The healthcare sector has undergone a profound transformation, owing to the influential role played by Internet of Medical Things (IoMT) technology. However, there are substantial concerns over these devices’ security and privacy-preserving mechanisms. The current literature on IoMT tends to focus on specific security features, rather than wholistic security concerning Confidentiality, Integrity, and Availability (CIA Triad), and the solutions are generally simulated and not tested in a real-world network. The proposed innovative solution is known as Secure-by-Design Real-Time IoMT Architecture for e-Health Population Monitoring (RTPM) and it can manage keys at both ends (IoMT device and IoMT server) to maintain high privacy standards and trust during the monitoring process and enable the IoMT devices to run safely and independently even if the server is compromised. However, the session keys are controlled by the trusted IoMT server to lighten the IoMT devices’ overheads, and the session keys are securely exchanged between the client system and the monitoring server. The proposed RTPM focuses on addressing the major security requirements for an IoMT system, i.e., the CIA Triad, and conducts device authentication, protects from Denial of Service (DoS) and Distributed Denial of Service (DDoS) attacks, and prevents non-repudiation attacks in real time. A self-healing solution during the network failure of live e-health monitoring is also incorporated in RTPM. The robustness and stress of the system are tested with different data types and by capturing live network traffic. The system’s performance is analysed using different security algorithms with different key sizes of RSA (1024 to 8192 bits), AES (128 to 256 bits), and SHA (256 bits) to support a resource-constraint-powered system when integrating with resource-demanding secure parameters and features. In the future, other security features like intrusion detection and prevention and the user’s experience and trust level of such a system will be tested.

Digital technology and innovation have transformed healthcare systems in multiple dimensions. In the dawn of this era, AI is revolutionizing the tackling of healthcare challenges by detecting and predicting medical diagnoses. On one hand, care and assistive robots are getting ready to fill the shortages of medical staff and carers in developed nations. The need for such care support is more relevant in Western society, as the older generation prefers to live independently. Such a system can provide quality independent living. However, this system deals with sensitive data of the users, so it is critical to ensure that the engagement, interaction, and access of user data are securely controlled and the privacy of the users is protected. The first line of defence in protecting the user's sensitive information is to securely identify and authenticate the user so that access is monitored and controlled. In this paper, a seamless multifactor secure-by-design authentication system using face recognition and a smartwatch is developed so that a continuous form of authentication is maintained when the user is around the robot. This ensures the robotic system is not open for its services unless the authorized user is present.

Traditional blockchain consensus mechanisms, such as Proof of Work (PoW) and Proof of Stake (PoS), face significant challenges related to the centralisation of validators and miners, environmental impact, and trustworthiness. While PoW is highly secure, it is energy-intensive, and PoS tends to favour wealthy stakeholders, leading to validator centralisation. Existing mechanisms lack fairness, and the aspect of sustainability is not considered. Moreover, it fails to address social trust dynamics within validator selection. To bridge this research gap, this paper proposes Proof of Friendship (PoF)—a novel consensus mechanism that leverages social trust by improving decentralisation, enhancing fairness and sustainability among the validators. Unlike traditional methods that rely solely on computational power or financial stakes, PoF integrates friendship-based trust scores with geo-location diversity, transaction reliability, and sustainable energy adoption. By incorporating a trust graph, where validators are selected based on their verified relationships within the network, PoF mitigates the risks of Sybil attacks, promotes community-driven decentralisation, and enhances the resilience of the blockchain against adversarial manipulation. This research introduces the formal model of PoF, evaluates its security, decentralisation, and sustainability trade-offs, and demonstrates its effectiveness compared to existing consensus mechanisms. Our investigation and results indicate that PoF achieves higher decentralisation, improved trustworthiness, reduced validator monopolisation, and enhanced sustainability while maintaining strong network security. This study opens new avenues for socially aware blockchain governance, making consensus mechanisms more equitable, efficient, and environmentally responsible. This consensus mechanism demonstrates a holistic approach to modern blockchain design, addressing key challenges in trust, performance, and sustainability. The mechanism is tested theoretically and experimentally to validate its robustness and functionality. Processing latency (PL), network latency (NL) [transaction size/network speed], synchronisation delays (SDs), and cumulative delay per transaction are 85 ms, 172 ms, 1802 ms, [PL + NL + SD] 2059 ms, respectively.

The healthcare sector has undergone a profound transformation, owing to the influential role played by IoMT (Internet of Medical Things) technology. However, there are substantial concerns over these devices' security and privacy-preserving nature. Current literature on IoMT tends to focus on specific security features like data confidentiality or data integrity or data availability or access control and most solutions are simulated and not tested in a real-world live network. This paper proposes a smart secure by design solution that safeguards user’s data during health and wellbeing monitoring of patients locally (home, care-home, and hospital) and remotely. The proposed innovative solution is known as Secure by Design Real Time IoMT Architecture for e-Health Population Monitoring (RTPM) for smart hospitals and any healthcare monitoring management. In this system, keys can also be generated by the patient monitoring system independent to maintain high privacy standard and trust during the monitoring process and to enable the IoMT devices run independently even if the server is compromised and are made safe from external exploits to the client nodes. However, the session keys are controlled by the trusted IoMT server to lighten the IoMT devices overheads and the session keys are securely exchanged between the client system and the monitoring server. The proposed RTPM focuses on addressing the major security requirements for an IoMT system: confidentiality, integrity, availability, conducts authentication, protect from DoS attacks and prevent from non-repudiation attack of patient medical data and the devices in a real time, sensory data communication environment for live e-health monitoring. A secure communication is tested by capturing the live network traffic and the system’s performance analysis of RTPM using different security algorithms with different key sizes of RSA, AES, and SHA shows that resource constraint low powered system can also successfully integrate with high-end state-of-the-art secure parameters and features and have the potential to support real time secure interaction. A stress test is also conducted to ensure that the system can withstand huge key sizes and different data types including multi-media information.