Quantum-Secure Healthcare: A Comprehensive Review of Post-Quantum Cryptography and Cyber Defense in IoMT

Abstract

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.