High-Dimensional Quantum Key Distribution for Secure Healthcare Communication Systems: Integrating Internet of Medical Things, Electronic Health Records, and Smart Medical Gate
The emergence and advancement of technologies such as the Internet of Medical Things (IoMT), Electronic Health Records (EHR), and Smart Medical Gate (SMG) have remarkably changed patient care practices. With the digitization of healthcare services, concerns regarding data security have increased. These systems face increasing risks due to cyber threats and the advances of quantum computing technology. For instance, Peter Shor’s quantum algorithms are predicted to affect the integrity and confidentiality of sensitive medical data. This puts classical (non-quantum) cryptographic systems such as RSA (Ron Rivest, Adi Shamir, and Leonard Adleman) and ECC (Elliptic Curve Cryptography) at risk. This work proposes an integrated high-dimensional quantum key distribution (HD-QKD) infrastructure for secure medical data transmission across IoMT, EHR, and SMG ecosystems. It introduces a cloud-based Central EHR/Cloud Server for key management, along with edge Quantum Security Gateways. The system employs qudit encoding (d > 2) over a 50 km optical fiber link with 12-dB attenuation. Its edge-centric design ensures noise resilience and delivers a high information rate per photon. It also provides low-latency security against quantum threats while maintaining compatibility with existing fiber networks through wavelength division multiplexing. Simulations validate the system's potential, achieving secure key rates of 2.5 megabits per second between medical structures-double the rate of prior qubit-based Quantum Key Distribution (QKD) protocols-demonstrating superior scalability and performance for real-time healthcare applications.
The emergence and advancement of technologies such as the Internet of Medical Things (IoMT), Electronic Health Records (EHR), and Smart Medical Gate (SMG) have remarkably changed patient care practices. With the digitization of healthcare services, concerns regarding data security have increased. These systems face increasing risks due to cyber threats and the advances of quantum computing technology. For instance, Peter Shor’s quantum algorithms are predicted to affect the integrity and confidentiality of sensitive medical data. This puts classical (non-quantum) cryptographic systems such as RSA (Ron Rivest, Adi Shamir, and Leonard Adleman) and ECC (Elliptic Curve Cryptography) at risk. This work proposes an integrated high-dimensional quantum key distribution (HD-QKD) infrastructure for secure medical data transmission across IoMT, EHR, and SMG ecosystems. It introduces a cloud-based Central EHR/Cloud Server for key management, along with edge Quantum Security Gateways. The system employs qudit encoding (d > 2) over a 50 km optical fiber link with 12-dB attenuation. Its edge-centric design ensures noise resilience and delivers a high information rate per photon. It also provides low-latency security against quantum threats while maintaining compatibility with existing fiber networks through wavelength division multiplexing. Simulations validate the system's potential, achieving secure key rates of 2.5 megabits per second between medical structures-double the rate of prior qubit-based Quantum Key Distribution (QKD) protocols-demonstrating superior scalability and performance for real-time healthcare applications.
The increasing digitalization of the healthcare system, driven by electronic health records, medical IoT devices, and AI-aided diagnostics, has significantly expanded the attack surface for cyber threats. Although current cryptographic protocols provide sufficient security against classical adversaries, new developments in quantum computing threaten the confidentiality, integrity, and availability of medical information as never before. Shor’s algorithm could break widely used asymmetric encryption systems, and Grover’s algorithm weakens symmetric ones, which could render modern healthcare security systems obsolete. This review provides an in-depth and organized analysis of the evolving quantum threat environment in healthcare ecosystems and of the need to move toward quantum-resilient security architectures. It synthesizes the existing literature on post-quantum cryptography (PQC) and identifies lattice-based, hash-based, multivariate, and code-based algorithms as potentially viable long-term replacements. Moreover, it examines the cybersecurity issues that quantum-enabled attacks pose to medical IoT systems, clinical decision-support systems, wearable sensors, telemedicine systems, and cloud-based health information exchanges. The review also covers hybrid quantum-classical defenses, quantum key distribution (QKD), quantum random number generation (QRNG), and blockchain-based trust systems that aim to make systems resilient to advanced persistent quantum attacks. This paper identifies key gaps and outlines future research directions for developing quantum-secure medical systems. The results highlight the importance of early adoption of PQC standards and a layered cyber defense approach to protect patient privacy, ensure regulatory compliance, and retain trust in next-generation digital medical data communication.
