Post-Quantum Cryptography for Protecting Long-Term Medical Data Archives

Andreas S. Andreou, Constandinos X. Mavromoustakis, Evangelos Markakis +3 more

Homer Papadopoulos, Antonis Korakis, George Balaskas

Hospitals increasingly store highly sensitive clinical data outside the primary facility, including medical imaging archives, long-term backups, clinical documents, and inter-site replicated data. While essential for care delivery, resilience, and collaboration, these off-site workflows expose data to long-term confidentiality risks such as harvest-now-decrypt-later attacks, insider threats at external providers, and future cryptographic degradation—under strict requirements for availability and minimal operational disruption. This paper presents a practical hybrid security architecture that combines post-quantum cryptography (PQC) and quantum key distribution (QKD) to protect off-site hospital data. PQC provides an always-available baseline for secure key delivery across all workflows and coordination between distributed security components, while QKD, when available, supplies additional high-entropy key material through a centralized Key Management System (KMS). Importantly, QKD is treated as an optional enhancement rather than a dependency: when QKD is unavailable, all services continue uninterrupted using PQC-based protection. The architecture is applied to three representative workflows: off-site PACS imaging storage, FHIR-based off-site health record storage, and secure inter-site data transfers.

Mohammed Suhail Hussain, Karmel Arockiasamy, G. Kanimozhi

Taboka Ngwenya, Belinda Mutunhu Ndlovu

The traditional cryptographic methods used to protect healthcare data, especially for the long-term storage of medical imaging records, are becoming increasingly threatened by the quick development of quantum computing. The purpose of this study is to assess the challenges, efficacy, and preparedness of integrating Post-Quantum Cryptography (PQC) into healthcare information systems. Twenty peer-reviewed studies published between 2020 and 2025 were analysed following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) protocol. The review was conducted using a systematic research design that included qualitative thematic synthesis, predetermined eligibility criteria, and database searching. According to the results, lattice-based PQC schemes, specifically, CRYSTALS-Kyber for encryption and CRYSTALS-Dilithium for authentication, show great promise because of their effectiveness, resilience, and suitability for decentralized architectures like blockchain and Internet-of-Medical-Things environments. Nonetheless, the review points out a notable deficiency of empirical assessment in actual healthcare settings, particularly with regard to cloud-based platforms and Picture Archiving and Communication Systems utilized in medical imaging processes. Scalability limitations, intricate key-management specifications, system interoperability restrictions, and the requirement for conformity with regulatory and compliance frameworks are some of the major issues noted. The results indicate that lattice-based PQC schemes have great promise, deployment readiness remains largely at the conceptual and experimental stage, particularly for cloud-based PACS environments. Real-world implementation validation in a healthcare setting has not been achieved.

Yujin Lee, Mpyana Mwamba Merlec, Jin Woo Jung +2 more

The convergence of blockchain technology and the Internet of Medical Things (IoMT) significantly enhances data security and interoperability in healthcare systems. However, emerging quantum computing capabilities pose critical threats to conventional cryptographic algorithms underpinning blockchain security. Moreover, as IoMT devices manage sensitive patient data and perform essential healthcare functions, ensuring robust protection against both classical and quantum attacks has become increasingly urgent. To mitigate these risks, this paper introduces a Post-Quantum Cryptography Integration Framework (PQCIF), designed to protect blockchain-enabled IoMT (BIoMT) systems and infrastructures against classical and quantum attacks. PQ-CIF is a hybrid framework leveraging NIST-standardized post-quantum cryptographic (PQC) algorithms combined with conventional public-private key pair cryptography schemes, strategically integrating them within BIoMT architectures for robust long-term security. We provide comprehensive evaluation metrics and present a detailed case study demonstrating the efficacy and minimal overhead of our proposed framework in a simulated healthcare blockchain network.

Shanu Shrivastava