Formulating an Advanced Security Protocol for Internet of Medical Things based on Blockchain and Fog Computing Technologies

The Internet of Medical Things (IoMT) is an evolving field in healthcare that connects medicaldevices to the Internet to enable efficient data sharing and health information collection. The IoMT aims toimprove the quality of healthcare, facilitate diagnosis and treatment, and enhance patient safety. Nonetheless, theIoMT networks are usually exposed to multiple security attacks. Also, recent studies indicate that securityprotocols contain flaws in protecting patient data. Thus, data must be protected by innovative security protocols. Inour work, we propose a Medical Security Protocol (MedSecP) to support security in IoMT. The proposed protocoladopts the Twofish encryption, Naive Bayes (NB), and decision tree (DT) within the private blockchain (PBC) FogComputing (FC) to build robust security procedures. The Twofish encryption algorithm is used to provide medicalinformation concealment. In our proposed protocol, the type of data is first determined, and accurate andappropriate medical decisions are made based on the collected data using a decision tree algorithm, and then rapidclassification of the patient data is done using the Naive Bayes algorithm. Confidential medical data is thenencrypted using the Twofish algorithm to ensure the confidentiality of this data and prevent unauthorized access.Finally, this encrypted medical data is stored using blockchain technology. Twofish, NB, and DT are organized towork harmoniously with the PBC. The latter manages and distributes data peer-to-peer in IoMT. We leverage FogComputing to speed up decision-making without resorting to the remote cloud. We analyzed our protocol in termsof security and performance. Our results indicate that MedSecP provides reliable security against attacks as theprotocol demonstrated an average security attack response rate of 97.20%, demonstrating its resistance to externalthreats by keeping the encrypted medical data, classified and achieving appropriate medical decisions. In terms ofperformance, MedSecP has demonstrated an average security response time of around 50ms, providing fast andefficient performance. In MedSecP, the highest value for encryption is 0.000015 ms, and decryption is 0.000017ms when applying the Twofish algorithm which is considered extremely suitable for implementing health systemsoperations compared to existing encryption algorithms. Consequently, MedSecP provides lightweight operations insupport of complex security measures that qualify it to support healthcare institutions.