DIMScern: A Framework for Discerning DIMSE Services on Remote Medical Devices

Area of Science:

• Digital Health and Medical Informatics
• Cybersecurity in Healthcare
• Network Protocol Analysis

Background:

• The DICOM Message Service Element (DIMSE) protocol is crucial for exchanging sensitive medical imaging data.
• Increased connectivity in digital healthcare makes DIMSE a target for security attacks.
• DIMSE implementations vary across products, leading to inconsistent service availability.

Purpose of the Study:

• To investigate security concerns related to DIMSE message exchange methods.
• To develop a framework for identifying available DIMSE services on remote medical devices.
• To assess the variability of DIMSE service implementations in healthcare IT systems.

Main Methods:

• Development of a novel framework named DIMScern.
• Evaluation of DIMScern on various DIMSE implementations, including commercial products and libraries.
• Remote identification of supported DIMSE services across different healthcare IT systems.

Main Results:

• DIMScern successfully identifies available DIMSE services on remote medical devices.
• The framework demonstrated effectiveness across multiple DIMSE implementations.
• Significant variations in supported DIMSE services were identified across 22 healthcare IT systems.

Conclusions:

• DIMScern provides a valuable tool for understanding the security landscape of DIMSE services in healthcare.
• Awareness of available DIMSE services is critical for identifying potential security vulnerabilities.
• The framework aids in assessing the security posture of digital healthcare systems by highlighting service inconsistencies.