: Digital Twins (DTs) are increasingly adopted in healthcare to enable real-time patient monitoring, predictive analytics, and decision support. However, their deployment relies on highly distributed and heterogeneous infrastructures, where sensitive medical data are continuously exchanged across multiple components. This raises critical challenges for secure data governance, including the protection of data across its lifecycle, compliance with regulatory frameworks, and interoperability among existing systems. Despite the growing body of research on healthcare DTs, existing approaches lack a systematic integration of security, privacy, and compliance mechanisms within a unified architectural model. In particular, no reference architecture currently addresses security concerns across data in transit, at rest, and in use in a comprehensive and reusable manner. In this paper, we address this gap by proposing a security-by-design reference architecture for data governance in healthcare Digital Twins. The architecture is derived through a combined research-driven and threat-driven methodology, explicitly linking requirements to data lifecycle threats and to relevant standards (e.g., GDPR, HIPAA, ISO). To assess feasibility, we implement a prototype based on a microservices architecture and evaluate it in a representative healthcare scenario. The results show how the proposed solution supports secure data management across data in transit, at rest, and in use, while preserving interoperability and compliance. It can thus be considered as a practical and reusable foundation for secure data governance in healthcare DTs.
C. Braghin, S. Cimato, Andrea Marchesini et al.· Proceedings of the 23rd Inte...· 0 citations
This paper reports a five-scenarios migration study from classical ECDSA to post-quantum cryptography (PQC) and hybrid signature settings for Ethereum-like blockchains. Using reproducible pipeline outputs from a multi-repository toolchain, we compare baseline ECDSA, hybrid ECDSA+ML-DSA, ML-DSA throughput collapse, ML-DSA latency spike (larger blocks), and SLH-DSA computational bottleneck cases. We also include Layer 2 roll-up/data-availability (DA) scenarios at 2-second cadence. Results show that PQC migration substantially reduces key-exposure risk but introduces severe throughput and fee penalties under fixed block limits. Enlarging blocks restores throughput but increases propagation delay, storage growth, and fork/orphan risk. Hybrid deployment preserves migration compatibility but inherits significant fee pressure. We provide quantitative security, performance, network, and blockchain-health metrics. The results expose three migration regimes. First, fixed-cap PQC replacement (1 MB) results in significant throughput loss and fee inflation. Second, capacity compensation (larger blocks) can recover TPS but amplifies propagation delay and chain-growth pressure, increasing fork/orphan risk. Third, hybrid deployment provides compatibility and reduces crypto-graphic risk, but it incurs substantial overhead.
M. Ramzan, S. Cimato· Annual International Compute...· 0 citations
Zero-Knowledge Proofs (ZKP) provide strong data privacy and rely on the principle of proving a statement without revealing the underlying data. However, the ZK-SNARK system has a scalability problem while generating proofs. Systems like PLONK take longer to generate a proof with increasing size of the input data. EHR(Electronic Health Records) may present a short proving time but large size data sine when they contain images and genomics it could take more time to generate a proof. ZK-Rollup systems provide scalability by batching the transactions in off-chain mode; however, they also suffer from longer proving time with large data. In this paper, we propose an approach to generate KZG commitments from healthcare FHIR records and then use these values to generate single validity ZKP. In this way, we can not only reduce the proving time, but also ensure data integrity and data correctness.
Jahanzeb Shahid, S. Cimato· Annual International Compute...· 0 citations