Systematic Review of Hybrid Encryption and Blockchain Security Framework in IoMT Cloud Based Medical Record

Abstract

Internet of Medical Things (IoMT) devices, due to their resource constraints, require specialized security solutions that can operate efficiently without compromising performance and maintaining data confidentiality and integrity while minimizing computational overhead. This review examines various IoMT-based security frameworks designed to secure healthcare records in the cloud, emphasizing their effectiveness, challenges, and best practices. The study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. 100 studies were identified published between 2020to 2025 and 50 papersthat were relevant to the study was carefully selected through a structured screening process. The papers were obtained from major academic databases such as PubMed, Scopus, IEEE Xplore, SpringerLink, Wiley, and Google Scholar. A systematic review protocol was developed before the literature search to establish clear criteria for inclusion and exclusion, ensuring transparency and reproducibility. The review showed that despite the progress made in safeguarding IoMT cloud-based health records, numerous prevailing frameworks predominantly emphasize either encryption or blockchain technology in a singular context, thereby neglecting to exploit the synergistic advantages inherent in the integration of both methodologies. Also, the encryption techniques currently employed for the protection of records within IoMT cloud environments frequently fail to achieve the essential equilibrium between security and operational performance which is characterized by limited resources. The study recommends the formulation of a framework that integrates several encryption schemes and blockchain technology to address the prevailing security problems.