The healthcare sector increasingly relies on Cyber-Physical Systems (CPS) that integrate medical devices, networks, and digital records to deliver critical patient care. Protecting sensitive medical data within these interconnected systems is vital due to potential privacy violations and safety risks. The initiation of quantum computing poses substantial threats to traditional cryptographic algorithms, which underpin current healthcare data security. This article examines the deployment of quantum-safe cryptographic algorithms considered to resist quantum attacks, enabling robust protection of healthcare CPS. It highlights advanced encryption methods including lattice-based, hash-based, and code-based post-quantum schemes, alongside quantum key distribution (QKD) for secure key management. The discussion includes challenges related to healthcare-specific system constraints, regulatory compliance, and integration complexity. Through adopting quantum-resistant cryptography and comprehensive key management protocols, healthcare organizations can safeguard electronic health records (EHRs), device communication, and patient data against incipient post-quantum threats, ensuring long-term data confidentiality, integrity, and system resilience.
The advent of Quantum Key Distribution (QKD) and quantum-based privacy-preserving techniques has ushered in a new era for securing communication channels within the Internet of Medical Things (IoMT) systems. We examine the fundamentals, uses, and ramifications of quantum cryptography in relation to healthcare data security in this thorough investigation. The journey commences with an in-depth overview of quantum cryptography, unraveling the concepts of superposition, entanglement, and quantum gates that form the bedrock of quantum computing. As we proceed, we investigate the uses of quantum cryptography, highlighting its contribution to resolving the particular issues brought about by the data-intensive and networked character of IoMT systems. The relevance of QKD in ensuring secure communication within IoMT is meticulously dissected, with case studies and experiments demonstrating the practicality and effectiveness of quantum-based privacy-preserving techniques. From telemedicine networks to wearable health devices, each case study offers valuable insights into the application of quantum-safe cryptography, showcasing its ability to fortify data integrity and confidentiality. A meticulous survey of existing research, coupled with an analysis of advancements in quantum cryptography, provides a panoramic view of the current landscape. From hardware limitations to distance constraints, the study navigates through challenges and breakthroughs, offering a roadmap for the future integration of quantum technologies into IoMT systems.Comparing quantum-based approaches with classical cryptography unveils a nuanced landscape of computational complexity, key distribution methodologies, and real-time encryption considerations. This comparative analysis serves as a guide for healthcare practitioners and technologists in making informed decisions regarding the adoption of quantum-based privacy-preserving techniques in IoMT environments. The case studies and experiments collectively paint a picture of the practicality and promise of quantum-based privacy-preserving techniques in IoMT scenarios. Anticipating future advancements, the exploration extends into quantum hardware improvements, standardization efforts, and the integration of quantum technologies with emerging trends like edge computing and blockchain. As the healthcare industry stands on the cusp of a quantum revolution, the comprehensive insights provided herein offer a foundation for understanding, implementing, and shaping the future of secure healthcare communication through the lens of quantum cryptography.
