PROXY RE-ENCRYPTION WITH, BENCHMARKING, AND PHASED HYBRID MIGRATION FOR TELEMEDICINE ARCHITECTURES

The blistering development of the Internet of Medical Things (IoMT) and telemedicine platforms has radically changed the healthcare delivery, providing the opportunity to conduct remote monitoring, diagnose in real-time, and manage electronic health records. Nevertheless, these developments present the serious weaknesses in data protection, especially when it comes to ciphertext integrity, unauthorized access, and the potential threat posed by quantum computing. In this paper, a single framework has been provided to consider the short-term and long-term cryptographic issues in healthcare data sharing. As a follow-up of a blockchain-mimicking Proxy Re-Encryption (PRE) protocol and an extensive post-quantum cryptographic (PQC) benchmarking analysis, we present a single security architecture of IoMT settings. In the scheme based on PRE, identity hash binding is also introduced when creating keys to ensure that there can be verifiable connections between the identity of the user and the public keys to improve accountability in data sharing between the Data Owners and the Data Users. The transactions of blockchain are used to create a pairing-function ciphertext verification scheme that is used to effectively stop the manipulation of encrypted data stored on the cloud server. Accumulators that are managed by smart contracts make it easy to manage user identities as well as perform queries efficiently. At the same time, despite the fact that traditional encryption protocols like RSA and ECC are becoming obsolete when quantum adversaries use the Shor algorithm, the framework compares four PQC algorithms that have been standardized by NIST Kyber, Dilithium, Falcon, and SPHINCS+. The performance benchmarking indicates that Falcon has better encryption efficiency of 17.16 ms with optimized storage capacity of 2.05 MB hence it can be found to be highly suitable in the telemedicine applications that require low latency whereas Kyber has a balance of speed and low computational overhead of 35.98. One-way statistical analysis based on ANOVA helps prove that performance differences are statistically significant between PQC algorithms. The evaluation of the healthcare institutional preparedness indicates that technical expertise and infrastructure capacity is a significant predictor of the success of PQC adoption compared to budget allocation, with high-preparedness institutions registering a score of 6.97/10 on both dimensions. The combined scheme entails a computational efficiency improvement of the currently existing methods and will cut down on the time of encryption, re-encryption, decryption, and re-decryption by around 23.8, 71.4, 48 and 15.3 percent respectively and yet will not compromise on the IND-ID-CPA security with the DBDH-assumption. All these findings support a gradual hybrid cryptography migration plan, which includes the introduction of quantum-resistant algorithms into the current IoMT systems without interruption of care. [1,2]