Abstract

The Internet of Medical Things (IoMT) has transformed traditional healthcare systems by enabling real-time monitoring, remote diagnostics, and data-driven treatment. However, security and privacy remain significant concerns for IoMT adoption due to the sensitive nature of medical data. Therefore, we propose an integrated framework leveraging blockchain and explainable artificial intelligence (XAI) to enable secure, intelligent, and transparent management of IoMT data. First, the traceability and tamper-proof of blockchain are used to realize the secure transaction of IoMT data, transforming the secure transaction of IoMT data into a two-stage Stackelberg game. The dual-chain architecture is used to ensure the security and privacy protection of the transaction. The main-chain manages regular IoMT data transactions, while the side-chain deals with data trading activities aimed at resale. Simultaneously, the perceptual hash technology is used to realize data rights confirmation, which maximally protects the rights and interests of each participant in the transaction. Subsequently, medical time-series data is modeled using bidirectional simple recurrent units to detect anomalies and cyberthreats accurately while overcoming vanishing gradients. Lastly, an adversarial sample generation method based on local interpretable model-agnostic explanations is provided to evaluate, secure, and improve the anomaly detection model, as well as to make it more explainable and resilient to possible adversarial attacks. Simulation results are provided to illustrate the high performance of the integrated secure data management framework leveraging blockchain and XAI, compared with the benchmarks.