A Comprehensive Review Of Artificial Intelligence-Enabled Cyber-Physical Systems Security In Smart Healthcare: Taxonomy Of Cyber Attacks And Defense Mechanisms
TL;DR
Although significant progress has been achieved in securing healthcare CPS, challenges remain in ensuring scalability, interoperability, regulatory compliance, and trustworthy AI deployment and future research should focus on developing adaptive, intelligent, and privacy-preserving cybersecurity frameworks capable of supporting next-generation digital healthcare ecosystems.
Abstract
Background: The rapid adoption of Artificial Intelligence (AI)-enabled Cyber-Physical Systems (CPS) has transformed modern healthcare by enabling intelligent patient monitoring, remote diagnosis, wearable health devices, robotic assistance, and real-time clinical decision-making. While these technologies improve healthcare quality and accessibility, their increasing connectivity exposes healthcare infrastructures to a wide range of cyber threats that may compromise patient safety, privacy, and clinical operations. Methods: This review presents a comprehensive taxonomy of cyber attacks targeting AI-driven healthcare CPS, including attacks on sensors, communication networks, cloud platforms, medical Internet of Things (IoMT) devices, AI algorithms, and control systems. Recent research on intrusion detection, encryption techniques, blockchain, federated learning, explainable AI, trust management, and zero-trust architectures is systematically analyzed to evaluate existing defense mechanisms. Results: The review identifies major vulnerabilities across healthcare CPS components and summarizes current mitigation strategies designed to improve system resilience, data integrity, patient privacy, and operational reliability. Furthermore, emerging AI-based security solutions capable of detecting sophisticated attacks in real time are critically discussed. Conclusion: Although significant progress has been achieved in securing healthcare CPS, challenges remain in ensuring scalability, interoperability, regulatory compliance, and trustworthy AI deployment. Future research should focus on developing adaptive, intelligent, and privacy-preserving cybersecurity frameworks capable of supporting next-generation digital healthcare ecosystems.