post-quantum-healthcare-migration

name	post-quantum-healthcare-migration
description	Post-Quantum Cryptography (PQC) migration framework for IoT-based healthcare systems. Provides systematic approach for transitioning healthcare infrastructure from classical to post-quantum cryptographic standards (NIST ML-KEM, ML-DSA) while maintaining HIPAA/GDPR compliance. Activation: post-quantum healthcare, PQC migration IoT healthcare, healthcare cryptography upgrade, medical device PQC, HIPAA quantum security
metadata	{"arxiv_id":"2604.15584","published":"2026-04","tags":["post-quantum","healthcare","IoT","PQC-migration","HIPAA"]}

Context

Healthcare IoT devices (implantable monitors, wearable sensors, hospital networks) face a critical threat from quantum computing's ability to break RSA/ECC. Healthcare systems have unique constraints: long device lifecycles (10-20 years), regulatory compliance (HIPAA, GDPR), and real-time data requirements. PQC migration must be planned now to avoid future breaches.

Core Methodology

Step 1: Risk Assessment

1. Inventory all cryptographic dependencies in healthcare infrastructure
2. Classify devices by quantum vulnerability level (critical, high, medium, low)
3. Assess data sensitivity: PHI (Protected Health Information) requires highest protection
4. Map device lifecycle: devices with >5 year remaining life need immediate PQC planning

Step 2: PQC Algorithm Selection

Use Case	Recommended Algorithm	NIST Standard
Key exchange (device-server)	ML-KEM (Kyber)	FIPS 203
Digital signatures (data integrity)	ML-DSA (Dilithium)	FIPS 204
Stateless signatures (firmware)	SLH-DSA (SPHINCS+)	FIPS 205

Step 3: Migration Phases

1. Phase 1 — Crypto-agility: Implement hybrid classical+PQC support
2. Phase 2 — PQC-primary: Switch to PQC as primary, classical as fallback
3. Phase 3 — PQC-only: Remove classical algorithms entirely

Step 4: Device Constraints Handling

1. Resource-constrained devices: Use optimized PQC implementations (e.g., liboqs)
2. Firmware updates: Sign with SLH-DSA for stateless verification
3. Network protocols: TLS 1.3 with ML-KEM key exchange

Pitfalls

• Device firmware size limits: PQC keys/signatures are larger than RSA/ECC. ML-KEM-768 public key = 1184 bytes vs RSA-2048 = 256 bytes. Verify device storage capacity.
• Regulatory lag: HIPAA/GDPR haven't yet mandated PQC. Plan migration ahead of regulatory deadlines.
• Hybrid mode overhead: Running both classical and PQC doubles computational cost. Use hardware acceleration where available.
• Long-lived devices: Implantable devices cannot be updated easily. Select devices with PQC-ready hardware during procurement.

Verification

1. All PHI transmission uses ML-KEM key exchange
2. Device firmware integrity verified via ML-DSA signatures
3. No classical-only cryptographic paths remain in production
4. Migration timeline: complete within 3 years (before cryptographically relevant quantum computers)