J Med Syst (2017) 41:14 DOI 10.1007/s10916-016-0658-3 SYSTEMS-LEVEL QUALITY IMPROVEMENT A Survey of Authentication Schemes in Telecare Medicine Information Systems Muhammad Umair Aslam 1 · Abdelouahid Derhab 2 · Kashif Saleem 2 · Haider Abbas 1,2,3 · Mehmet Orgun 4,5 · Waseem Iqbal 1 · Baber Aslam 1 Received: 6 June 2016 / Accepted: 8 November 2016 © Springer Science+Business Media New York 2016 Abstract E-Healthcare is an emerging field that provides mobility to its users. The protected health information of the users are stored at a remote server (Telecare Medi- cal Information System) and can be accessed by the users at anytime. Many authentication protocols have been pro- posed to ensure the secure authenticated access to the Telecare Medical Information System. These protocols are designed to provide certain properties such as: anonymity, untraceability, unlinkability, privacy, confidentiality, avail- ability and integrity. They also aim to build a key exchange mechanism, which provides security against some attacks such as: identity theft, password guessing, denial of ser- vice, impersonation and insider attacks. This paper reviews these proposed authentication protocols and discusses their This article is part of the Topical Collection on Systems-Level Quality Improvement  Haider Abbas haidera@kth.se 1 National University of Sciences and Technology, Islamabad, Pakistan 2 Center of Excellence in Information Assurance (CoEIA), King Saud University, Riyadh, 12372, Kingdom of Saudi Arabia 3 Department of Computer Sciences, Florida Institute of Technology, 150 W University Blvd, Melbourne, FL 32901, USA 4 Department of Computing, Macquarie University, Sydney, NSW, 2109, Australia 5 The Faculty of Information Technology, Macau University of Science and Technology, Taipa, Macau, People’s Republic of China strengths and weaknesses in terms of ensured security and privacy properties, and computation cost. The schemes are divided in three broad categories of one-factor, two-factor and three-factor authentication schemes. Inter-category and intra-category comparison has been performed for these schemes and based on the derived results we propose future directions and recommendations that can be very helpful to the researchers who work on the design and implementation of authentication protocols. Keywords Telecare medicine information system · Password · Smart card · Biometric · User anonymity · User interaction Introduction With the advancement of technology, healthcare services can be provided remotely, where sensors measure the patient’s condition, feed the data to mobile devices such as PDAs or cell phones and from where it is transmitted to heath provider’s Telecare Medicine Information System (TMIS). TMIS has provided the leverage of movement to both patients and physicians. Patients can login to the sys- tem to check their medical records, get test results and history of prescribed medicines. Physicians can check the history of prescribed medicines, test results and on the basis of those can always change the prescription [1, 2]. As the communication between a cell phone/smart card and TMIS takes place on the public Internet, the whole sys- tem is vulnerable to threats associated with open Internet [2]. Privacy and especially anonymity is the biggest hur- dle in implementation of an e-Healthcare system globally. In e-Healthcare, a patient registers with the TMIS to access health services remotely. Then, he/she needs to login to