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Journal of Applied Informatics and Computing

A Systematic Review of Post-Quantum Cryptography for Healthcare Data Protection: Performance, Readiness, and Deployment Challenges

Taboka Ngwenya, Belinda Mutunhu Ndlovu

Published Feb 4, 2026• 3 citations
Publisher

Abstract

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.

DOI
10.30871/jaic.v10i1.11836

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Quantum computing is rapidly advancing and threatens the cryptographic systems that secure digital communications. Classical cryptosystems, such as RSA and ECC, rely on mathematical problems that are difficult for classical computers but can be solved easily by quantum algorithms, such as Shor’s. This challenge underscores the pressing need for Post-Quantum Cryptography (PQC) to safeguard data against both classical and quantum threats. This study provides a comprehensive review of PQC Approaches in securing data against quantum threats b‌y analyzing reviewed journals,‍ conference proceedings, book chapters, and websites. Several researchers reviewed relevant literature published between 2019 and 2026 using the ACM Digital Library, Wiley Online⁠ Library, Taylor & Francis‌, Springer, ScienceDirect, MDPI, IEEE Xplore Digital Library, and Google Scholar. The review evaluates lattice-based, code-based, Hash-based, multivariate, and isogeny-based schemes across security strength, performance, interoperability, and deployment feasibility in heterogeneous environments, including cloud platforms and Internet of Things devices. The findings indicate that lattice-based schemes, particularly CRYSTALS-Kyber and CRYSTALS-Dilithium, currently offer the most balanced trade-off between efficiency and quantum resistance, while Hash-based schemes such as SPHINCS+ prioritize conservative security at notable performance cost. Code-based approaches, including McEliece, demonstrate strong long-term security but remain constrained by large key sizes. The review highlights implementation, energy, migration, and governance barriers that must be addressed before adoption. The review concludes by emphasizing that transitioning to PQC requires a collaborative effort from academia, industry, and government. Future research should focus on integrating lightweight PQC in IoT, 5G/6G, and cloud environments, as well as developing hybrid models that combine classical and quantum-safe systems. Addressing these issues is crucial for establishing secure data protection in the quantum era.
Because many modern healthcare security systems rely on traditional cryptographic primitives that are susceptible to quantum attacks, the quick development of quantum computing poses previously unheard-of risks. With the increasing use of wearable sensors, telemedicine, AI-driven diagnostics and distributed clinical databases, as well as the increasing digitisation of healthcare, the need for quantum-resilient protection becomes critical. The integration of quantum and post-quantum cryptography (PQC) as fundamental security measures for upcoming intelligent healthcare ecosystems is thoroughly examined in this chapter. We summarise recent developments in cryptographic standards, secure communication protocols, AI-enabled defence mechanisms and blockchain-based data integrity systems using a PRISMA-guided systematic review. With an emphasis on performance, scalability and resistance to Shor- and Grover-based attacks, we further develop a simulation framework to assess hybrid quantum, classical security architectures under adversarial quantum scenarios. Our results show that while hash-based signatures provide ultra-long-term integrity for genomic and archival medical data, lattice-based PQC schemes, in particular CRYSTALS-Kyber and Dilithium, show strong suitability for electronic health record (EHR) encryption, secure IoMT communication and federated learning aggregation. A unified quantum-resilient architecture incorporating PQC, blockchain consensus, AI-based anomaly detection and quantum key distribution (QKD) is one of the theoretical contributions. In summary, we highlight the potential of quantum homomorphic AI, neuromorphic cryptosystems, quantum biometrics and adaptive threat intelligence to develop a safe, reliable and scalable paradigm for quantum-ready healthcare.
The rapid deployment of Internet of Things (IoT) devices across critical infrastructure’s sectors such as healthcare, transportation, and smart cities brings unprecedented security challenges; particularly as quantum computing threatens the classical cryptography. This systematic review analyzes IoT security in relation to post-quantum cryptography (PQC), highlighting vulnerabilities, evolving threat, and cryptographic countermeasures. Using the PRISMA 2020 protocol, our work employed a rigorous and reproducible search strategy, where the initial Boolean query, ((“IoT” OR “Internet of Things”) AND (“Cryptography” OR “Encryption Scheme”) AND “Quantum”), was developed and effectively customized for nine reputable databases to maximize the coverage. From an initial pool of 5,151 publications dated between 2020 and February 12, 2025, a content-based screening was conducted at the title, abstract, and full-text levels. This meticulous filtering resulted in a final corpus of 161 studies deemed relevant for in-depth analysis and synthesis. Then, we categorize and analyze PQC algorithms by vulnerabilities, suitability for resource-constrained IoT environments, performance evaluation, scalability, and quantum resilience. We also identify key limitations in implementations of current cryptographic schemes, including issues in key management and authentication; and outline major challenges such as resource constraints of IoT devices, environmental noise, quantum reversible computing, security vulnerabilities, quantum hardware constraints, and complexities in integration. To counter these threats, we propose a framework of PQC countermeasures and illustrated by a hypothetical case study of PQC adoption in a real-world IoT system. Finally, we propose future research directions in lightweight PQC, hybrid frameworks, improved key management and distribution, addressing quantum distance matters, countering quantum threats, and standardization for IoT environments.
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Quantum computers are capable of solving problems that classical computers cannot, particularly in the realm of cryptographic algorithms such as RSA, DSA, and ECC. Post quantum cryptography refers classical cryptographic algorithm that are designed to secure sensitive data. This research explores the application of post-quantum cryptographic techniques in healthcare systems, with a specific focus on integrating Quantum Key Distribution (QKD) with Genetic Algorithms (GA) for enhanced key optimization. As quantum computing advances, traditional cryptographic systems employed in health care are more and more vulnerable to being broken. Security of sensitive patient information—like electronic health records (EHRs), diagnostic data, and personally identifiable information— requires strong solutions that can handle future quantum attacks. Post-quantum cryptography (PQC) provides a hopeful way forward by employing quantum computer-resistant algorithms. This paper investigates the deployment of PQC methods—e.g., lattice-based, hash-based, and multivariate polynomial cryptography—inside healthcare systems to improve data confidentiality, integrity, and availability. It assesses the weaknesses of present encryption technologies and introduces PQC as a necessary update to protect patient information from sophisticated cyberattacks. The study also addresses the interoperability, computational overhead, and infrastructure readiness challenges of implementing PQC in healthcare. By implementing quantum-resilient cryptographic protocols, healthcare facilities are able to future-proof data protection practices and guarantee the safeguarding of patient data in an era governed by quantum computing.
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.