation, enhanced logging…).
[7.1-4]
Based on operator policy, the 5G system shall provide suitable means to allow a trusted and authorized 3rd party to consult security related logging information for the network slices dedicated to that 3rd party.
[7.1-5]
The 5G system shall support data integrity protection and confidentiality methods that serve URLLC, high data rates and energy constrained devices.
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7.2  Network services performance requirementsWord‑p. 54
Requirement Characteristic parameter Influence quantity
Communi­cation service availa­bility: target value in % Communi­cation service reliabi­lity: Mean Time Between Failure End-to-end latency: maximum Bit rate Direction Message Size [byte] Survival time UE speed # of active UEs Service Area
5.2.2 - 8K 120 fps HDR 10bits real-time video stream with lossless compression
5.2.3 - 4K 120 fps HDR 10bits real-time video stream with lossless compression
>99.99999>1 year<1 ms<50 Gbit/sUE to Network~1500 - ~9000 (note 1)~8msstationary1Room
5.2.4 - Stereoscopic 4K 120 fps HDR 10bits real-time video stream with lossless compression>99.99999>1 year<2 ms<24 Gbit/s (note 2)Network to UE; UE to Network~1500 - ~9000 (note 1)~8msstationary1Room
5.2.2 - 8K 120 fps HDR 10bits real-time video stream with lossless compression
5.2.3 - 4K 120 fps HDR 10bits real-time video stream with lossless compression
5.2.4 - 4K 120 fps HDR 10bits real-time video stream with lossless compression
>99.99999>1 year<1 ms<50 Gbit/sNetwork to UEs~1500 - ~9000 (note 1)~8msstationary<10Room
5.2.3 3D 256 x 256 x 256 voxels 24 bits 10 fps ultrasound unicast data stream>99.9999>1 year<10ms<4 Gbit/sUE to Network~1500~100 msstationary1Room
5.2.4 - Motion control data stream>99.999999>10 year<2 ms<16 Mbit/sNetwork to UE; UE to Network<2000~1 msStationary1Room
5.2.4 - Haptic feedback data stream>99.999999>10 year<2 ms<16 Mbit/sNetwork to UE; UE to Network<2000~1 msStationary1Room
NOTE 1:
MTU size of 1500 bytes is not generally suitable to gigabits connections as it induces many interruptions and loads on CPUs. On the other hand, Ethernet jumbo frames of up to 9000 bytes require all equipment on the forwarding path to support that size in order to avoid fragmentation.
NOTE 2:
No subsampling considered for the generation of the stereoscopic view
 
Requirement Characteristic parameter Influence quantity
Communi­cation service availa­bility: target value in % Communi­cation service reliabi­lity: Mean Time Between Failure End-to-end latency: maximum Bit rate Direction Message Size [byte] Survival time UE speed # of active UEs Service Area
5.3.2 - Compressed 4K (3840x2160 pixels) 60 fps 12 bits per pixel color coded (e.g. YUV 4:1:1) real-time video stream
5.3.4 - Compressed 4K video stream
>99.99>1 month<20 ms<25 Mbit/sUE to Network; Network to UE~1500~100 msstationary<20 per 100 km2Regional
5.3.2 - Uncompressed 512x512 pixels 32 bits 20 fps video stream from ultra-sound probe
5.3.4 - Uncompressed 512x512 pixels 32 bits 20 fps video stream from ultra-sound probe
99.999>>1 month (<1 year)<20 ms160 Mbits/sUE to Network~1500~50 msstationary<20 per 100 km2Regional
5.3.3 - Stereoscopic 4K 60 fps HDR 10bits frame packed real time video (loss less compressed)
5.3.4 - Stereoscopic 4K 60 fps 12 bits per pixel color coded (e.g. YUV 4:1:1) real time video (loss less compressed)
99.99 - 99.9999 (note 2)>1 month (<1 year) (note 2)< 250 ms<6 Gbit/sNetwork to UE; UE to Network~1500 - ~9000 (note 1)~16 msstationary<20 per 100 km2National; Regional
5.3.3 - 4K 60 fps 12 bits per pixel color coded (e.g. YUV 4:1:1) real time video (loss less compressed)>99.999>>1 month (<1 year)< 250 ms<2 Gbit/sNetwork to UEs~1500 - ~9000 (note 1)~16 msstationary<5 per 100m2 (note 3)National
5.3.3 - Haptic feedback
5.3.4 - Haptic feedback data stream
>99.9999> 1 year<20 ms<16 Mbit/sNetwork to UE; UE to Network<2000~1 msstationary<20 per 100 km2National; Regional
NOTE 1:
MTU size of 1500 bytes is not generally suitable to gigabits connections as it induces many interruptions and loads on CPUs. On the other hand, Ethernet jumbo frames of up to 9000 bytes require all equipment on the forwarding path to support that size in order to avoid fragmentation.
NOTE 2:
Higher values are needed for telesurgery systems.
NOTE 3:
This comprises a maximum of 5 displays gathered in the same 100m2 room considering a room density <2 per 1000km2
 
