SHIELD: Blockchain-Enabled Lightweight Authentication Framework for Secure Wearable Health Monitoring in IoMT Environments.

Wang, Chao; Xue, Xingsi; Wang, Jing; Jiang, Huamao · IEEE J Biomed Health Inform · 2026

basic_science · Level V

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Abstract

Consumer health devices generate massive volumes of sensitive medical data requiring secure authentication mechanisms that accommodate the resource constraints of wearable sensors and portable diagnostic equipment. Traditional centralized authentication approaches in Internet of Medical Things (IoMT) environments suffer from single points of failure, privacy vulnerabilities, and scalability limitations when managing diverse health monitoring devices. This paper presents secure healthcare IoMT enhanced lightweight device authentication (SHIELD), a blockchain-based lightweight authentication framework designed for resource-constrained consumer health devices. The framework leverages blockchain's immutable and decentralized properties, combined with efficient elliptic curve cryptography, to ensure secure storage and verification of device identities while providing mutual authentication between health devices and medical data servers. Security analysis demonstrates that SHIELD satisfies twelve critical security properties, including decentralization, resistance to password guessing and replay attacks, perfect forward secrecy, and session key security. Performance evaluation reveals that SHIELD achieves computational efficiency at 9.837 milliseconds authentication latency, representing 31% improvement over previous best-performing schemes. The framework requires only 1384 bits of communication overhead and maintains minimal average delay times suitable for real-time health monitoring applications. Blockchain implementation analysis confirms practical deployment feasibility with 0.0356 MGas operational costs per authentication session.