Abstract
The advancement of the Internet of Medical Things (IoMT) has transformed healthcare delivery by enabling real-time health monitoring. However, it introduces critical challenges related to latency and, more importantly, the secure handling of sensitive patient data. Traditional cloud-based architectures often struggle with latency and data protection, making them inefficient for real-time healthcare scenarios. To address these challenges, we propose a Hybrid Fog-Edge Computing Architecture tailored for effective real-time health monitoring in IoMT systems. Fog computing enables processing of time-critical data closer to the data source, reducing response time and relieving cloud system overload. Simultaneously, edge computing nodes handle data preprocessing and transmit only valuable information-defined as abnormal or high-risk health signals such as irregular heart rate or oxygen levels-using rule-based filtering, statistical thresholds, and lightweight machine learning models like Decision Trees and One-Class SVMs. This selective transmission optimizes bandwidth without compromising response quality. The architecture integrates robust security measures, including end-to-end encryption and distributed authentication, to counter rising data breaches and unauthorized access in IoMT networks. Real-life case scenarios and simulations are used to validate the model, evaluating latency reduction, data consolidation, and scalability. Results demonstrate that the proposed architecture significantly outperforms cloud-only models, with a 70% latency reduction, 30% improvement in energy efficiency, and 60% bandwidth savings. Additionally, the time required for threat detection was halved, ensuring faster response to security incidents. This framework offers a flexible, secure, and efficient solution ideal for time-sensitive healthcare applications such as remote patient monitoring and emergency response systems.