Requirement Characteristic parameter Influence quantity
Communi­cation service availa­bility: target value in % Communi­cation service reliabi­lity: Mean Time Between Failure End-to-end latency: maximum Bit rate Direction Message Size [byte] Survival time UE speed # of active UEs Service Area
5.5.2 - Uncompressed 2048x2048 pixels 16 bits per pixel 10 fps real-time video scan stream99.99>>1 month (<1 year)< 100ms670 Mbit/sUE to Network~1500<100 ms<150<20 per 100 km2Regional
5.5.2 - Compressed 4K (3840x2160 pixels) 12 bits per pixel (e.g. YV12) 60 fps real time video stream99.99>1 month< 100ms25 Mbits/sUE to Network~1500<100 ms<150<20 per 100 km2Regional
5.5.2 - Physical vital signs monitoring data stream>99.999>>1 month (<1 year)<100 ms<1 Mbit/sUE to Network~80-<150<20 per 100 km2Regional
5.5.2 - High quality audio stream>99.99>1 month<100 ms<128 kbit/sNetwork to UE; UE to Network~300~16 ms<150<20 per 100 km2Regional
5.5.3 - Cardiac telemetry outside the hospital (note 2)>99.9999<1 year (>>1 month)<100 ms0.5 Mbit/sUEs to Network<1000<1 s<50010/km2 - 1000/km2Country wide including rural areas; Deep Indoor (note 1)
NOTE 1:
In this context, "deep indoor" term is meant to be places like e.g. elevators, building's basement, underground parking lot, …
NOTE 2:
These performance requirements aim energy-efficient transmissions performed using a device powered with a 3.3V battery of capacity <1000 mAh that can last at least 1 month without recharging and whereby the peak current for transmit operations stays below 50 mA.
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7.3  Clock synchronization requirementsWord‑p. 57
Use case reference Number of devices for clock synchronisation Clock synchronicity requirement Service area
5.3.3 - Communication QoS requirement for robotic telesurgeryUp to 10 UEs< 50 μs400 km
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8  Conclusion and recommendationsWord‑p. 58
The current TR provides a number of use cases for communication services related to critical medical applications in the following categories:
Image Assisted Surgery inside hybrid operating rooms equipped with high quality and augmented imaging systems
Robotic Aided Surgery inside hybrid operating rooms or in remote medical facilities
Tele-diagnosis and monitoring in ambulances, hospitals or remote healthcare facilities
For the above listed areas, the document identifies potential performances requirements for 3GPP communication systems involved in the delivery of care or surgery to patients so that considered medical procedures are carried out with adequate level of safety and efficiency.
In addition, the document also proposes potential requirements needed to ensure handling of medical related data in 3GPP communication systems while fulfilling confidentiality, integrity and auditability principles set forth in regulatory texts.
It is proposed that those requirements are considered for development of normative requirements.
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A  Security ConsiderationsWord‑p. 59

A.1  Regulatory texts' analysis

As a general rule, organizations involved in controlling and/or processing the data have to be careful with the data and exact in knowing where it is being stored, how it is being processed and whether consent has been given. Parsing national regulations along those lines for general data management requirements in light of the role models explained in clause 6.2, leads to the following mapping of high-level requirements on the involved actors.
Requirements Controllers Processors Comment
Explicit Consent: data subjects to explicitly give their consent (declaratory statement or opt-in tick box) for processing their medical, genetic or biometric data X
Right to Data Portability: data subjects to have their personal data sent back to them to transmit elsewhere more easily X
Right to Be Forgotten: data subjects to have their personal data erased without undue delay X
Right to rectification: data subjects to obtain from the controller without undue delay the rectification of inaccurate personal data concerning him or her X
Right to restriction of processing: data subjects to obtain from the controller restriction of processing under certain circumstances X
Subject Access Rights, the request to access data must be addressed quickly (less than one month) X
Appointment of a Data Protection Officer where medical, genetic or biometric data is processed in a large scale XX
Data Protection Impact Assessment: risk assessment of the impact of anticipated processing activities on personal, medical, genetic or biometric data XXFor telcos, this implies a certain level of security policies parametrization in order to cope with different type of data
Mandatory data breach reporting: breaches must be reported to a data protection regulator within 72 hours, and those affected by the breach must also be informed. XX
Anonymization: the method of processing personal data in order to irreversibly prevent identification. XX
Data confidentiality: protection of data from being accessed by unauthorised parties through e.g. pseudonymization and/or encryption of personal data XX
Data Integrity: maintenance of the accuracy and consistency of data throughout its entire life cycle XX
Integrity, availability and resilience of processing systems and services against accidental loss, destruction or malicious actions that compromise the availability, authenticity, integrity and confidentiality of stored or transmitted personal data XXFor telcos, this requirement leads to the need of having self-assessment of systems related to their ability to process the data according to regulatory rules
Existence of a process for regularly testing, assessing and evaluating the effectiveness of technical and organisational measures for ensuring the security of the processing XXFor telcos this means the ability to monitor and assess security policies and their efficiency
Traceability: care providers to determine the initial source of the data, and what happened to it through its various locations and transformations. XXFor telcos this implies enhanced logging capabilities for highly secured communication services
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$  Change historyWord‑p. 61

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