A patient-centric secure access control architecture with dynamic edge data integrity verification in Internet of Medical Things

In the Internet of Medical Things (IoMT), securing patient data access is critical, but must be achieved without overwhelming the limited computational resources of edge devices. While cryptographic methods and access policies are widely applied to secure medical data, existing solutions often assume high computational capacity, centralized infrastructure, or predefined key structures, which are not ideal for the heterogeneous and resource-constrained environments found in IoMT. In addition to security, patient-centricity is becoming an essential design principle, where patients must have control over who accesses their data and under what conditions. Similarly, edge computing has emerged as a means to reduce latency, but edge devices are often semi-trusted, exposed to physical threats, and limited in processing power, making them unsuitable for heavyweight integrity verification or outsourced computation. Therefore, this paper presents a lightweight, patient-centric architecture that unifies attribute-based access control, dynamic edge data integrity verification, and consent-driven sharing in a secure and scalable architecture. The system minimizes communication and computational overhead by eliminating predefined keys, restricting edge computation, and guaranteeing verifiable data delivery. The experimental results demonstrate efficient handling of tampered and untampered cases, achieving fast, verifiable, and secure access with minimal resource consumption. This paper offers a practical and integrative solution to ensure security without sacrificing lightweight performance in real-world IoMT deployments.