Quantum-resilient and adaptive multi-region data aggregation for IoMT using zero-knowledge proofs and edge intelligence

Abstract

The Internet of Medical Things (IoMT) transforms healthcare by enabling real-time monitoring of patient vitals, such as heart rate and glucose levels, but faces significant challenges in securing sensitive data against cyber threats and ensuring reliability in resource-constrained wearable devices, like low-power biosensors with limited computational capacity. The rise of quantum computing, particularly Shor algorithm, threatens to break traditional cryptographic methods (e.g., RSA, ECC) within 5–10 years by efficiently solving their underlying mathematical problems, endangering patient data confidentiality. Post-quantum cryptography (PQC), such as lattice-based schemes, offers resilience but demands high computational resources, challenging IoMT scalability. Unlike other PQC IoMT frameworks, such as those using NTRU, which prioritize computational simplicity but lack advanced privacy mechanisms, Q-PRADAX pioneers a secure, adaptive data aggregation framework, integrating Ring-LWE-based PQC for quantum-resilient confidentiality, compact zk-SNARK proofs for tamper-proof verification of patient vitals, and adaptive clustering for enhanced network reliability and scalability. Evaluated using OMNeT + + 6.0.3 with INET 4.5, Q-PRADAX achieves 94.5% diagnostic accuracy on ECG datasets, 100% tampering detection, and 99.9% packet delivery across 1000 devices in its Baseline scenario, with a security latency of 12.2 ms/packet and energy consumption of 0.38 mJ/packet on ARM Cortex-M4 devices (200 mAh). Outperforming existing IoMT solutions in security and fault tolerance, Q-PRADAX establishes a global standard for a secure, patient-centric IoMT ecosystem, redefining reliable healthcare delivery.