Security challenges and solutions in Internet of Medical Things (IoMT) communication: A review

The Internet of Medical Things (IoMT) is defined by the connectivity that does exist between wearable sensors, implant devices and hospital information systems to a cloud based platforms allowing for real-time-healthcare data monitoring and clinical decision making driven by data. On the other hand, heterogeneity and limited resources of IoMT communication infrastructures enlarge considerably their attack surface on the cybersecurity side leading to critical challenges around patient safety, data integrity and system availability. This narrative review introduces a novel communication-centric IoMT threat taxonomy which would systematically overview vulnerabilities across the device, network, data, application and system-availability layers followed by analysis of inter-layer propagation and ultimately cross-layer propagation of threats to IoMT. PRISMA principles on literature selection permits transparency of methods. Well- this is to build a one comprehensive technical comparative evaluation report rather than descriptive surveys, especially if we replicate the above said references in relation with IoMT-specific Daggers and teeths flourished around classical cryptography, lightweight security primitives, AI-powered anomoly detection systems, Blockchain-based trusted architecture compositions rooted around post-quantum paradigms. From the analysis, it is concluded that lightweight cryptographic schemes and ECC-based authentication are still the most applicable communication protocols for resource-constrained medical devices while AI- and consortium-based blockchain architectures act as supplementary enhancements at the infrastructure level rather than as a substitute to secure communication protocols. Multiple real-life healthcare cyber incidents further emphasize the impact of infrastructure-enabled attacks in IoMT surroundings. This review is based on layered threat model, technical trade-off analysis, regulatory compliance mapping and empirical case studies to provide an implementation-aware design guide for enhancing resilience of the IoMT communication security design in accordance with regulations.