1. Security of medical data transfer and storage in Internet. Cryptography, antiviral security and electronic signature problems, which must be solved in nearest Future in practical context Piotr Kasztelowicz Piotr Kasztelowicz (Ludwig Rydygier Hospital, Torun) Marek Czubenko, Iwona Zięba Marek Czubenko, Iwona Zięba (Nicholas Copernicus University, Torun)

2. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 2 Security - Important problem In medicine it seems more important to avoid transporting and spreading computing viruses, hacking including illegal information capturing from broken servers and destroying servers as well as other network components. The Law in many countries takes into considerations the legal problem associated with computer and network. Especially specific regulations concerning new technologies in context of Internet publications should be created - the law for authors – copyrights

3. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 3 Local regulations In our opinion except general used legal principles a local regulation code should be created and requested for use. Authorities, who will use Internet for professional medical information transfer can in this situation, if any code exists, keep in their hands important instruments to secure this network Strong careful controls are not necessary, here it seems to be recommended more education activity to learn network users, how to avoid possible complications and what is allowed to do in their network activity

4. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 4 Elements of code (1) Principles of usage PC-computers connected to network Principles of creating, storing and protecting account password to data, servers and services Principles which way and who will be informed about network accidents and damage or problems and how many time need to be to react on such signals. Existing of helpdesk for users is very desirable. Instruments for network and institutional authorities, operators including administrators of whole network and detailed network services (for instance discussing list moderators). Here any special services can posses their separate regulations

5. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 5 Elements of code (2) Network security systems and regulation, how punish attempts of it abuse. What kinds of proofs should be collected before removing a user from network in such cases. Principles to avoid publishing and spreading inappropriate information (propagated sexual violation, racism, other illegal information, permanent, not accepted by institution serving network) to remove it form servers Principles of accessing and staying in rooms, where are placed computers and other network elements.

6. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 6 Passwords avoid to set a password containing simple and known phrases or data, which are characteristic for him or his family (name of wife, date of birth of daughter, registration number of users car) password should be difficult to break it and it should contain minimum eight characters including at least: one letter, one digit and one special character (*,&,@,#...)

7. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 7 Password protection The user should know, he must not give his account to network and password to other persons and to write down password the way, that it can not be simple captured. Network administrator has an important role to educate all, how crucial to network security significance in Internet plays appropriate password protection.

8. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 8 confidentiality levels free free professional professional confidential confidential

9. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 9 Free the information are completely free. There are no access limitation for access to it. There is permission to copy it to others or cite.

10. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 10 Professional this is form of limited access to information, which give permission to get it. if conditions of subscription has been met. The user will be asked to read the code, fill in a form to get access, sometimes to pay a fee. This same level can have the information on net, which seemingly are totally free, but copyright or permission to resent it has been not allowed. Here should be distinguished intentional permission as very important not to t violate the network etiquette and privacy. Intentional permission is like the principle of opened door with inscription, who can go in

11. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 11 Confidential the information are especially protected and can be read by permitted individuals only. It has respect to a large extent of telemedicine, where information about a patient has being transferred through net.

12. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 12 Access control systems – the most important tools of server administrator Control access is most often used and typical to assure a higher degree of security of server This tool can specify the host, which can be permitted to connect to any given port of our server and to accept particular services and reject access from the places, which we can consider to be suspicious of hacking our server Our team has good experience with this method and introducing it to all service can effective protect a medical server from destroying

13. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 13 Example 1 - server Dorota An example of unpermitted access to server Dorota to ftp, connection has been refused Sep 3 00:30:38 dorota ftpd[15251]: refused connect from alfa.robot.plikoskop.pl Sep 5 15:09:06 dorota ftpd[1160]: refused connect from a234190.upc-a.chello.nl Sep 6 00:29:47 dorota ftpd[3177]: refused connect from ip-160-101.evhr.net Sep 8 05:17:02 dorota ftpd[14710]: refused connect from salesjobs.com Sep 8 21:17:33 dorota ftpd[18394]: refused connect from rsh.man.poznan.pl

14. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 14 Example 2 - server Nike An example of unpermitted access to server Nike to ftp, connection has been refused Sep 4 22:46:57 nike ftpd[20570]: refused connect from 202.150.2.34 Sep 5 15:02:47 nike ftpd[24384]: refused connect from a234190.upc-a.chello.nl Sep 6 00:16:11 nike ftpd[26663]: refused connect from ip-160-101.evhr.net Sep 7 21:05:14 nike ftpd[6811]: refused connect from 217.57.19.30 Sep 8 04:47:45 nike ftpd[8817]: refused connect from root@salesjobs.com Sep 8 19:57:41 nike ftpd[12701]: refused connect from rsh.man.poznan.pl

15. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 15 Example of DNS data violation Here was foiled attempt to retrieve by intruder records from domain names server from Sun. DNS is an important service for all networks, therefore information including such data should be primarily secured 2002-04-18 10:35:29.592013500 tcpserver: status: 0/40 2002-04-22 12:28:36.740827500 tcpserver: status: 1/40 2002-04-22 12:28:36.758824500 tcpserver: pid 7240 from 216.23.92.170 2002-04-22 12:28:36.758842500 tcpserver: deny 7240 0:212.51.193.152:53 :216.23.92.170::1897

16. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 16 PGP - public key -----BEGIN PGP PUBLIC KEY BLOCK----- Version: GnuPG v1.0.4 (SunOS) Comment: For info see http://www.gnupg.org mQGiBDpU6zYRBADG3EmYOWIfZQeg8pcsJjDkvRK5RFDIEK3wGOMPGidIJ318n4ee xQF4BJZAo/nIkiaKi3mUDD9qJBuwXB7Dm0+WBD/RovGcHNDsNJZGLA5XE3AQUjMa NmDluSf/vq3lSOsGGmWm1ZiX/+qb4wrZNv+1nnbESAM2MvZklThgsAOfpwCgy6Gj BYlG0qwregGWIq2mLdqXoRcEAKqBlPgRyfbbcmKLl9qQrcraeAsTFAQf9JYkVnzs co4/GoWW3g3QGfhfbHqgmhRvhceU01iVYwUbPwo8ijshcgGth2TbMc6Eu0XInfS6 o3Eh7MdAGqJOXMj6jlgVr3lxaLogRxy2C/3hiYQ3hTIQVtBDN3bkNohuH6fUgTHQ y1Q4A/422X/5fk2tsU4tSuzmzERSsX/3LQJQ1rNp0oD4t8TDD+63c4bf+TSwO9FT 91uuqeCTk/4a5TsLtZa5AvrPxevvScZf4+NvFMB5Y0j5WIPcUh8tuz+WOIUvXgtO 3KhduLLWKFBrVUZ0SWsW5YYbrw9NZbZ8SEpN1VzDvCh6sGQS6rQwUGlvdHIgS2Fz enRlbG93aWN6IChwZWthc3opIDxwZWthc3pAYW0udG9ydW4ucGw+iFcEExECABcF AjpU6zYFCwcKAwQDFQMCAxYCAQIXgAAKCRBdOHPy8+7YrxTJAKClzp37Qw7Fdnyg VjXL+B+FQCquIwCdEy9KkL/n2rUA1Yyg0FWD43jFSFe0PFBpb3RyIEthc3p0ZWxv d2ljeiAocGVrYXN6KSA8UGlvdHIuS2FzenRlbG93aWN6QGFtLnRvcnVuLnBsPohX BBMRAgAXBQI6XMl6BQsHCgMEAxUDAgMWAgECF4AACgkQXThz8vPu2K9r0gCghgk3 PDpkf314abypPNOerM9YubIAoMRmvKcDYQE1MKNl62IbCOb66vO+uQENBDpU69MQ BADaARDwJib9ls/ghnwYAEVXxVZ1Y8Of5F+w96yAJElXXbDjA00oS3iq7j1Z5su0 O1qvCLfZs8EBCWqXNG/Co0Zvr3xss68mvLofsA4FVJEjxrZEc9Qqqm/RUMy3sqig whTLxGDymntb5Hze8gazI4rxp+hWVKkoTtNds/uV1i+efwADBwQAk29GZ8aaqA8F 7FKtcIjBq+WrHc+XZDsJRFz0lAwP3tHcD5Zvzl/UdZjq5U3n9T9zYLfR3iZdGY5u sjaMeRgglxIbTOZPkgVAUXM9OD5pTdV1RsUrQoTv3LN9bPFGpN3D8QWTN6gvzDxN miA4QFc8FQQHp9xr1vVmnoBrX7HUIDyIRgQYEQIABgUCOlTr0wAKCRBdOHPy8+7Y r1cgAJ9E1oJHSptidiU8Bw5s5oKMRJanHACgyMMkGU89aspVrpWLhq0IvOVwXck= =gvP/ -----END PGP PUBLIC KEY BLOCK-----

17. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 17 Letter with electronic signature Date: Sat, 8 Sep 2001 23:36:25 +0200 (MET DST) To: Subject: test podpisanej przesylki -----BEGIN PGP SIGNED MESSAGE----- Hash: SHA1 ta przesylka jest zaopatrzona w elektroniczny podpis -----BEGIN PGP SIGNATURE----- Version: GnuPG v1.0.4 (SunOS) Comment: For info see http://www.gnupg.org iD8DBQE7mo9lXThz8vPu2K8RAoBtAJ0QZAbLdVrzlUN7hcwRFbDg4OlTGwCfcwzk Olrv7EshRYaR4Hr2p0/KfN8= =rJK5 -----END PGP SIGNATURE-----

18. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 18 Verification of signature Date: Sat, 8 Sep 2001 23:36:25 +0200 (MET DST) From: Piotr Kasztelowicz To: Piotr.Kasztelowicz@ptkardio.pl Subject: test podpisanej przesylki ta przesylka jest zaopatrzona w elektroniczny podpis ------------ Output from gpg ------------ gpg: Signature made Sat Sep 08 23:36:37 2001 MET DST using DSA key ID F3EED8AF gpg: Good signature from "Piotr Kasztelowicz (pekasz) " gpg: aka "Piotr Kasztelowicz (pekasz) "

19. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 19 Signing MS-Word document

20. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 20 Signing

21. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 21 Verification signed file (document)

22. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 22 PGP 7.0.3

23. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 23 Keys properties

24. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 24 Sending encrypted mail

25. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 25 Encrypting

26. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 26 Encrypted mail

27. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 27 Decrypting

28. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 28 Signature verifing

29. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 29 Decrypted message

30. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 30 GnuPG/PGP Software compatibility -----BEGIN PGP MESSAGE----- -----BEGIN PGP MESSAGE----- Version: GnuPG v1.0.6 (SunOS) Version: GnuPG v1.0.6 (SunOS) Comment: For info see http://www.gnupg.org Comment: For info see http://www.gnupg.org hQEOA21Q97XJMIdpEAQAqhwOOnhVgbal5ZWjWEvYh0oG 5Lp/dTtb8pEs324fodFp hQEOA21Q97XJMIdpEAQAqhwOOnhVgbal5ZWjWEvYh0oG 5Lp/dTtb8pEs324fodFp b4GNpe3LXVJRmLmoX6u/Ar/bAWEZtCTHDqNWVoiZjTNL pChKdrdPcnQthgF/g+2V b4GNpe3LXVJRmLmoX6u/Ar/bAWEZtCTHDqNWVoiZjTNL pChKdrdPcnQthgF/g+2V g42vZbX9BYhJV+2/akKqP+xFsF7FSmUWwXZ6tlMdMtMy 5h14z4cPsvY+W5vLG2UD g42vZbX9BYhJV+2/akKqP+xFsF7FSmUWwXZ6tlMdMtMy 5h14z4cPsvY+W5vLG2UD +gJtZPF6Yy//HyAsUo+imWkD8VdCVnEcVbLGLAo7TAm+ fVFsOhAF+XomuOHzMzMX +gJtZPF6Yy//HyAsUo+imWkD8VdCVnEcVbLGLAo7TAm+ fVFsOhAF+XomuOHzMzMX PqsByAUDYxYXP+v1UYXH4gRzuZSKOKGjJVxieZEo6rOT QCCjHtLJVWCzBRKha7/o PqsByAUDYxYXP+v1UYXH4gRzuZSKOKGjJVxieZEo6rOT QCCjHtLJVWCzBRKha7/o J4yceVMPMj/oxZCOtBIARMpf1erRZiiRRSHWXtUWIyRK ycAGNAWxVW1oN55sdLag J4yceVMPMj/oxZCOtBIARMpf1erRZiiRRSHWXtUWIyRK ycAGNAWxVW1oN55sdLag UBpWX6fjyd6at0aisaeQioZRy0DGFwfJgz2ncrwS0KYh m/ofJsO8fj7P64skSbeB UBpWX6fjyd6at0aisaeQioZRy0DGFwfJgz2ncrwS0KYh m/ofJsO8fj7P64skSbeB D65eN7gpyLygP2ouV8XrcBwtzb2XEAIzGt0lmgn1HAOY 50Yq9eohYXFqd1els2l3 D65eN7gpyLygP2ouV8XrcBwtzb2XEAIzGt0lmgn1HAOY 50Yq9eohYXFqd1els2l3 izPglAEXr50Lk1il2te4/CQa8MusniE+WxQ2rkJcVtj0 GT2zOe3QInI2v99HTI4o izPglAEXr50Lk1il2te4/CQa8MusniE+WxQ2rkJcVtj0 GT2zOe3QInI2v99HTI4o ZUwfEOjoBrQXObgUgXYkEceKKovn+AcqQ0sOu01L8+d8 sHh7/CtvX5Ld ZUwfEOjoBrQXObgUgXYkEceKKovn+AcqQ0sOu01L8+d8 sHh7/CtvX5Ld =Doyx =Doyx -----END PGP MESSAGE----- -----END PGP MESSAGE----- *** PGP Signature Status: good *** Signer: Piotr Kasztelowicz (pekasz) *** Signed: 02-05-01 19:24:14 *** Verified: 02-05-18 13:11:07 *** BEGIN PGP DECRYPTED/VERIFIED MESSAGE *** test --- Piotr Kasztelowicz [http://www.am.torun.pl/~pekasz] *** END PGP DECRYPTED/VERIFIED MESSAGE ***

31. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 31 Keyserver of Polish Cardiac Society Protocol - http Protocol - http Server - sun.lodz.ptkardio.pl Server - sun.lodz.ptkardio.pl Port - 11371 Port - 11371

32. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 32 Retrieving key from keyserver

33. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 33 Antiviral protection Computing viruses in last years periodically attack computing systems and software They are significant source of problems, losses of profits in commercial system and damages in attacked computers Paradoxically, other than in case of hacking, viruses very seldom destroy internet servers but are only transferred through to Windows workstations, where the devastation is done It is necessary to use on our computer connected to Internet at least two antiviral software –one from this two with function of activity monitoring

34. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 34 Principles how avoid infection (1) it should be avoided to open attachments, and installing it on disks when obtained from unknown persons or from persons, who are us known, but from content of mail body (information) dont follow, that this person will send us such file. The peoples, who send binaries as attachments should inform about it in message body and inform, from which sources originates a file and which with antiviral software has been checked it should be used to send normal email message body only simple text mode, do not use RTF or www form. This can secure of pinning the virus itself to email messages. Simple text mode messages are not able to transfer viruses.

35. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 35 Principles how avoid infection (2) There should be avoided to use email software on workstation to connect with mailservers, which has known bad opinion as viruses transferplaces. We highly recommend Pegasus- Mail or Eudora (including useful Eudora-Light) as free, proven and safe.

36. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 36 Antiviral scanners installed on server A new way to protect our computer against infection is to install antiviral scanner on mail server. The idea is to remove virus before it reaches the target place – work station The scanners installed on mail servers protect many users not only to get email containing such a virus but to send a virus to other peoples from our computer as well In our servers we will gradually install this high effective protection tool

37. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 37 Working of scaner Date: 16 Sep 2001 16:05:40 -0000 From: postmaster@lodz.ptkardio.pl To: pekasz@am.torun.pl Subject: VIRUS IN YOUR MAIL TO Piotr.Kasztelowicz@lodz.ptkardio.pl V I R U S A L E R T Our viruschecker found a VIRUS in your email to "Piotr.Kasztelowicz@lodz.ptkardio.pl". We stopped delivery of this email! Now it is on you to check your system for viruses For further information about this viruschecker see: http://amavis.org/ AMaViS - A Mail Virus Scanner, licenced GPL

38. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 38 example of efficiency to stop popular Romeo & Juliet virus Now it is on you to check your system for viruses Originally bin/qmail-local -- alias /var/qmail/alias Piotr.Kasztelowicz - Piotr.Kasztelowicz lodz.ptkardio.pl pekasz@am.torun.pl./Mailbox The mail has been stored as /var/virusmails/alias/virus-20010916-24862 xxxxxxxxxxxxxxxxxxSun Sep 16 18:05:38 MET DST 2001xxxxxxxxxxxxxxxxxxxxxxx qmail-local (0.2.1) called -- alias /var/qmail/alias Piotr.Kasztelowicz - Piotr.Kasztelowicz lodz.ptkardio.pl pekasz@am.torun.pl./Mailbox FROM: pekasz@am.torun.pl TO: Piotr.Kasztelowicz@lodz.ptkardio.pl maxlevel: 0 Contents of /var/tmp/qmail-local24862/unpacked.: total 86 drwx------ 3 alias nofiles 512 Sep 16 18:05. drwx------ 3 alias nofiles 512 Sep 16 18:05.. -rw------- 1 alias nofiles 242 Sep 16 18:05 1000656338.24879-0.sun drwx------ 2 alias nofiles 512 Sep 16 18:05 SFX -rw------- 1 alias nofiles 6360 Sep 16 18:05 xjuliet.chm -rw------- 1 alias nofiles 34304 Sep 16 18:05 xromeo.exe

39. Telemedicine inter- and intradisciplinary applications May 23-25, 2002 39 Safe network behaviour Establishing common security standards for medical network community based on simple but proven rules and software Educating medical professional s the safe network behaviour Installing antiviral scanners on mail servers and using antiviral software on work stations Creating legal codes to guard network and systems against abusive activity Still monitoring and interchanging information about potential security problems and methods to solve it.