Authentication in the Internet of Medical Things: Taxonomy, Review, and Open Issues

The Internet of Medical Things (IoMT) has revolutionized the world of healthcare by remotely connecting patients to healthcare providers through medical devices connected over the Internet. IoMT devices collect patients' medical data and share them with healthcare providers, who analyze it for early control of diseases. The security of patients' data is of prime importance in IoMT. Authentication of users and devices is the first layer of security in IoMT. However, because of diverse and resource-constrained devices, authentication in IoMT is a challenging task. Several authentication schemes for IoMT have been proposed in the literature. However, each of them has its own pros and cons. To identify, evaluate and summarize the current literature on authentication in IoMT, we conducted a systematic review of 118 articles published between 2016 and 2021. We also established a taxonomy of authentication schemes in IoMT from seven different perspectives. We observed that most of the authentication schemes use a distributed architecture and public key infrastructure. It was also observed that hybrid cryptography approaches have become popular to overcome the shortcomings of single cryptographic approaches. Authentication schemes in IoMT need to support end-to-end, cross-layer, and cross-domain authentication. Finally, we discuss some open issues and future directions.