The speeding up of digitalization within the health industry and rising dependency on EHRs pose an immediate need for stronger cybersecurity architectures and protocols powered by quantum computing. The long-term confidentiality of EHRs is threatened by the assumption in cryptographic algorithms such as RSA and ECC that large-scale quantum computers will never exist, since these algorithms will be broken when they do. We propose a satisfaction-based Quantum-Secured Blockchain Ecosystem (QSBE) combining QKD with a permissioned blockchain to protect the provenance and availability of medical data while eliminating unauthorized detection from third parties. Automated and auditable patient-centric consent is enforced via smart contracts, with quantum-resistant cryptography safeguarding data against harvest-now, decrypt-later attacks. The ecosystem enables cross-institutional interoperability, regulatory oversight, and removal of single-point-of-failure. Use cases—telehealth, EHR exchange, drug traceability, emergency access—demonstrate relevance.
The speeding up of digitalization within the health industry and rising dependency on EHRs pose an immediate need for stronger cybersecurity architectures and protocols powered by quantum computing. The long-term confidentiality of EHRs is threatened by the assumption in cryptographic algorithms such as RSA and ECC that large-scale quantum computers will never exist, since these algorithms will be broken when they do. We propose a satisfaction-based Quantum-Secured Blockchain Ecosystem (QSBE) combining QKD with a permissioned blockchain to protect the provenance and availability of medical data while eliminating unauthorized detection from third parties. Automated and auditable patient-centric consent is enforced via smart contracts, with quantum-resistant cryptography safeguarding data against harvest-now, decrypt-later attacks. The ecosystem enables cross-institutional interoperability, regulatory oversight, and removal of single-point-of-failure. Use cases—telehealth, EHR exchange, drug traceability, emergency access—demonstrate relevance.
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 are increasingly data-driven through EHRs, telemedicine, and IoT-based medical devices. However, cyber threats, poor interoperability, and data tampering expose the vulnerabilities of centralized systems. Blockchain offers immutability and transparency, yet its traditional cryptography faces risks from quantum computing, which can compromise existing encryption. To address this, the chapter proposes a quantum-enhanced blockchain framework integrating post-quantum cryptography (PQC), quantum key distribution (QKD), and hybrid quantum-classical consensus. The model strengthens confidentiality, integrity, and availability (CIA) of healthcare data while ensuring interoperability and regulatory compliance. Key applications include secure EHR and genomic data management, automated patient consent handling, transparent drug supply chain monitoring, and protection of clinical research. The chapter also discusses ethical, technical, and regulatory challenges, offering insights into building resilient, quantum-secure healthcare ecosystems.
Healthcare data management has undergone a transformation through digital advancements which emerged from clinical research databases, pharmaceutical supply chains, electronic health records (EHRs), and patient consent systems. Quantum computing systems that execute Shor's algorithm to break down RSA and ECC cryptographic systems will join the list of cyber threats which currently includes ransomware and insider attacks. The blockchain system provides a transparent decentralized ledger with permanent records that protects data integrity and traceability. Its ability to scale and defend against quantum attacks remains limited. The proposed multi-layered solution in this chapter combines blockchain technology with approximate quantum cloning and privacy-preserving machine learning (ML) to enhance healthcare data security, redundancy, and analytics capabilities. By addressing quantum threats and regulatory requirements, this framework fosters a resilient, patient-centric healthcare ecosystem, with future research focusing on scalability and quantum hardware integration.
Objective: The authors propose and evaluate a novel cybersecurity architecture for telehealth that is resilient against future quantum computing cyber threats. By integrating post-quantum cryptography (PQC) with quantum key distribution (QKD) and privacy-preserving mechanisms, data confidentiality and immutability for patient records in a post-quantum era are ensured. Methods: A multi-layered design approach was adopted. The PQC algorithms (e.g. CRYSTALS-Dilithium) were integrated at the blockchain consensus layer to resist quantum attacks. A directed acyclic graph (DAG)-based ledger managed high transaction throughput and latency constraints typical of telehealth. A QKD-enhanced key management protocol leveraged quantum channels for secure exchanges. Zero-knowledge proofs (ZKPs) and secure multiparty computation (MPC) verified transactions without exposing sensitive patient data. A granular access control model used attribute-based encryption and smart contracts to govern which participants could view or modify encrypted medical records. Results: The prototype was developed within a simulated telehealth network comprising hospitals, clinics, and patient devices. The PQC signatures at the consensus layer provided effective resistance to both classical and anticipated quantum attacks. The QKD facilitated secure key distribution, while ZKPs and MPC enabled validation of healthcare transactions without compromising patient privacy. Despite increased computational overhead, the DAG approach efficiently handled parallel transactions, indicating improved scalability compared to traditional linear blockchains. Conclusion: A QKD-enhanced, PQC-driven framework successfully addresses critical security and privacy requirements, safeguarding medical data from emerging quantum threats. Although overhead and infrastructural costs are significant, sustained cryptographic resilience and robust patient confidentiality underscore its suitability for next-generation healthcare systems. Future studies should explore additional optimizations, homomorphic encryption, and larger-scale pilots under regulatory standards.
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 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.