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International Conference on Information and Communication Technology Convergence (ICTC)

PQCIF: Post-Quantum Cryptography Integration Framework for Securing Blockchain-enabled Internet of Medical Things

Yujin Lee, Mpyana Mwamba Merlec, Jin Woo Jung, Sami Souihi, Hoh Peter In

Published Oct 14, 2025• 1 citation
Publisher

Abstract

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.

DOI
10.1109/ictc66702.2025.11388883

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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.
The classic methods of encryption and ciphering techniques have a major threat due to the rapid growth of quantum computing. This is particularly true for the Internet of Medical Things (IoMT) where sensitive patients’ data needs to be protected in terms of confidentiality, integrity, and authenticity. RSA and ECC serve as two examples of public key cryptographic algorithms that are highly vulnerable to quantum attacks especially the Shor’s and Grover’s algorithm. In the context of resource constrained IoMT systems, this thesis proposes a new hash-based hybrid cryptographic algorithm that is resilient to post-quantum cryptographic (PQC) attacks. In order to achieve resistance against quantum threats the proposed method uses hash-based digital signatures such as XMSS, SPHINCS+, or symmetric encryption like AES-256 with higher key sizes. In the Qiskit environment (Python, Anaconda Navigator, and Jupyter Notebook), Grover’s algorithm is modeled to simulate quantum threats. The proposed method is tested through quantum circuit analysis to evaluate their robustness. Our results will prove that the hybrid scheme, while remaining lightweight and suitable for real-time medical applications, significantly lowers the efficiency gains of quantum attacks. The proposed method will bridge the gap between the theoretical world of PQC and the practical world of IoMT networks, improving the long-term security and trust in critical healthcare systems.
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.
The rapid advancement of quantum computing poses a significant threat to classical cryptographic methods used in blockchain-based healthcare systems. Existing security mechanisms such as RSA and ECC are vulnerable to quantum attacks, posing a risk to patient data integrity, confidentiality, and authentication mechanisms. To address this challenge, postquantum cryptographic (PQC) solutions, including lattice-based, hash-based, code-based, and multivariate polynomial-based techniques, have been proposed. This study systematically reviews and classifies PQC methods and their integration into blockchainbased healthcare infrastructures. A three-layer security model is discussed to enhance blockchain resilience against quantum attacks. The study further explores on-chain, off-chain, and crosschain security mechanisms within healthcare applications to ensure secure medical data storage, patient identity management, and interoperability among healthcare providers. The findings suggest that hybrid cryptographic models, combining classical and post-quantum techniques, provide a practical transition strategy for ensuring long-term security in blockchain networks. This research contributes to the field by offering a structured classification of quantum-resistant blockchain security mechanisms and providing insights into future research directions, particularly in the areas of quantum-safe healthcare data management, performance optimization of PQC methods, and the development of quantum-resistant smart contracts.
With the progress of quantum computing, medical institutions that use classical public-key cryptography to secure the confidentiality of long-lasting and delicate healthcare information are facing great security challenges.This research aims to suggest a policy framework for Post-Quantum Cryptographic Policy (PQCP) to facilitate systematic shift of healthcare infrastructures to quantum resistant infrastructure security.It seamlessly combines cryptographic asset discovery, quantum-risk assessment, asset prioritization, cryptoagility, hybrid cryptographic migration, secure key management, governance, compliance monitoring, and ongoing security evaluation.It covers electronic health records, healthcare platforms in the cloud, medical imaging, telemedicine applications and resource-limited Internet of Medical Things devices.A risk-oriented migration strategy gives institutions the ability to prioritize systems based on the amount of data in a system, the vulnerabilities of the cryptographic functions used, the clinical criticality of the system, and the length of time the information must be kept confidential.There are hybrid (classical and post-quantum) mechanisms for gradual migration and interoperability or clinical continuity.Finally, the suggested framework offers a structured approach to enhance the preparedness of healthcare institutions, adherence to regulations, resilience against cryptographic attacks, and long-term protection of healthcare information from the evolving quantum cybersecurity landscape.
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 evolution of healthcare systems, coupled with advancements in the Internet of Medical Things (IoMT), has introduced unprecedented security and privacy challenges. Traditional security solutions fail to address emerging threats posed by quantum computing and AI-driven cyberattacks. This paper proposes an Integrative Quantum Blockchain and AI-Driven Security Framework for Healthcare Systems, incorporating Quantum Key Distribution (QKD), Post-Quantum Cryptography (PQC), and AI-powered threat detection. The proposed framework enhances data integrity, authentication, and resistance against cyber threats, while optimizing energy efficiency. This paper presents the architecture, security benefits, performance analysis, and future research directions for integrating quantum blockchain and AI in healthcare security.