Fine-Grained and Flexible Dual Authentication for IoT-Connected Healthcare Sensor Networks

IoT-connected healthcare sensor networks require authenticated and privacy-preserving data exchange among wearable sensors, mobile medical terminals, edge gateways, cloud servers, and medical institutions. Existing authentication schemes for healthcare IoT often bind signatures directly to user identities, exposing sensitive personal or institutional information and imposing heavy verification costs on resource-constrained sensing devices. To address this problem, we propose a fine-grained and flexible dual authentication scheme for healthcare sensor networks. In the proposed scheme, health data and diagnoses are signed with a fresh signing key and a fine-grained access control policy each time, so that the signer identity remains hidden while authorized entities can still modify permitted parts of signed data. No entity other than an authorized entity can trace a malicious signer or modify signed data without changing the data source. To support lightweight verification in sensor-edge-cloud deployments, we further present a verifiable outsourced authentication scheme that outsources time-consuming pairing operations to cloud servers; the online verification process then requires only six multiplication operations. As a fundamental technical component, we present a practical attribute-based sanitizable signature with shorter signature and key lengths and more efficient signing and signature-changing operations than the state-of-the-art policy-based sanitizable signature (P3S). Formal security analysis and experiments demonstrate the security and practicality of the proposed scheme for privacy-preserving healthcare sensing and medical data exchange.