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arXiv · 2610.04661

Post-Quantum Authentication Protocol for Internet of Medical Things

Kartick Sutradhar·Ranjitha Venkatesh
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Abstract

IoMT communication systems should provide origin authentication and ensure integrity protection for the messages produced by patients' devices for transmission to gateways and further processing by other hospital services. With regard to IoMT, this paper discusses tampering, impersonation, and replay attacks on messages provided as medical reports. Long-term security of the communication system is also addressed considering potential quantum attacks. For this purpose, we design a protocol that meets requirements of practical implementation and employs an ISIS like lattice-based construction combined with concepts of the blockchain technology. Patients' devices generate a canonical JSON format medical report containing a timestamp and critical information. Using a nonce, the patients create a cryptographic signature of the message with a challenge generated from hash of a message. The gateway verifies signatures utilizing the public key of a trusted ledger associated with a particular patient and ensures freshness of the transmitted message. To optimize the performance in case when many devices interact with a gateway at once, the gateway performs batch signature validation using vectorized modular linear equations. The trusted ledger uses tamper-resistant REGISTER and TRUST UPDATE entries, maintaining a trust score of each registered patient and updating the value after each ACCEPT/REJECT operation. Our prototype application demonstrates registration procedure of a new patient, signing and verifying medical reports, auditing of the ledger, and performance assessment. Based on our experiments in the prototype, we argue that, when applied to large-scale systems, batch verification is superior to simple signature validation approach.

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Kartick Sutradhar, Ranjitha Venkatesh. 2026-10-03. Post-Quantum Authentication Protocol for Internet of Medical Things. https://arxiv.org/abs/2610.04661

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