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 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 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.
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.
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.
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.
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.
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.