Secure communication and authentication in the Internet of Medical Things (IoMT) are critical for patient safety and healthcare data protection, yet existing protocols face significant vulnerabilities that remain undetected by conventional verification approaches. This paper presents the computational security verification of an IoMT authentication protocol incorporating NTRU lattice-based post-quantum cryptography using CryptoVerif, a formal verification tool that provides concrete probability bounds under standard cryptographic assumptions. Through systematic analysis of a multi-entity healthcare protocol, this study identifies two critical security flaws overlooked by previous symbolic verification methods: device registration authentication failure enabling man-in-the-middle device substitution attacks, and forward secrecy violation through static key encryption that exposes historical medical data upon key compromise. To address these vulnerabilities, we provide an enhanced protocol incorporating Strong Unforgeability under Chosen Message Attacks (SUF-CMA) MAC-based device authentication that cryptographically binds device identity to patient identity, and HMAC-based key derivation function (HKDF)-derived ephemeral session keys that achieve forward secrecy through fresh key derivation for each communication session. Our CryptoVerif implementation successfully proves nine security properties including mutual authentication, data confidentiality, device binding, and forward secrecy, with aggregate security bound for 128-bit quantum-resistant security. Unlike symbolic verification tools that assume perfect cryptography, our computational analysis provides concrete security guarantees essential for safety-critical healthcare systems.
Secure communication and authentication in the Internet of Medical Things (IoMT) are critical for patient safety and healthcare data protection, yet existing protocols face significant vulnerabilities that remain undetected by conventional verification approaches. This paper presents the computational security verification of an IoMT authentication protocol incorporating NTRU lattice-based post-quantum cryptography using CryptoVerif, a formal verification tool that provides concrete probability bounds under standard cryptographic assumptions. Through systematic analysis of a multi-entity healthcare protocol, this study identifies two critical security flaws overlooked by previous symbolic verification methods: device registration authentication failure enabling man-in-the-middle device substitution attacks, and forward secrecy violation through static key encryption that exposes historical medical data upon key compromise. To address these vulnerabilities, we provide an enhanced protocol incorporating Strong Unforgeability under Chosen Message Attacks (SUF-CMA) MAC-based device authentication that cryptographically binds device identity to patient identity, and HMAC-based key derivation function (HKDF)-derived ephemeral session keys that achieve forward secrecy through fresh key derivation for each communication session. Our CryptoVerif implementation successfully proves nine security properties including mutual authentication, data confidentiality, device binding, and forward secrecy, with aggregate security bound for 128-bit quantum-resistant security. Unlike symbolic verification tools that assume perfect cryptography, our computational analysis provides concrete security guarantees essential for safety-critical healthcare systems.
The emergence and growth of the Internet of Medical Things (IoMT) have transformed the way healthcare services are delivered, but this growth comes with its own security challenges, especially with the emergence of quantum computing. This paper presents a lightweight, privacy-preserving authentication scheme for edge-based IoMT environments, integrating CRYSTALS-Kyber Key Encapsulation Mechanism (KEM) to securely establish session keys between participating entities and resilience against quantum attacks, while CRYSTALS-Dilithium is utilized as the digital signature scheme to ensure message integrity, authentication, and non-repudiation. These NIST-standardized post-quantum primitives collectively strengthen the system's resistance against quantum adversaries and enhance overall cryptographic robustness. The proposed system comprises two phases: Registration and Authentication. During registration, patients, wearable devices that utilize Physically Unclonable Functions (PUFs), and medical specialists register with a Trusted Authority via edge nodes. The authentication phase encompasses mutual authentication among patients, devices, medical specialists, edge nodes, and cloud servers, ensuring that only authorized entities access sensitive health information. In addition, the proposed scheme employs the formal security properties, such as authenticity and secrecy, are verified using the AVISPA tool under the Dolev-Yao model, with results confirming that all defined goals are achieved and no attacks are found. Performance evaluations indicate that the scheme is computationally efficient and suitable for resource-constrained IoMT devices. Furthermore, BAN logic is employed to formally verify the correctness of the authentication protocol, demonstrating that mutual authentication is securely established among the participating entities under well-defined trust assumptions. By integrating post-quantum cryptographic techniques, this authentication framework addresses emerging security challenges posed by quantum computing, aligning with the objectives of enhancing edge-based consumer electronics devices and Internet of Things (IoT) ecosystems with post-quantum cryptosystems.