The rapid advancement of quantum computing poses a significant threat to current cryptographic standards, particularly those securing electronic health records (EHRs) in healthcare systems.Traditional encryption methods such as RSA, ECC, and AES, while robust against classical attacks, are vulnerable to quantum algorithms like Shor's and Grover's, which can efficiently break cryptographic keys and compromise patient data integrity.As healthcare systems become increasingly interconnected through the Internet of Things (IoT) and cloud-based infrastructures, the need for quantum-resistant security mechanisms becomes paramount.Post-Quantum Cryptography (PQC) emerges as a viable solution to future-proof EHR security by employing lattice-based, hash-based, code-based, and multivariate polynomial cryptographic techniques that remain resistant to quantum attacks.This paper explores the implications of quantum computing on healthcare cybersecurity, emphasizing the vulnerabilities of existing encryption protocols and the necessity of transitioning toward PQC frameworks.Furthermore, we examine the integration of PQC within healthcare infrastructures, focusing on key exchange mechanisms, digital signatures, and end-to-end encryption for secure EHR transactions.Additionally, the study highlights regulatory and compliance considerations, including the National Institute of Standards and Technology (NIST) PQC standardization efforts and the role of Zero Trust security models in mitigating quantum-era cyber risks.Case studies illustrate successful implementations of PQC in healthcare networks, demonstrating its feasibility and effectiveness in safeguarding sensitive medical information.By adopting quantum-resistant cryptographic standards, healthcare institutions can proactively defend against emerging cyber threats, ensuring data confidentiality, integrity, and long-term resilience in the face of quantum computing advancements.
The rapid digitalisation of healthcare has accelerated the adoption of telemedicine, Electronic Health Records (EHRs), and the Internet of Medical Things (IoMT), transforming healthcare delivery into a highly interconnected and patient-centric ecosystem. In response to growing concerns about data security, privacy, and interoperability, blockchain technology has emerged as a promising solution for its decentralization, immutability, auditability, and secure access control. However, many existing blockchain infrastructures rely on classical cryptographic primitives, including RSA- or elliptic-curve-based public-key mechanisms and cryptographic hash functions such as SHA-256, whose relevant security properties may be affected by sufficiently powerful quantum attacks. This review investigates the convergence of blockchain and quantum technologies to address emerging security threats in e-health systems. A structured literature review was conducted in accordance with the PRISMA 2020 guidelines using the IEEE Xplore, PubMed, ACM Digital Library, Google Scholar, and Crossref databases, covering studies published between January 2018 and June 2025. Following a systematic screening and eligibility-verification process, 57 relevant studies were selected and analyzed. The review evaluates quantum-resilient security mechanisms, including Quantum Key Distribution (QKD), Quantum Random Number Generation (QRNG), and NIST-standardized Post-Quantum Cryptography (PQC) algorithms specified in FIPS 203, FIPS 204, and FIPS 205. Based on the identified research gaps in the state of the art, this study also proposes a novel four-layer Quantum-Blockchain Security Architecture (QBSA) designed for secure healthcare environments. The analysis further reveals significant challenges associated with lightweight PQC deployment for IoMT devices, interoperability standardization, quantum hardware limitations, and regulatory compliance in cross-institutional healthcare systems. The findings highlight the necessity of integrating quantum-resilient cryptographic frameworks with blockchain infrastructures to support the development of secure, scalable, and patient-centric next-generation e-health ecosystems.
Healthcare systems increasingly depend on interoperable electronic health records, picture archiving and communication systems, cloud analytics, remote monitoring, and connected medical devices. These workflows create a long-lived confidentiality problem: clinical, genomic, pediatric, psychiatric, and family-linked data may remain sensitive for decades, whereas the public-key algorithms that protect current transport and identity systems are vulnerable to future cryptographically relevant quantum computers. Shor's algorithm threatens RSA, finite-field Diffie-Hellman, elliptic-curve Diffie-Hellman, and elliptic-curve signatures, while Grover's algorithm reduces the effective security margin of symmetric primitives. This review validates the post-quantum transition pathway for healthcare and distinguishes software-deployable post-quantum cryptography from hardware-specialized quantum key distribution. We summarize the standardized NIST primitives, correct the status of Falcon/FN-DSA as a FIPS 206 algorithm still in development, analyze deployment constraints in Internet of Medical Things environments, and map cryptographic migration to healthcare governance. A staged, hybrid, crypto-agile migration strategy is recommended: prioritize long-confidentiality data, inventory cryptographic dependencies, deploy hybrid key establishment at enterprise gateways, reserve QKD for selected high-value fixed links, and require vendor update pathways for clinical devices.