On the use of CryptDB for securing Electronic Health data in the cloud: A performance study

Electronic Health Records (EHRs) are the very personal data and ensuring its privacy and security is an utmost priority. Various laws require the privacy of this data to be ensured and usually this is achieved using strict access control methods. However, these methods have limitations, specifically in case of a server breach. In this paper, we use CryptDB to ensure data confidentiality in EHR Systems. In particular, we investigate the performance of CryptDB with OpenEMR, on different deployment scenarios and varying workloads over the cloud and a local testbed. We identify that CryptDB successfully provides the data confidentiality on the database server when deployed on the cloud. We also find that for a mix workload, the average performance of the OpenEMR with CryptDB in the cloud remains under two seconds which makes CryptDB a viable option for providing security to EHR systems deployed in the cloud. This is the first study to integrate CryptDB with OpenEMR and to profile performance overhead to ensure the data confidentiality under different deployment and varying workload scenarios in the cloud.