The use of Electro Cardio Gram (ECG) signals as a biometric modality has been well-established in healthcare applications and facilities because of its robustness against security attacks compare to the traditional biometrics (e.g. Iris, facial, fingerprint biometrics etc.), which provide momentary verification and require direct contact or proximity. However, recent biometrics based on physiological signals such as ECG, photoplethysmogram, Arterial Blood Pressure etc. possess continuous, aliveness and internal nature properties which make them suitable and unique for providing security and privacy in healthcare remote monitoring systems. The emergence of Internet of Medical Things (IoMTs), biosensors and Wireless Body Area Networks (WBANs) devices have enabled easy monitoring of our vital signals for diagnosis and made remote health monitoring more convenient and seamless. These innovations however, brought with them other challenges including various security threats to communicated or stored data which require stringent security measures to protect the sensitive personal patients’ data. To the best of the authors’ knowledge, previous surveys provide limited discussion on ECG- based biometric security and privacy solutions for healthcare institutions, especially in health remote monitoring systems. In order to provide broader discussion on this regard, this review systematically presents the various ECG-based biometric techniques/measures designed to provide security and privacy of patients’ data in healthcare institutions. Taxonomy of ECG-based biometric techniques for healthcare security is presented. Discussions, challenges and research opportunities were presented to guide healthcare institutions, especially in developing countries to embrace ECG biometric technology in order to mitigate the glaring dangers of security threats on patient’s health records.

Keywords : Biometric; Electrocardiogram; Healthcare; Security; Remote Monitoring Systems.