# Smart Healthcare Applications over 5G Networks: A Systematic Review
## 3 Results and Discussion
### RQ3: What Are the Security Mechanisms or Protocols Required by Smart Health Systems Based on 5G?
#### 3.3.1 Authentication  
This protocol is established in three ways: between the user and the service provider, between two devices, and between a device and the network [24].  
Figure 13 shows that authentication (31.82%, \(n=14\)) is the security protocol that attracted most the attention from the authors. [PERSON] and [PERSON] [24] proposed an identity management (IdM) framework for mutual authentication, identity protection, and trusted security. This system was considered for both wireless access and cloud access. Additionally, it is mentioned that through the use of AI [26; 48], an authentication system for users can be achieved, which ensures the security of updating patient information periodically via portable devices through scripts [34]. Additionally, [41] presented Zero-Trust, which is a security architecture that constantly evaluates network vulnerabilities based on traffic detection, logging, and analysis. In this, way it reduces malicious access and continuously monitors client behavior.  
Figure 13: Security protocols.  
Another type of security architecture that uses authentication is EAP-TLS (Extensible Authentication Protocol--Transport Layer Security) [46]. This architecture is used in private networks and in systems that make use of IoT devices, for the authentication of the user equipment (UE) and the virtual network. It consists of three main actors: user, authenticator, and server. It is focused on the use of symmetric keys and has the ability to manage user accessibility to virtual systems through user and system authentication.  
To ensure the protection of medical data in telemedicine systems, [PERSON] and [PERSON] [49] proposed an architecture for federated anonymous identity management (FAIDM). The presented scheme has three nodes: a restricted node, a gateway node, and a remote server node. The restricted node is in the layer of devices (body sensors and wearable devices) that collect physiological data. The gateway node is in the communication layer, and the remote server node is in the system architecture layer. This security scheme provides a key to the user for secure transmission of information. Validation is performed by mutual authentication. Additionally, it provides the devices with an anonymous identity to reduce the risk of patient data leakage.  
UCSSO (User Controlled Single Sign-On Authentication) is another authentication system proposed by [PERSON] et al. [53], which through authenticated session keys can establish a reliable communication channel between patients and services. In addition, the user can use a smartcard to access the server securely. The proposed system consists of four stages (initialization stage, registration stage, authenticated password exchange stage, and offline key change stage) that guarantee the privacy of the user's medical data.  
The protocol proposed by [PERSON] et al. [54] consists of three stages: registration, login, and authentication. In the registration stage, the user and the server are connected through the Internet. The server registers and provides the user with a smart card. In the login stage, the user uses a smart card reader to communicate with the server. Additionally, in the authentication stage, if the user is legal, he can make use of the services provided by the server.