IEEE Consumer Electronics Magazine - September 2018 - 28

Although HIPAA violations can
result in substantial civil and
criminal penalties, the law cannot
fully prevent the theft of private
health information.
system. At the same time, it helps to control the spread of com-
municable diseases.

VISA APPROVAL TO PROTECT FROM
COMMUNICABLE DISEASES
The Internet has become a trusted resource for everyone, and
people are increasingly reliant upon it. Just a few clicks of a
mouse make shopping simpler and more popular than ever.
Studies have shown that demonetization would further increase
the number of online shoppers [1]. Nearly all transactions
require the sharing of sensitive information, such as personal
data, card details, and account-related information, among
others [2]. In today's world, however, the availability of this
information is an attractive target for identity thieves. IBM's
security reports indicate that the total cost of data breaches
increased last year from US$3.8 to US$4 million [3]. Accord-
ing to Steve Durbin of the Information Security Forum, the
situation took an alarming turn in 2017: criminal syndicates,
which are expected to become large private-sector organiza-
tions determined to facilitate their diversification at the global
level, have now turned their attention to damaging companies'
brand reputations [4]. As a result, data security and content
protection is a matter of utmost importance in today's inter-
connected world. [5]. Today, steganography is prevalent in the
field of health-care security [6].

STEGANOGRAPHY IN THE HEALTH-CARE INDUSTRY
The popularity of online applications in varied industries has
prompted the health-care industry to upgrade its information
systems by sharing patients' health records online. However,
this accessibility of patient data prompts concerns of infor-

FIGURE 1. Five-month-old David Henrique Ferreira has microcephaly, a condition linked to the Zika virus and characterized by a
very small head and severe brain damage [14].
28 IEEE Consumer Electronics Magazine

september 2018

mation security. According to HIPAA, patient privacy and
security are essential to safeguarding protected health infor-
mation [7]. Although HIPAA violations can result in substan-
tial civil and criminal penalties, the law cannot fully prevent
the theft of private health information. Secured file sharing
and storing, however, can keep patients' records safe from
unauthorized staff members and outside attackers, thereby
reducing the occurrence of breaches.
The use of steganography is becoming a viable solution
for protecting data. Researchers have found that electrocardi-
ography (ECG) readouts consume many of the signals nec-
essary for hiding patients' confidential data. In [8], a wavelet-based
ECG steganography has been proposed that provides double-
layered security. The encrypted data are hidden within the
ECG signal using discrete wavelet transform steganography.
ECG steganography is also used by employing ant colony
optimization in [9]. A squint pixel-based medical image steg-
anography technique is introduced in [10]. The proposed tech-
nique introduces a new audio steganography approach for the
secure transmission of patients' medical reports from a medi-
cal center to an embassy to facilitate strict and transparent
visa processing, as well as mitigate the spread of communica-
ble diseases. The strong sensitivity of the human auditory
system (HAS) makes audio steganography a challenging
security technique [11]. Despite this fact, the popularity of
audio as cover media is due to the representation of ampli-
tudes in real-number format, which causes very small dis-
tortions after embedding the bits of target data. At the same
time, audio also has some unique characteristics, including
a gradual-rather than sudden-change in amplitudes, the
ability of high frequency to suppress lower-frequency com-
ponents, and the likelihood of environmental factors caus-
ing distortions.

THREATS OF COMMUNICABLE DISEASES
Communicable diseases are transmitted through direct con-
tact (e.g., blood exchange with an infected host) or a nonliv-
ing thing (contaminated surfaces, water, air, foods, and so
on). Medical statistics suggest that international migrants are
carriers of communicable diseases. These diseases are typi-
cally spread through bodily fluids, such as saliva and blood,
and affect the population of the country to which they have
migrated to obtain better job opportunities, higher salaries,
and the prestige of working abroad.
In the 1980s, Haitians were singled out as a high-risk group
of human immunodeficiency virus transmission, which prompt-
ed strict migrant control. The severe acute respiratory syn-
drome outbreak in 2003, H1N1 influenza (swine flu) outbreak
in 2009, Ebola fever outbreak in 2014, and Zika virus out-
break [12] recorded in Brazil in 2015 (Figure 1) became mat-
ters of global concern within a short period of time. These
global health crises necessitated the implementation of an
effective screening process for international entries not only
in the United States but in other countries as well. Interna-
tional adoptees, a subset of these migrants, are also carriers
of diseases such as Balamuthia amebic, meningoencephalitis,

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