Patients, pacemakers, and implantable defibrillators

Abstract

Implantable medical devices (IMDs) improve patients' quality of life and help sustain their lives. In this study, we explore patient views and values regarding their devices to inform the design of computer security for wireless IMDs. We interviewed 13 individuals with implanted cardiac devices. Key questions concerned the evaluation of 8 mockups of IMD security systems. Our results suggest that some systems that are technically viable are nonetheless undesirable to patients. Patients called out a number of values that affected their attitudes towards the systems, including perceived security, safety, freedom from unwanted cultural and historical associations, and self-image. In our analysis, we extend the Value Sensitive Design value dams and flows technique in order to suggest multiple, complementary systems; in our discussion, we highlight some of the usability, regulatory, and economic complexities that arise from offering multiple options. We conclude by offering design guidelines for future security systems for IMDs.