Security Challenges In Healthcare Cloud Apis: A Systematic Review

Abstract

Cloud computing has a substantial influence on the healthcare ICT infrastructure because of its flexible, scalable, and cost-effective features; it also plays an important role in electronic health record management, clinical workflow, and the
interoperability of disparate healthcare systems. The use of cloud-based Application Programming Interfaces in a healthcare system raises security and compliance risks due to sensitive protected health information and strict data protection requirements. This systematic review describes the various privacy and security challenges and vulnerabilities associated with healthcare cloud application programming interfaces and identifies the most important security areas that need consideration, including authentication protocols, data encryption protocols, and secure data transmission protocols. This article also explains the fundamental building blocks of healthcare cloud APIs and reviews their unique privacy and security challenges for real-time access and interoperability, as well as informed consent workflows. The article analyzes the potential attack surfaces for healthcare
cloud APIs, such as man-in-the-middle attacks, distributed denial of service, and unauthorized access, and their impact on healthcare operations and patient safety. Additional threats include issues with verifying and managing medical device access (like credential management, MFA, token-based authentication, role-based access control, and attribute-based access control), using encryption for stored and transmitted data, managing encryption keys, and how end-to-end encryption affects performance in complex systems. Existing security standards include general and sector-specific recommendations for security hygiene, such as security securityby- design, continuous security monitoring, incident reporting, and regulatory compliance. Emerging security concerns for APIs include artificial intelligence for threat detection, the adoption of zero-trust architecture, and the use of quantumresistant encryption mechanisms in light of quantum computing developments. Recommendations are made for healthcare organizational leadership, cloud service providers, and policymakers to improve API security posture, prompt security innovation and address security challenges while maintaining operational efficiency and privacy compliance.