A Multi‐cluster Security Framework for Healthcare <scp>IoT</scp>: The Synergy of Redundant Byzantine Fault Tolerance with Extensions and Coati‐Based Network

ABSTRACT The rapid integration of Internet of Things (IoT) devices into healthcare systems has revolutionized medical care delivery but has also introduced significant security challenges. Ensuring secure communication, privacy preservation, and system resilience in resource‐constrained healthcare IoT networks is critical, given the sensitivity of the data involved and the potential for malicious attacks. This research addresses these concerns by proposing a Multi‐cluster Security Framework for Healthcare IoT, designed to overcome existing limitations in security and scalability. The framework combines Redundant Byzantine Fault Tolerance with Extensions (RB‐BFT X) and CoatiNet, leveraging lightweight cryptographic techniques, role‐based access control, and dynamic routing algorithms. RB‐BFT X enhances intra‐cluster security through fault tolerance and anomaly detection, while CoatiNet optimizes inter‐cluster communication using adaptive routing and self‐recovery mechanisms inspired by coatis' natural behavior. Experimental results demonstrate the framework's efficacy, achieving a high detection rate of 98.20%, minimal latency, and stable throughput under various adversarial conditions. Compared to existing methods, it outperforms in maintaining network lifetime and reducing false positives, even with increased malicious activity. These findings have significant implications for enhancing the security and efficiency of healthcare IoT networks. The proposed methodology ensures robust data protection, efficient communication, and adaptability to evolving threats, contributing to safer and more reliable healthcare systems.