The rapid adoption of Internet of Medical Things (IoMT) devices enables real-time patient monitoring and remote diagnostics and has revolutionized healthcare delivery. Traditional cryptographic schemes like RSA and ECC, which rely on meaningful mathematical challenges, are under great threat from quantum computing, threatening sensitive medical data confidentiality and integrity. This paper proposes a quantum-resistant healthcare security framework based on lattice-based cryptographic primitives such as Learning With Errors (LWE), Ring-LWE (RLWE), and Short Integer Solution (SIS). To this end, we design a five-phase IoMT-friendly framework—Initialization, Registration, Authentication, Data Exchange, and Treatment—where each phase is backed up by lightweight cryptography primitives that can be easily implemented on the low-resource IoMT devices. Relative to the state-of-the-art lattice- and hash-based constructions, our framework involves 50-75% smaller ciphertext sizes, up to a 50% reduction of the communication overhead, and nearly 60% less in computational cost. Furthermore, the solution relies on zero-knowledge proofs, homomorphic encryption as well and attribute-based access control to guarantee strong security and privacy. Using the AVISPA tool, the framework is formally verified, showing its resistance against classical and quantum adversaries. Focusing on tangible healthcare threats, including data tampering and unlicensed access to patient diagnostics, this research paves the way for scalable, efficient, and quantum-resistant medical data protection. Our results pave the way for future investigations into secure post-quantum healthcare and IoT applications.
As the healthcare sector transitions to the Internet of Medical Things (IoMT), it promises significant improvements in productivity by streamlining processes, reducing administrative burdens, and automating routine tasks. However, the current authentication methods are vulnerable due to reliance on simple passwords and a lack of additional protective layers, posing a heightened risk of data breaches. Given the significant value of medical data, security measures for medical devices remain inadequate, especially in safeguarding user and device identities against future quantum computing threats. This paper proposes an enhanced authentication protocol aimed at ensuring the confidentiality and integrity of medical data. The protocol validates user and device identities while incorporating post-quantum cryptography to address upcoming challenges posed by quantum technology.
In an Internet of Things (IoT)-based healthcare system, medical IoT devices gather and transmit critical patient data. Ensuring the security and privacy of medical data is paramount. One of the most critical challenges in this regard is the authentication of participating entities. The literature proposes specific authentication approaches for healthcare systems based on integer factorization and discrete logarithm problems. However, the advent of quantum computers would fundamentally break all of these protocols. In this study, we conducted an analysis of a recently proposed authentication and access control scheme for e-health systems, which is based on lattice-based cryptography and was developed by Gupta et al. Our analysis revealed that the scheme is vulnerable to several types of attacks, including impersonation, de-synchronization, and smart card stolen attacks, which could compromise the confidentiality and integrity of sensitive medical data. To address these security challenges, we propose an alternative authentication and access control scheme that uses Saber, a finalist lattice-based key encapsulation algorithm from round three of the NIST post-quantum cryptography standardization. One of the biggest advantages of Saber is its simplicity and efficiency. Our proposed scheme is designed specifically for e-health systems and provides robust protection against the vulnerabilities identified in Gupta et al.’s scheme. We believe that our proposed scheme represents a significant improvement over existing approaches and could help to enhance the security and privacy of e-health systems. Upon completion of our improved protocol, we proceeded to implement it within the Vivado 2018.3 environment for Zynq UltraScale FPGAs. To gather insight into its performance, we conducted a performance comparison study with various related protocols.
With IoMT, healthcare is being changed rapidly by allowing data from patients to be monitored and managed remotely. But the fact that IoMT devices have weak resources, need strict timing and send sensitive data makes it challenging to secure and operate efficiently. As quantum computers are almost ready to break conventional cryptography, it is important to create post-quantum cryptographic methods for the IoMT. The paper introduces an Energy-Saving, Layered and Safe Routing Protocol (EEMSRP) for use in post-quantum cryptographic networks in the IoMT. It includes several layers of security, using lattice-based post-quantum cryptography and improved routing methods to cut back on energy use. The framework uses hierarchical architecture to organize devices, adopts clustering and relies on lightweight algorithms for post-quantum key exchange. Results from simulations find that EEMSRP is able to save up to 30% of the energy used by existing quantum-resistant protocols, but still remains secure against eavesdropping, man-in-the-middle attacks and quantum-based cryptanalysis. Because of its multi-layer defense, the protocol guarantees the privacy, accuracy and continued accessibility of IoMT data. This research provides a base for upcoming secure and power-efficient communication standards in the post-quantum world, which is important for guarding private medical details and guaranteeing reliable IoMT use.
Given the critical role of medical information in medical cryptographic processes, it is essential to have rigorous security validation to prevent any vulnerabilities in the authentication process that could lead to unauthorized access and access to clinical information and allow unauthorized treatment decisions to be made.This study introduces a formal security-proof framework to assess the security of authentication, confidentiality, integrity, anonymity and security of session-keys in connected healthcare settings.The proposed protocol uses finite field operations, cryptographic hashes, key derivation functions, random nonces, timestamps and medical professionals and patients.Adversarial games, mutual-authentication proofs, session-key indistinguishability and resistance to replay, impersonation, man-in-the-middle and privileged-insider attacks are discussed in the context of security.The formal reasoning approach has a negligible adversarial advantage, given the computational assumptions.Comparative evaluation shows the overhead of the authentication process is lower, but the protection of the medical devices is still high, even when considering the limited resources of medical devices.The framework provides a mathematically sound basis for designing reliable, private and effective healthcare communication systems in a heterogeneous clinical network and infrastructure.